Choi Ja Young, Choi Yoon Seong, Park Eun Sook
Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Speech Lang Hear Res. 2017 May 24;60(5):1330-1338. doi: 10.1044/2016_JSLHR-L-16-0281.
The purpose of this study was to investigate characteristics of language development in relation to brain magnetic resonance imaging (MRI) characteristics and the other contributing factors to language development in children with cerebral palsy (CP).
The study included 172 children with CP who underwent brain MRI and language assessments between 3 and 7 years of age. The MRI characteristics were categorized as normal, malformation, periventricular white matter lesion (PVWL), deep gray matter lesion, focal infarct, cortical/subcortical lesion, and others. Neurodevelopmental outcomes such as ambulatory status, manual ability, cognitive function, and accompanying impairments were assessed.
Both receptive and expressive language development quotients (DQs) were significantly related to PVWL or deep gray matter lesion severity. In multivariable analysis, only cognitive function was significantly related to receptive language development, whereas ambulatory status and cognitive function were significantly associated with expressive language development. More than one third of the children had a language developmental discrepancy between receptive and expressive DQs. Children with cortical/subcortical lesions were at high risk for this discrepancy.
Cognitive function is a key factor for both receptive and expressive language development. In children with PVWL or deep gray matter lesion, lesion severity seems to be useful to predict language development.
本研究旨在调查脑瘫（CP）患儿语言发育特征与脑磁共振成像（MRI）特征以及其他影响语言发育的因素之间的关系。
该研究纳入了172例3至7岁接受脑MRI和语言评估的CP患儿。MRI特征分为正常、畸形、脑室周围白质病变（PVWL）、深部灰质病变、局灶性梗死、皮质/皮质下病变及其他。评估神经发育结局，如行走状态、手部能力、认知功能及伴随的损伤情况。
接受性和表达性语言发育商（DQ）均与PVWL或深部灰质病变严重程度显著相关。在多变量分析中，仅认知功能与接受性语言发育显著相关，而行走状态和认知功能与表达性语言发育显著相关。超过三分之一的患儿接受性和表达性DQ之间存在语言发育差异。皮质/皮质下病变患儿出现这种差异的风险较高。
认知功能是接受性和表达性语言发育的关键因素。对于患有PVWL或深部灰质病变的患儿，病变严重程度似乎有助于预测语言发育。
