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痉挛型脑瘫儿童的注意力和执行功能障碍。

Attentional and executive impairments in children with spastic cerebral palsy.

机构信息

Department of Psychology, University of Copenhagen, Copenhagen, Denmark.

出版信息

Dev Med Child Neurol. 2010 Feb;52(2):e42-7. doi: 10.1111/j.1469-8749.2009.03533.x. Epub 2009 Nov 30.

Abstract

AIM

Children with cerebral palsy (CP) are reported to have learning and social problems. The aim of the present study was to examine whether children with CP have impairments in attention or executive function.

METHOD

We examined attention and executive function with standardized neuropsychological measures in a group of children with unilateral (n=15) or bilateral (n=18) spastic CP (14 females, 19 males, mean age 11y 4mo, SD 1y 1mo, range 9y 1mo-13y 7mo; Gross Motor Function Classification System level I n=22, II n=3, III n=6, and IV n=2). Performance was compared with test norms.

RESULTS

Verbal cognitive functioning fell within the normal range, whereas sustained (p=0.001) and divided attention (p<0.001) were found to be impaired. Greater impairment was observed in executive function in general (p<0.001) and in inhibition (p=0.038) and shifting (p<0.001) in particular. No significant difference was found between types of CP (unilateral and bilateral). Performance of all timed tasks was slower than the test norm (p<0.00).

INTERPRETATION

The finding of slower performances across tasks may indicate a general impairment in efficiency of information processing in relation to white-matter lesions. Impairments in attention and executive functions are present in children with CP and may help to explain why these children have increased social and learning problems.

摘要

目的

据报道,脑瘫(CP)患儿存在学习和社交问题。本研究旨在探讨 CP 患儿是否存在注意力或执行功能障碍。

方法

我们使用标准化神经心理学测试评估了一组单侧(n=15)或双侧(n=18)痉挛型 CP 患儿(14 名女性,19 名男性,平均年龄 11 岁 4 个月,标准差 1 岁 1 个月,范围 9 岁 1 个月至 13 岁 7 个月;粗大运动功能分级系统 I 级 n=22,II 级 n=3,III 级 n=6,IV 级 n=2)的注意力和执行功能。将表现与测试标准进行比较。

结果

言语认知功能处于正常范围内,而持续性(p=0.001)和分散注意力(p<0.001)则存在障碍。一般执行功能(p<0.001)和抑制(p=0.038)和转换(p<0.001)的损伤更为明显。两种 CP(单侧和双侧)类型之间无显著差异。所有定时任务的表现均慢于测试标准(p<0.00)。

解释

各项任务表现较慢可能表明与白质病变相关的信息处理效率普遍受损。CP 患儿存在注意力和执行功能障碍,这可能有助于解释为什么这些患儿存在更多的社交和学习问题。

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