Sigurdardottir Solveig, Eiriksdottir Audur, Gunnarsdottir Eva, Meintema Marrit, Arnadottir Unnur, Vik Torstein
State Diagnostic and Counselling Centre, Kopavogur, Iceland.
Dev Med Child Neurol. 2008 May;50(5):357-62. doi: 10.1111/j.1469-8749.2008.02046.x. Epub 2008 Mar 18.
We describe the cognitive profile in a complete national cohort of children with cerebral palsy (CP). One hundred and twenty-seven Icelandic children (67 females, 60 males) with CP, born between 1985 and 2000 and assessed between the ages of 4 and 6 years 6 months (mean age 5y 5mo, SD 6mo), were included in the study. IQ was measured using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and developmental quotient (DQ) was obtained using various developmental scales. Physiological classification of CP in the children was: spasticity, n=104 (82%); dyskinesia, n=14 (11%); ataxia, n=six (4.7%), and unclassified CP, n=3 (2.3%). Spastic diplegia was the most prevalent subtype (35%) followed by hemiplegia and quadriplegia. Forty-five per cent of the group were at Level I of the Gross Motor Function Classification System, 32% were at Levels II and III, and 23% were at Levels IV and V. Sixty per cent of the children had an IQ or DQ >70. Median scores on the WPPSI were Full-scale IQ 84, Verbal IQ (VIQ) 92, and Performance IQ (PIQ) 77. Children with spastic diplegia and quadriplegia had a significantly lower PIQ than VIQ. Of the children who failed to complete the WPPSI, 20% had DQ >85. Thus, cognitive skills can be masked by limitations of movement and motor control in children with CP.
我们描述了一个完整的全国性脑瘫（CP）儿童队列的认知概况。该研究纳入了127名冰岛CP儿童（67名女性，60名男性），他们出生于1985年至2000年之间，在4岁至6岁6个月（平均年龄5岁5个月，标准差6个月）接受评估。使用韦氏学前和小学智力量表（WPPSI）测量智商，并使用各种发育量表获得发育商（DQ）。这些儿童CP的生理分类为：痉挛型，n = 104（82%）；运动障碍型，n = 14（11%）；共济失调型，n = 6（4.7%），未分类的CP，n = 3（2.3%）。痉挛性双侧瘫是最常见的亚型（35%），其次是偏瘫和四肢瘫。该组中45%处于粗大运动功能分类系统的I级，32%处于II级和III级，23%处于IV级和V级。60%的儿童智商或发育商>70。WPPSI的中位数分数为全量表智商84、言语智商（VIQ）92和操作智商（PIQ）77。痉挛性双侧瘫和四肢瘫的儿童PIQ显著低于VIQ。在未完成WPPSI的儿童中，20%的发育商>85。因此，CP儿童的运动和运动控制限制可能会掩盖其认知技能。
