幼儿创伤性脑损伤后的执行功能:一项初步分析。

Executive functions following traumatic brain injury in young children: a preliminary analysis.

作者信息

Ewing-Cobbs Linda, Prasad Mary R, Landry Susan H, Kramer Larry, DeLeon Rosario

机构信息

Department of Pediatrics, University of Texas Health Science Center, 7000 Fannin, Suite 2401, Houston, TX 77030, USA.

出版信息

Dev Neuropsychol. 2004;26(1):487-512. doi: 10.1207/s15326942dn2601_7.

Abstract

To examine executive processes in young children with traumatic brain injury (TBI), we evaluated performance of 44 children who sustained moderate-to-severe TBI prior to age 6 and to 39 comparison children on delayed response (DR), stationary boxes, and spatial reversal (SR) tasks. The tasks have different requirements for holding mental representations in working memory (WM) over a delay, inhibiting prepotent responses, and shifting response set. Age at the time of testing was divided into 10- to 35- and 36- to 85-month ranges. In relation to the community comparison group, children with moderate-to-severe TBI scored significantly lower on indexes of WM/inhibitory control (IC) on DR and stationary boxes tasks. On the latter task, the Age x Group interaction indicated that performance efficiency was significantly reduced in the older children with TBI relative to the older comparison group; performance was similar in younger children irrespective of injury status. The TBI and comparison groups did not differ on the SR task, suggesting that shifting response set was not significantly altered by TBI. In both the TBI and comparison groups, performance improved with age on the DR and stationary boxes tasks. Age at testing was not significantly related to scores on the SR task. The rate of acquisition of working memory (WM) and IC increases steeply during preschool years, but the abilities involved in shifting response set show less increase across age groups (Espy, Kaufmann, & Glisky, 2001; Luciana & Nelson, 1998). The findings of our study are consistent with the rapid development hypothesis, which predicts that skills in a rapid stage of development will be vulnerable to disruption by brain injury.

摘要

为了研究创伤性脑损伤(TBI)幼儿的执行过程,我们评估了44名6岁前遭受中度至重度TBI的儿童以及39名对照儿童在延迟反应(DR)、静止盒子和空间反转(SR)任务中的表现。这些任务对在延迟期间将心理表象保持在工作记忆(WM)中、抑制优势反应以及改变反应集有不同要求。测试时的年龄分为10至35个月和36至85个月两个范围。与社区对照组相比,中度至重度TBI儿童在DR和静止盒子任务的WM/抑制控制(IC)指标上得分显著更低。在后者任务中,年龄×组间交互作用表明,与年龄较大的对照组相比,年龄较大的TBI儿童的表现效率显著降低;无论损伤状况如何,年龄较小的儿童表现相似。TBI组和对照组在SR任务上没有差异,这表明TBI并没有显著改变反应集的改变。在TBI组和对照组中,DR和静止盒子任务的表现均随年龄增长而提高。测试时的年龄与SR任务的得分没有显著关系。工作记忆(WM)和IC的获得率在学前阶段急剧增加,但不同年龄组中反应集改变所涉及的能力增长较少(埃斯皮、考夫曼和格利斯基,2001年;卢西亚娜和纳尔逊,1998年)。我们的研究结果与快速发展假说一致,该假说预测处于快速发展阶段的技能将容易受到脑损伤的干扰。

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