Impact of General Anesthesia in Childhood on Cognitive Processes

NCT07141797 | Completed DMC

• 1 other identifier: 2023-A00110-83
• Study Type: observational
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the potential long-term cognitive effects of general anesthesia administered before the age of 4. Specifically, it investigates executive functions-including inhibition, working memory, and cognitive flexibility-in children aged 9 to 10 years. A secondary objective assesses visuo-spatial attention. Participants will be divided into two groups: (1) children exposed to a single general anesthesia for functional surgery before age 4, and (2) a control group with no such exposure. Cognitive performance will be assessed through computerized tasks with time constraints, conducted in a school setting. The study is designed to compare these groups prospectively in order to determine whether early exposure to general anesthesia is associated with differences in cognitive functioning at school age.

Conditions

Neurodevelopmental Disorders; Child Behavior Disorders

Keywords

general anesthesia; children; developing brain; executive functions; cognitive assessment

Outcome Measures

Primary Outcomes (1)

• Inhibition/ working memory/ flexibility

  Cold Inhibition: Measured by the Stroop task (color-word interference). Unit: reaction time difference (ms). Hot Inhibition: Measured by the emotional Stroop (faces and emotional words). Unit: reaction time difference (ms). Working Memory: Assessed via forward and backward spatial recall on a grid. Unit: number of correct sequences. Cognitive Flexibility: Measured by a rule-switching task (digit color cues: magnitude vs. parity). Flexibility is the RT difference between switch and control tasks. Unit: reaction time difference (ms).

  Day 1 (single school testing session). The assessment of all judgment criteria is conducted during a 30-minute timed testing session on a computer, with the child present.

Secondary Outcomes (1)

• Visuo-spatial abilities/ measure of general intelligence

  Day 1 (single school testing session). The assessment of all judgment criteria is conducted during a 30-minute timed testing session on a computer, with the child present.

Study Arms (2)

General anesthesia group

Children aged 9 or 10 at the time of the study, who were exposed to a single general anesthesia for a functional surgery during childhood before the age of 4.

Other: Executive functions assessment

Control group

Children aged 9 or 10 at the time of the study, who were not exposed to general anesthesia for surgery during childhood.

Other: Executive functions assessment

Interventions

Executive functions assessment OTHER

Inhibition: Emotional (hot) and logical (cold) inhibition using Emotional and Classic Stroop tests. Participants identify the color of words or emotion in photos while inhibiting automatic responses. Inhibition scores are based on the difference in response times between congruent and interference conditions. Working Memory: Participants recall a sequence of points on a grid, first in the original order, then in reverse. The working memory score is the difference between the two tasks. Cognitive Flexibility: A task requiring alternation between identifying numbers as greater/less than 5 or even/odd based on color cues. Flexibility is scored by comparing response times for alternating and non-alternating tasks. Visuospatial abilities are assessed with a global-local task. Raven's Progressive Matrices will assess general intelligence, and socio-economic data will be collected.

Control group; General anesthesia group

Eligibility Criteria

• Age: 8 Years - 10 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Children aged 9-10 years, attending school, who have either been exposed or not exposed to general anesthesia for a functional surgery before the age of 4.

You may qualify if:

• Children aged 9-10 years Mainstream class (non-specialized) Requirement for information on the right to object Requirement for affiliation with social security French-speaking

You may not qualify if:

• Criteria for "Parents" Parental refusal Twins Exposure to general anesthesia during pregnancy, including cesarean section under general anesthesia
• Pregnancy-related pathology:
• Pregnancy-induced hypertension
• Preeclampsia
• Gestational diabetes
• Threat of preterm labor
• Depressive syndrome
• Chronic treatment during pregnancy:
• Pregnancy-induced hypertension: antihypertensive treatment (beta-blockers, calcium channel blockers)
• Preeclampsia: antihypertensive treatment (beta-blockers, calcium channel blockers), magnesium sulfate
• Gestational diabetes: dietary regimen, insulin
• Threat of preterm labor: prenatal corticosteroid therapy, magnesium sulfate
• Depressive syndrome: antidepressant psychotropic treatment Smoking during pregnancy, alcohol consumption during pregnancy, drug use during pregnancy Criteria for "Children" Child refusal to participate in the study Premature birth (i.e., before 37 weeks of gestation) Evolving or chronic psychiatric pathology, whether or not requiring chronic treatment Evolving or chronic neurological or neuromuscular pathology Genetic pathology Any chronic pathology requiring specialized follow-up and/or treatment (doctor, psychologist, speech therapist) Specialized neuro-pediatric or pediatric psychiatric follow-up, or follow-up with a psychologist or speech therapist during childhood Neuro-visual disorders (excluding normal vision with correction) Hearing disorders, whether or not using hearing aids Chronic otorhinolaryngological pathology, including sleep apnea syndrome, with or without apparatus Developmental disorders: ADHD, autism, or other, whether or not requiring chronic treatment Pediatric intensive care hospitalization Conventional hospitalization for more than 1 week during childhood Child who underwent multiple general anesthesias before the age of 4

Sponsors & Collaborators

• University Hospital, Caen: lead

Study Sites (1)

University Hospital Caen Normandie

Caen, Normandy, 14000, France

Location

MeSH Terms

Conditions

Neurodevelopmental Disorders; Child Behavior Disorders

Condition Hierarchy (Ancestors)

Mental Disorders

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 2, 2025
• First Posted: August 26, 2025
• Study Start: March 1, 2025
• Primary Completion: March 1, 2025
• Study Completion: November 1, 2025
• Last Updated: January 14, 2026

Record last verified: 2025-12

Locations

FR (1)