Phonological memory and vocabulary learning in children with focal lesions

Eleven children with early focal lesions were compared with 70 age-matched controls to assess their performance in repeating non-words, in learning new words, and in immediate serial recall, a triad of abilities that are believed to share a dependence on serial ordering mechanisms (e.g.,; ). Results for the experimental group were also compared with other assessments previously reported for the same children by. The children with brain injury showed substantial impairment relative to controls in the experimental tasks, in contrast with relatively unimpaired performance on measures of vocabulary and non-verbal intelligence. The relationships between word learning, non-word repetition, and immediate serial recall were similar to those observed in several other populations. These results support previous reports that there are persistent processing impairments following early brain injury, despite developmental plasticity. They also suggest that word learning, non-word repetition, and immediate serial recall may be relatively demanding tasks, and that their relationship is a fundamental aspect of the cognitive system.     

Neuroimaging the serial position curve. A test of single-store versus dual-store models

Neuroimaging data could help clarify the long-standing dispute between dual-store and single-store models of the serial position curve. Dual-store models assume that retrieval from late positions is dependent on short-term memory (STM), whereas retrieval from early positions is dependent on long-term memory (LTM). Single-store models, however, assume that retrieval processes for early and late items are similar, but that early items are more difficult to discriminate than late items. The present study used functional magnetic resonance imaging to examine this question. Ten young adults were scanned while they recognized items from early or late serial positions. Recognition of early items uniquely activated brain areas traditionally associated with LTM, namely, regions within the hippocampal memory system. None of these areas was activated for retrieval of late items. These results indicate differential use of LTM retrieval processes, and therefore support dual-store models over single-store models.     

Narrative Discourse in Children with Early Focal Brain Injury

Children with early brain damage, unlike adult stroke victims, often go on to develop nearly normal language. However, the route and extent of their linguistic development are still unclear, as is the relationship between lesion site and patterns of delay and recovery. Here we address these questions by examining narratives from children with early brain damage. Thirty children (ages 3;7–10;10) with pre- or perinatal unilateral focal brain damage and their matched controls participated in a storytelling task. Analyses focused on linguistic proficiency and narrative competence. Overall, children with brain damage scored significantly lower than their age-matched controls on both linguistic (morphological and syntactic) indices and those targeting broader narrative qualities. Rather than indicating that children with brain damage fully catch up, these data suggest that deficits in linguistic abilities reassert themselves as children face new linguistic challenges. Interestingly, after age 5, site of lesion does not appear to be a significant factor and the delays we have witnessed do not map onto the lesion profiles observed in adults with analogous brain injuries.     

The role of timing deviations and target position uncertainty on temporal attending in a serial auditory pitch discrimination task

Listeners were presented with sequences of tones that ascended in semitone intervals. On each trial a single target tone in the sequence was displaced in pitch, and listeners were required to indicate whether the target tone was higher or lower than its normal pitch. Task constraints, specifically target serial position uncertainty and the probabilistic relationship between time deviations and target tones, were varied in order to determine the impact of task constraints on temporal attending strategy. When listeners had no advance knowledge of the serial position of the target, and early and late targets provided information regarding target serial position, performance was better for early and late target trials than for on-time target trials (Experiment 1). When listeners had no advance knowledge of the serial position of the target, and early and late temporal deviations provided no information regarding target serial position, performance for late target trials was superior to that for early and on-time target trials (Experiment 2). Finally, when target serial position uncertainty was eliminated, performance was equivalent across all three levels of target timing (early, on time, late). The results indicate that performance profiles based on stimulus timing properties are affected by various task constraints as well as by stimulus properties.     

Hemispatial neglect and serial order in verbal working memory

Working memory refers to our ability to actively maintain and process a limited amount of information during a brief period of time. Often, not only the information itself but also its serial order is crucial for good task performance. It was recently proposed that serial order is grounded in spatial cognition. Here, we compared performance of a group of right hemisphere-damaged patients with hemispatial neglect to healthy controls in verbal working memory tasks. Participants memorized sequences of consonants at span level and had to judge whether a target consonant belonged to the memorized sequence (item task) or whether a pair of consonants were presented in the same order as in the memorized sequence (order task). In line with this idea that serial order is grounded in spatial cognition, we found that neglect patients made significantly more errors in the order task than in the item task compared to healthy controls. Furthermore, this deficit seemed functionally related to neglect severity and was more frequently observed following right posterior brain damage. Interestingly, this specific impairment for serial order in verbal working memory was not lateralized. We advance the hypotheses of a potential contribution to the deficit of serial order in neglect patients of either or both (1) reduced spatial working memory capacity that enables to keep track of the spatial codes that provide memorized items with a positional context, (2) a spatial compression of these codes in the intact representational space.     

Spatial analysis after perinatal stroke: patterns of neglect and exploration in extra-personal space

This study was conducted to determine whether school-aged children who had experienced a perinatal stroke demonstrate evidence of persistent spatial neglect, and if such neglect was specific to the visual domain or was more generalized. Two studies were carried out. In the first, 38 children with either left hemisphere (LH) or right hemisphere (RH) damage and 50 age-matched controls were given visual cancellation tasks varying in two factors: target stimuli and stimulus array. In the second study, tactile neglect was evaluated in 41 children with LH or RH damage and 72 age-matched controls using a blindfolded manual exploration task. On the visual cancellation task, LH subjects omitted more target stimuli on the right, but also on the left, compared with controls. Children with RH lesions also produced a larger number of omissions on both the left and right sides than controls, but with poorer performance on the left. On the manual exploration task, LH children required significantly longer times to locate the target on both sides of the board than did controls. RH children had significantly prolonged search times on the left side, but not on the right, compared with controls. In both tasks, LH subjects employed unsystematic search strategies more often than both control and RH children. The search strategy of RH children also tended to be erratic when compared to controls, but only in the random arrays of the visual cancellation tasks; structure of the target stimuli improved their organization. These results demonstrate that children with early LH brain damage display bilateral difficulties in visual and tactile modalities; a pattern that is in contrast to that seen in adults with LH damage. This may result from disorganized search strategies or other subtle spatial or attentional deficits. Results of performance of RH children suggests the presence of contralateral neglect in both the visual and tactile modalities; a finding that is similar to the neglect in adult stroke patients with RH lesions. The fact that deficits in spatial attention and organizational strategies are present after very early focal damage to either the LH or the RH broadens our understanding of the differences in functional lateralization between the immature and mature brain. These results also add to evidence for limitations to plasticity in the developing brain. Our findings may have therapeutic and rehabilitative implications for the management of children with early focal brain lesions.     

Significance of latency and amplitude values of the visual evoked potential in children with early childhood brain damage

The latency and amplitude data of optically evoked potentials (unipolar from the vertex) were measured during the 50-200 ms interval in a group of normal boys (n = 26) and a group of boys with brain damage sustained during early childhood (n = 38). The latency periods were sometimes significantly longer and the amplitudes larger (flash stimulus) and smaller (pattern stimulus) respectively in the brain damaged than in the normal subjects. In view of the results of clinical, neurological and psychological examinations, these phenomena must be attributed to delayed maturation of the central nervous functional system.     

A reinterpretation of hemispherectomy data without functional plasticity of the brain: I. Intellectual function

A comprehensive reanalysis of post-hemispherectomy IQ, language, and other intellectual findings in patients whose brain damage occurred in infancy, childhood, or adulthood reveals no recovery advantages attributable to superior interhemispheric transfer of properties in the immature brain. Instead, recovery heterogeneity in each age group is considerable, while both individual differences within the groups and minor intergroup differences are parsimoniously explained by etiological, recovery-period, and experiential variables. The findings fail to support the presuppositions of the plasticity model: that the immature brain lacks functional asymmetry, that language acquisition must occur early in life, and that recovery from brain damage is facilitated by the brain's functional equivocality during an early, critical period.     

"Frog, where are you?" Narratives in children with specific language impairment, early focal brain injury, and Williams syndrome

In this cross-population study, we use narratives as a context to investigate language development in children from 4 to 12 years of age from three experimental groups: children with early unilateral focal brain damage (FL; N=52); children with specific language impairment (SLI; N=44); children with Williams syndrome (WMS; N=36), and typically developing controls. We compare the developmental trajectories of these groups in the following domains: morphological errors, use of complex syntax, complexity of narrative structure, and types and frequency of evaluative devices. For the children with early unilateral brain damage, there is initial delay. However, by age 10, they are generally within the normal range of performance for all narrative measures. Interestingly, there are few, if any, side specific differences. Children with SLI, who have no frank neurological damage and show no cognitive impairment demonstrate significantly more delay on all morphosyntactic measures than the FL group. Quantitatively, on morphosyntactic measures, the SLI group clusters with those children with WMS who are moderately retarded. Together these data help us to understand the extent and nature of brain plasticity for language development and those aspects of language and discourse that are dissociable.     

Grammaticality sensitivity in children with early focal brain injury and children with specific language impairment

Grammaticality judgments and processing times associated with violation detection were examined in typically developing children, children with focal brain lesions (FL) acquired early in life, and children with specific language impairment (SLI). Grammatical sensitivity in the FL group, while below typically developing children, was above levels seen in children with SLI. Age effects were noted with developmental changes in sensitivity extending into adolescence. Developmental delays in grammatical processing were particularly pronounced for children with SLI, who showed sensitivity levels below those of younger typically developing children. Sensitivity to agreement violations was also protracted in the SLI group providing further evidence of the vulnerability of morphology, a pattern not unlike that seen in adult aphasics. Findings for the FL group provide compelling evidence of neural and behavioral plasticity in children with early unilateral brain injury. Moreover, results from these children underscore how very different compensatory organization may be compared to profiles seen in adult aphasics who have comparable lesions. In contrast, although it was expected that the SLI children would perform below the typically developing children, the disadvantage seen with respect to the FL group suggests that the underlying pathology responsible for SLI may be more pervasive and less plastic than the focal pathology of children with early brain damage.     

Cerebral palsy in very preterm infants: new epidemiological insights

The focus of this review is on new insights from recent epidemiological research on cerebral palsy in preterm infants. These include: 1) a better understanding of issues related to diagnosis and classification; 2) new information about the brain abnormalities underlying cerebral palsy in preterm infants; and 3) a better understanding of biological mechanisms that may underlie previously described epidemiological associations. Ongoing efforts to improve the diagnosis and classification of cerebral palsy have been enhanced by findings from serial examinations of cohorts of very preterm infants. Cranial ultrasonography through the anterior fontanelle of very preterm infants has provided information about grossly evident brain damage, found in about one-half of preterm infants who develop cerebral palsy. Insights into the pathophysiologic basis for certain epidemiologic associations have come from studies of experimental brain damage in animals and clinical studies of neurologic disorders in adults. Much of the current epidemiological research into the causes of cerebral palsy in preterm infants has focused on two potential mechanisms of brain damage. One mechanism involves insufficient cerebral perfusion; the other, cytokine-mediated damage, potentially triggered by events such as maternal infection (e.g., intrauterine or periodontal infection), neonatal infection (e.g., sepsis and necrotizing enterocolitis), and neonatal oxygen- or ventilator-induced lung injury. In addition to the preterm infant's increased exposure to such damaging factors, the high frequency of cerebral palsy in these infants might be due, in part, to insufficient levels of developmentally regulated protective substances, such as thyroid hormone and glucocorticoids. Models of causation currently are being investigated using recently developed methods for quantifying, with small quantities of blood, biomolecules that are suspected to either promote or protect against brain damage in the neonate. Clinical investigations now under way can be expected to identify strategies to be tested in clinical trials that could lower the risk of cerebral palsy in very preterm infants.     

Which is more critical in identification of random figures,endpoints or closures?1

The present study intended to examine the criticality of the presence of endpoints and its complementary state, the presence of closures, in early figural identification. Three experiments used a same/different judgment task for simultaneously presented pairs of random figures. Rigorous control over the selections of stimulus figures containing closures and endpoints was ensured. Latencies predicted by six explanations of figural identification (i.e. parallel and the presence of endpoint detection; parallel and closure detection; serial, exhaustive and endpoint detection; serial, exhaustive and closure detection; serial, self‐terminating and endpoint detection; and serial, self‐terminating and closure detection) were evaluated by the obtained patterns of latencies. The experiments persistently indicated that serial, self‐terminating feature detections were executed as the means of the identification. Experiments 1 and 2 showed that closures were detected faster than endpoints. Experiment 3 further suggested that multiple closures were detected faster than a single closure.     

Perceptual asymmetry for chimeric stimuli in children with early unilateral brain damage

The present study used a chimeric stimuli task to assess the magnitude of the left-hemispace bias in children with congenital unilateral brain damage (n = 46) as compared to typically developing matched controls (n = 46). As would be expected, controls exhibited a significant left-hemispace bias. In the presence of left hemisphere (LH) damage, the left-hemispace preference was found to be present, but attenuated, whereas right hemisphere (RH) damage resulted in a less lateralized process. Examination of lesion severity revealed that large lesions in the RH were associated with a reversal of the typical left-hemispace bias, while small lesions resulted in a left bias approximating that of controls. In contrast, the left-hemispace preference in children with LH damage was similar across lesion size. We conclude that damage to either hemisphere early in brain development may alter hemispheric preference for processing of nonverbal stimuli, and that at least in the case of RH damage, alteration of the normal perceptual asymmetry may depend on the interaction between lesion side and severity.     

Early language development after peri-natal stroke

Early unilateral brain damage has different implications for language development than does similar damage in adults, given the plasticity of the developing brain. The goal of this study was to examine early markers of language and gesture at 12 and 24 months in children who had peri-natal right hemisphere (RH) or left hemisphere (LH) stroke (n = 71), compared with typically developing controls (n = 126). Parents completed the MacArthur-Bates Communicative Development Inventory (CDI): Words & Gestures (12 month data point), or the CDI: Words & Sentences (24 month data point). Statistical analyses were performed on percentile scores using analysis of variance techniques. At 12 months, there were no differences among groups for Words Understood, Phrases Understood or Words Produced. At 24 months, both lesion groups scored significantly lower than controls on Word Production, Irregular Words, and Mean Length of Sentences, but lesion groups did not differ from each other. In a longitudinal subset of participants, expressive vocabulary failed to progress as expected from 12 to 24 months in the stroke group, with no differences based on lesion side. Gesture and word production were dissociated in the left hemisphere subjects. Findings suggest that early language development after peri-natal stroke takes a different course from that of typical language development, perhaps reflecting brain reorganization secondary to plasticity in the developing brain.     

A Critical Review of the Clinical Effects of Therapeutic Irradiation Damage to the Brain: The Roots of Controversy

We critically examined the damaging affects of therapeutic irradiation by comparing results from cross-disciplinary studies of early- and late-delayed radiotherapy effects. Focus is attained by concentrating on clinical treatment issues (volume of brain, dose, timing of effects, age, modality types, and stereotactic treatment techniques), rather than on methodological means or problems, which is necessary to understand the mechanisms and characteristics of radiotherapy-induced behavioral dysfunction including cognition. We make observations and hypotheses about the actual risks from radiotherapy that could be informative in the treatment decision process, and which may lessen the concerns of some patients and their families about the risks they take when receiving radiation. Conditions that predispose to radiation injury are reviewed: (1) higher doses even to part of the brain versus lower doses to the whole brain, (2) combined treatment modalities, (3) malignancy itself, (4) radiation early during postnatal brain development, and (5) late-delayed effects (more than 3 years posttreatment). Current neurocognitive frameworks for understanding cognitive change over time in children and adults are summarized, along with the literature on effects of brain tumors and treatment on depression. No studies have as yet identified candidate brain regions that are more sensitive to radiotherapy. Two studies have provided early, preliminary evidence for a specific vulnerability of visual attention/memory to the early stage of late radiation damage. Furthermore, radiation effects appear severe only in a minority of patients. Risk is related to direct and indirect effects of cancer type, concurrent clinical factors, and premorbid risk factors.     

Differential effects of unilateral lesions on language production in children and adults.

We present the first direct comparison of language production in brain-injured children and adults, using age-corrected z scores for multiple lexical and grammatical measures. Spontaneous speech samples were elicited in a structured biographical interview from 38 children (5-8 years of age), 24 with congenital left-hemisphere damage (LHD) and 14 with congenital right-hemisphere damage (RHD), compared with 38 age- and gender-matched controls, 21 adults with unilateral injuries (14 LHD and 7 RHD), and 12 adult controls. Adults with LHD showed severe and contrasting profiles of impairment across all measures (including classic differences between fluent and nonfluent aphasia). Adults with RHD (and three nonaphasic adults with LHD) showed fluent but disinhibited and sometimes empty speech. None of these qualitative or quantitative deviations were observed in children with unilateral brain injury, who were in the normal range for their age on all measures. There were no significant differences between children with LHD and RHD on any measure. When LHD children were compared directly with LHD adults using age-corrected z scores, the children scored far better than their adult counterparts on structural measures. These results provide the first systematic confirmation of differential free-speech outcomes in children and adults and offer strong evidence for neural and behavioral plasticity following early brain damage.     

Writing,Reading, and Listening Differentially Overload Working Memory Performance Across the Serial Position Curve

Previous research has assumed that writing is a cognitively complex task, but has not determined if writing overloads Working Memory more than reading and listening. To investigate this, participants completed three recall tasks. These were reading lists of words before recalling them, hearing lists of words before recalling them, and hearing lists of words and writing them as they heard them, then recalling them. The experiment involved serial recall of lists of 6 words. The hypothesis that fewer words would be recalled overall when writing was supported. Post-hoc analysis revealed the same pattern of results at individual serial positions (1 to 3). However, there was no difference between the three conditions at serial position 4, or between listening and writing at positions 5 and 6 which were both greater than recall in the reading condition. This suggests writing overloads working memory more than reading and listening, particularly in the early serial positions. The results show that writing interferes with working memory processes and so is not recommended when the goal is to immediately recall information.     

Language outcome after perinatal stroke: does side matter?

The goal of this study was to examine structured language skills in children with perinatal strokes. Participants were 28 school-age children with early focal brain lesions (17 with left hemisphere [LH] damage, 11 with right hemisphere [RH] damage), and 57 controls. A standardized test of language (Clinical Evaluation of Language Fundamentals-Revised) was administered. Receptive, Expressive, and Total Language scores, as well as subtest scores, were analyzed. Control participants scored within the normal range, whereas the LH and RH groups scored significantly more poorly than did controls. There were no differences between the LH and RH groups on any of the language scores, and all scores were below the 14th percentile. Within the lesion group as a whole, scores were not related to lesion laterality, site, or severity. Results also were not accounted for by socioeconomic status or IQ. However, children who experienced seizures demonstrated significantly poorer performance than did children who did not experience seizures. Damage to either the LH or RH early in development adversely affects later language abilities, particularly on tasks with structured and complex linguistic demands. Although lesion side has little effect, the presence or absence of seizures is a major contributor to language outcome.     

Language Outcome After Perinatal Stroke: Does Side Matter?

The goal of this study was to examine structured language skills in children with perinatal strokes. Participants were 28 school-age children with early focal brain lesions (17 with left hemisphere [LH] damage, 11 with right hemisphere [RH] damage), and 57 controls. A standardized test of language (Clinical Evaluation of Language Fundamentals–Revised) was administered. Receptive, Expressive, and Total Language scores, as well as subtest scores, were analyzed. Control participants scored within the normal range, whereas the LH and RH groups scored significantly more poorly than did controls. There were no differences between the LH and RH groups on any of the language scores, and all scores were below the 14th percentile. Within the lesion group as a whole, scores were not related to lesion laterality, site, or severity. Results also were not accounted for by socioeconomic status or IQ. However, children who experienced seizures demonstrated significantly poorer performance than did children who did not experience seizures. Damage to either the LH or RH early in development adversely affects later language abilities, particularly on tasks with structured and complex linguistic demands. Although lesion side has little effect, the presence or absence of seizures is a major contributor to language outcome.     

Flicker fusion frequency and organic syndrome in alcoholics

Flicker fusion frequencies of 48 healthy controls and of 35 alcoholics were measured to detect possible associations between flicker fusion and signs of nonspecific brain damage, the aim of the study. FFF was statistically significantly lower in patients addicted to alcohol than in healthy subjects. Lower flicker fusion frequencies were associated with the severeness of organic psychosis as rated psychopathologically. The hypothesis that addiction to alcohol is a sign of diffuse, nonspecific, organic brain damage was discussed.