Fufaeva E V
Zh Vopr Neirokhir Im N N Burdenko. 2014;78(1):50-5; discussion 55-6.
Severe traumatic brain injury leads to a sharp increase in the number of children with severe disabilities. Early identification of higher mental functions disorders allows to develop rehabilitation programs and to increase effectiveness of intervention. The aim of this study was to investigate the executive function in children with severe traumatic brain injury at different stages of consciousness recovery and to develop the protocol of early neuropsychological assessment and intervention.
62 children in age from 4 to 17 years with sTBI (Glasgow Coma Scale (GCS) < or = 8) were studied. 11 of them were studied in a vegetative state and minimal consciousness state with functional magnetic resonance imaging (fMRI) and with neurobehavioral scales. 51 children were evaluated with Paediatric Luria Neuropsychological Battery test which was adapted for early stage of recovery.
The MRI data analysis has shown structural brain damage: bilateral cortical contusions of the frontal lobes and diffuse axonal injuries were the most frequent lesions. Assessment of neuropsychological outcomes has shown that the most destroyed functions at the early recovery period were executive functions, processing speed (neurodynamics of metal activity) and memory functions (modal-nonspecific memory). Early identification of higher mental functions disorders with analysis of patient's behavior by neurobehavioral scales allowed to develop a protocol of monitoring and rehabilitation methods for early stage of recovery.
严重创伤性脑损伤导致重度残疾儿童数量急剧增加。早期识别高级心理功能障碍有助于制定康复计划并提高干预效果。本研究旨在调查重度创伤性脑损伤儿童在意识恢复不同阶段的执行功能，并制定早期神经心理学评估与干预方案。
对62名4至17岁的重度创伤性脑损伤患儿（格拉斯哥昏迷量表（GCS）≤8）进行了研究。其中11名处于植物状态和最低意识状态的患儿接受了功能磁共振成像（fMRI）和神经行为量表检查。51名患儿接受了适用于恢复早期的儿科鲁利亚神经心理成套测验。
MRI数据分析显示存在脑结构损伤：双侧额叶皮质挫伤和弥漫性轴索损伤是最常见的损伤类型。神经心理学结果评估表明，恢复早期受损最严重的功能是执行功能、处理速度（心理活动的神经动力学）和记忆功能（模式非特异性记忆）。通过神经行为量表分析患者行为早期识别高级心理功能障碍，有助于制定恢复早期的监测和康复方法方案。
