Pueyo Roser, Junqué Carme, Vendrell Pere, Narberhaus Ana, Segarra Dolors
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
Pediatr Neurol. 2009 Jan;40(1):19-26. doi: 10.1016/j.pediatrneurol.2008.08.003.
The lower-than-average cognitive performance of individuals with bilateral cerebral palsy found in previous studies does not always refer to an abnormal performance or clinically significant impairment. We aimed to establish the percentage of persons with bilateral cerebral palsy who present neuropsychologic impairment, and its relationship to perinatal data and motor signs. Forty children, adolescents, and adults (age range, 6-38 years; 15 females and 25 males) with bilateral cerebral palsy were neuropsychologically assessed. Vocabulary was impaired in 85% of participants, language comprehension in 13-48%, visuoperceptual abilities in 60%, visuospatial abilities in 90%, short-term memory in 21-58%, declarative memory in 47-67%, and praxis comprehension in 20%, with executive deficits in 58-74%. Perinatal data (intrauterine growth and birth weight) contributed to explaining memory impairment. Among cerebral palsy subtypes (spastic, mixed, and dyskinetic), forms of impairment differed only in short-term verbal memory. No persons with dyskinetic cerebral palsy experienced impairment in immediate memory or working visual memory. We conclude that visuospatial deficit is the most frequent impairment in people with bilateral cerebral palsy. Moreover, short-term memory impairment seems sensitive to perinatal complications, and differs among bilateral cerebral palsy subtypes.
先前研究发现，双侧脑瘫患者的认知表现低于平均水平，但这并不总是意味着异常表现或具有临床意义的损害。我们旨在确定存在神经心理损害的双侧脑瘫患者的比例，以及其与围产期数据和运动体征的关系。对40名双侧脑瘫儿童、青少年和成人（年龄范围6 - 38岁；15名女性和25名男性）进行了神经心理学评估。85%的参与者存在词汇受损，13% - 48%存在语言理解受损，60%存在视觉感知能力受损，90%存在视觉空间能力受损，21% - 58%存在短期记忆受损，47% - 67%存在陈述性记忆受损，20%存在实践理解受损，58% - 74%存在执行功能缺陷。围产期数据（宫内生长和出生体重）有助于解释记忆损害。在脑瘫亚型（痉挛型、混合型和运动障碍型）中，损害形式仅在短期言语记忆方面有所不同。运动障碍型脑瘫患者在即时记忆或工作视觉记忆方面未出现损害。我们得出结论，视觉空间缺陷是双侧脑瘫患者最常见的损害。此外，短期记忆损害似乎对围产期并发症敏感，且在双侧脑瘫亚型之间存在差异。
