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Regula Everts Julia Pavlovic Franz Kaufmann Birgit Uhlenberg Ulrich Seidel Krassen Nedeltchev Walter Perrig Maja Steinlin 《Child neuropsychology》2008,14(4):323-338
Rationale: To provide a better understanding of cognitive functioning, motor outcome, behavior and quality of life after childhood stroke and to study the relationship between variables expected to influence rehabilitation and outcome (age at stroke, time elapsed since stroke, lateralization, location and size of lesion). Methods: Children who suffered from stroke between birth and their eighteenth year of life underwent an assessment consisting of cognitive tests (WISC-III, WAIS-R, K-ABC, TAP, Rey-Figure, German Version of the CVLT) and questionnaires (Conner's Scales, KIDSCREEN). Results: Twenty-one patients after stroke in childhood (15 males, mean 11;11 years, SD 4;3, range 6;10-21;2) participated in the study. Mean Intelligence Quotients (IQ) were situated within the normal range (mean Full Scale IQ 96.5, range IQ 79-129). However, significantly more patients showed deficits in various cognitive domains than expected from a healthy population (Performance IQ p = .000; Digit Span p = .000, Arithmetic's p = .007, Divided Attention p = .028, Alertness p = .002). Verbal IQ was significantly better than Performance IQ in 13 of 17 patients, independent of the hemispheric side of lesion. Symptoms of ADHD occurred more often in the patients' sample than in a healthy population (learning difficulties/inattention p = .000; impulsivity/hyperactivity p = .006; psychosomatics p = .006). Certain aspects of quality of life were reduced (autonomy p = .003; parents' relation p = .003; social acceptance p = .037). Three patients had a right-sided hemiparesis, mean values of motor functions of the other patients were slightly impaired (sequential finger movements p = .000, hand alternation p = .001, foot tapping p = .043). In patients without hemiparesis, there was no relation between the lateralization of lesion and motor outcome. Lesion that occurred in the midst of childhood (5-10 years) led to better cognitive outcome than lesion in the very early (0-5 years) or late childhood (10-18 years). Other variables such as presence of seizure, elapsed time since stroke and size of lesion had a small to no impact on prognosis. Conclusion: Moderate cognitive and motor deficits, behavioral problems, and impairment in some aspects of quality of life frequently remain after stroke in childhood. Visuospatial functions are more often reduced than verbal functions, independent of the hemispheric side of lesion. This indicates a functional superiority of verbal skills compared to visuospatial skills in the process of recovery after brain injury. Compared to the cognitive outcome following stroke in adults, cognitive sequelae after childhood stroke do indicate neither the lateralization nor the location of the lesion focus. Age at stroke seems to be the only determining factor influencing cognitive outcome. 相似文献
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Eva Michel Marianne Roethlisberger Regula Neuenschwander Claudia M. Roebers 《Child neuropsychology》2013,19(2):151-172
The current study presents a 1-year follow-up investigation of the development of executive functions (i.e., inhibition, updating, and shifting) in children with motor coordination impairments. Cognitive and motor coordination skills of children (N = 94) aged between 5 and 7 years with and without motor coordination impairments were compared. A second focus of the study was on pre-academic skills. The results indicate marked stability of motor coordination impairments and persistent executive functioning deficits in motor-impaired children. Inhibition and shifting performance was consistently lower, compared to the children without motor coordination impairments. Moreover, children with motor coordination impairments showed lower pre-academic skills, facing a substantial disadvantage at the beginning of formal schooling. The combined cognitive and motor problems may be the result of an underlying inhibition deficit or a general automation deficit. Implications for intervention are discussed. 相似文献