Long Brian, Spencer-Smith Megan M, Jacobs Rani, Mackay Mark, Leventer Richard, Barnes Chris, Anderson Vicki
University of Melbourne, Melbourne, Australia.
J Child Neurol. 2011 Mar;26(3):279-87. doi: 10.1177/0883073810380049. Epub 2010 Nov 29.
Child stroke is a major cause of death in children, although limited information exists on neurobehavioral functioning of stroke survivors. Executive function (important for goal-directed behavior) is thought to be vulnerable to early insults such as stroke because of its widespread representation in the immature brain. This study investigated the impact of lesion location on executive skills. Twenty-eight children diagnosed with stroke at least 18 months before assessment were recruited. Lesion characteristics were coded from magnetic resonance imaging (MRI) scans. Neurobehavioral assessment focused on cognitive and everyday executive skills. Deficits were found in the context of overall normal intellectual functioning (M = 91.60; SD = 19.40). Generally, insults involving frontal and extra-frontal regions impacted equally on cognitive performance. Everyday deficits were marginally more prominent following frontal insult. Subcortical frontal lesions were associated with impairments in everyday executive skills. Results provide further support for the diffuse representation of executive function in the immature brain.
儿童中风是儿童死亡的主要原因,尽管关于中风幸存者神经行为功能的信息有限。执行功能(对目标导向行为很重要)被认为由于其在未成熟大脑中的广泛分布而容易受到中风等早期损伤的影响。本研究调查了病变位置对执行技能的影响。招募了28名在评估前至少18个月被诊断为中风的儿童。从磁共振成像(MRI)扫描中对病变特征进行编码。神经行为评估集中在认知和日常执行技能上。在总体智力功能正常的情况下发现了缺陷(M = 91.60;SD = 19.40)。一般来说,涉及额叶和额叶外区域的损伤对认知表现的影响相同。额叶损伤后,日常功能缺陷略为明显。皮质下额叶病变与日常执行技能受损有关。研究结果为执行功能在未成熟大脑中的弥散分布提供了进一步的支持。