Queensland Cerebral Palsy and Rehabilitation Research Centre, Discipline of Paediatrics and Child Health, School of Medicine, The University of Queensland, Brisbane, Qld, Australia; School of Psychology, Faculty of Social and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia.
Dev Med Child Neurol. 2013 Oct;55(10):926-33. doi: 10.1111/dmcn.12195. Epub 2013 Jun 28.
The aim of this study was to compare executive function in children with left- and right-sided unilateral cerebral palsy (CP) and typically developing children.
There was a cross-sectional cohort of 46 children with unilateral CP (24 right-side, 22 left-side; 25 males, 21 females; mean age 11y 1mo, SD 2y 5mo) and 20 typically developing children (nine males, 11 females; mean age 10y 10mo, SD 2y 4mo). Four cognitive domains of executive function were assessed: attentional control, cognitive flexibility, goal setting, and information processing. Subtests from the Delis-Kaplan Executive Function System, the Test of Everyday Attention for Children, the Rey-Osterrieth Complex figure, and the Wechsler Intelligence Scale for Children - Fourth Edition were utilized. Between-group differences (right unilateral CP, left unilateral CP, and typically developing children) were examined using analyses of covariance.
Children with CP performed significantly more poorly than typically developing children on all executive function measures (aggregate executive function: F(1,63)=31.16; p<0.001; η(2) =0.33). There were no significant differences between children with left and right unilateral CP, except in the case of inhibition/switching total errors, with children with left unilateral CP making fewer errors than children with right unilateral CP (F(1,39)=4.14; p=0.049; η(2) =0.1).
Children and adolescents with unilateral CP experience difficulties across multiple executive function domains compared with typically developing children, irrespective of the side of hemiplegia. This finding supports an early vulnerability model of early brain injury and has implications for intervention for children with CP.
本研究旨在比较左、右侧单侧脑瘫（CP）患儿与正常发育儿童的执行功能。
这是一项横断面队列研究，共纳入 46 例单侧 CP 患儿（24 例右侧，22 例左侧；25 例男性，21 例女性；平均年龄 11 岁 1 个月，标准差 2 岁 5 个月）和 20 例正常发育儿童（9 例男性，11 例女性；平均年龄 10 岁 10 个月，标准差 2 岁 4 个月）。评估了执行功能的四个认知领域：注意力控制、认知灵活性、目标设定和信息处理。采用德利斯-卡普兰执行功能系统、儿童日常注意测验、雷氏复杂图形和韦氏儿童智力量表第四版的子测验进行评估。使用协方差分析比较组间差异（右侧单侧 CP、左侧单侧 CP 和正常发育儿童）。
CP 患儿在所有执行功能测量上的表现明显差于正常发育儿童（总执行功能：F（1,63）=31.16；p<0.001；η²=0.33）。左侧和右侧单侧 CP 患儿之间除抑制/转换总错误外，无显著差异，左侧单侧 CP 患儿的错误少于右侧单侧 CP 患儿（F（1,39）=4.14；p=0.049；η²=0.1）。
与正常发育儿童相比，单侧 CP 患儿在多个执行功能领域均存在困难，与偏瘫侧无关。这一发现支持早期脑损伤的早期易损性模型，对 CP 患儿的干预具有启示意义。
