Department of Medical Psychology, Radboud University Nijmegen Medical Centre, The Netherlands.
Eur J Paediatr Neurol. 2010 Jan;14(1):86-92. doi: 10.1016/j.ejpn.2009.01.003. Epub 2009 Feb 23.
Spina bifida is a complex neuroembryological disorder resulting from incomplete closure of the posterior neural tube. Morbidity in the different fields of motor and cognitive neurodevelopment is variable in nature and severity, and often hard to predict.
The current study investigates the relationship between cognitive functioning, fine motor performance and motor quality in children with spina bifida myelomeningocele (SBM) and SB-only, taking into consideration the cerebral malformations.
Forty-one children were included (22 girls and 19 boys aged between 6 and 14 years, mean age 10;0 years) in the study. A comprehensive assessment was conducted of cognitive functioning and motor profile, including fine motor and visual-motor functioning, and motor quality. The performance outcomes were analyzed for the total group of children and separately for the nonretarded children (FSIQ> or =70, N=30) to eliminate the influence of global intellectual impairment.
Although the children with spina bifida showed increased incidence of cognitive and fine motor impairment, and impaired motor quality, after exclusion of the overall retarded children no associations were found between cognitive functioning and motor profile. In the comparison of SBM to SB-only specific differences were found for performance IQ, visual-motor functioning and motor quality, but not fine motor functioning.
Our findings underscore the role of cerebral malformation in spina bifida and its consequences for neuropsychological functioning. The complicated developmental interactions found strengthen the need for an individualized management of children with SB.
脊柱裂是一种复杂的神经胚胎发育障碍，是由于后神经管不完全闭合引起的。运动和认知神经发育的不同领域的发病率在性质和严重程度上是不同的，而且往往难以预测。
本研究调查了伴有和不伴有脊髓脊膜膨出的脊髓裂（SBM）患儿认知功能、精细运动表现和运动质量之间的关系，同时考虑了脑畸形的因素。
共有 41 名儿童（22 名女孩和 19 名男孩，年龄在 6 至 14 岁之间，平均年龄为 10.0 岁）纳入本研究。对认知功能和运动状况进行了全面评估，包括精细运动和视动功能以及运动质量。对所有儿童的表现结果进行了分析，并对非智力迟钝儿童（FSIQ≥70，N=30）进行了单独分析，以消除整体智力障碍的影响。
尽管脊柱裂患儿的认知和精细运动障碍以及运动质量受损的发生率增加，但在排除整体智力迟钝的儿童后，认知功能与运动状况之间没有发现相关性。在 SBM 与 SB-only 的比较中，发现了表现智商、视动功能和运动质量的差异，但精细运动功能没有差异。
我们的研究结果强调了脑畸形在脊柱裂中的作用及其对神经心理学功能的影响。发现的复杂的发育相互作用强调了对 SB 患儿进行个体化管理的必要性。
