Discipline of Paediatrics and Child Health, School of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Australia.
BMJ Open. 2013 Apr 3;3(4). doi: 10.1136/bmjopen-2012-002500. Print 2013.
Early brain injury, as found in children with unilateral cerebral palsy (CP), may cause deficits in higher-order cognitive tasks known as executive functions (EF). EF has been conceptualised as comprised of four distinct yet inter-related components: (1) attentional control, (2) cognitive flexibility, (3) goal setting and (4) information processing. The aim of this study was to examine EF in children with unilateral CP and compare their performance with a typically developing reference group (TDC). The potential laterality effects of unilateral CP on EF will be explored, as will the relationship between the cognitive measures of EF, behavioural manifestations of EF, psychological functioning and clinical features of unilateral CP.
This cross-sectional study aims to recruit a total of 42 children with unilateral CP (21 right unilateral CP and 21 left unilateral CP) and 21 TDC aged between 8 and 16 years. Clinical severity will be described for gross motor function and manual ability. Outcomes for cognitive EF measureswill include subtests from the Wechsler Intelligence Scale for Children-Fourth Edition, Delis-Kaplan Executive Function System, Rey Complex Figure Test and the Test of Everyday Attention for Children. Behavioural manifestations of EF will be assessed using the Behaviour Rating Inventory of Executive Function, Parent and Teacher versions. Psychological functioning will be examined using the Strengths and Difficulties Questionnaire. Between-groups differences will be examined in a series of one-way analyses of covariance and followed up using linear comparisons. An overall composite of cognitive EF measures will be created. Bivariate correlations between the EF composite and psychological measures will be calculated.
This protocol describes a study that, to our knowledge, is the first to examine multiple components of EF using a cohort of children with unilateral CP. Exploration of potential laterality effects of EF among children with a congenital, unilateral brain injury is also novel. Possible relationships between EF and psychological functioning will also be investigated. Ethics have been obtained through the University of Queensland School of Psychology Ethics Committee and the Queensland Children's Health Services Human Research Ethics Committee. Results will be disseminated in peer reviewed publications and presentations at national and international conferences. This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611000263998).
早期脑损伤，如在单侧脑瘫（CP）患儿中发现的，可能导致被称为执行功能（EF）的高级认知任务缺陷。EF 被概念化为由四个不同但相互关联的组成部分组成：（1）注意力控制，（2）认知灵活性，（3）目标设定和（4）信息处理。本研究的目的是检查单侧 CP 患儿的 EF，并将其表现与典型发育参考组（TDC）进行比较。将探讨单侧 CP 的潜在偏侧效应对 EF 的影响，以及 EF 的认知测量、EF 的行为表现、心理功能和单侧 CP 的临床特征之间的关系。
这项横断面研究旨在招募总共 42 名单侧 CP 儿童（21 名右侧单侧 CP 和 21 名左侧单侧 CP）和 21 名 TDC，年龄在 8 至 16 岁之间。将描述粗大运动功能和手动能力的临床严重程度。认知 EF 测量的结果将包括韦氏儿童智力量表第四版、德里斯-卡普兰执行功能系统、雷氏复杂图形测试和儿童日常注意力测验的子测验。EF 的行为表现将使用行为评定量表执行功能、家长和教师版本进行评估。心理功能将使用优势和困难问卷进行检查。将在一系列单向协方差分析中检查组间差异，并使用线性比较进行跟踪。将创建认知 EF 测量的综合总体。将计算 EF 综合与心理测量之间的双变量相关性。
本方案描述了一项研究，据我们所知，这是首次使用单侧 CP 患儿队列检查 EF 的多个组成部分。探索先天性单侧脑损伤儿童 EF 的潜在偏侧效应也是新颖的。EF 与心理功能之间的可能关系也将进行调查。伦理已通过昆士兰大学心理学伦理委员会和昆士兰儿童健康服务人体研究伦理委员会获得。结果将在同行评议的出版物中发表，并在国内和国际会议上发表。本研究已在澳大利亚和新西兰临床试验注册中心（ACTRN12611000263998）注册。
