Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia (N.P.R., M.G., L.C., A.C, L.C., R.W.H., P.M., M.T.M., V.A.).
School of Psychology, Deakin University, Geelong, Australia (N.P.R.).
Stroke. 2021 May;52(5):1609-1617. doi: 10.1161/STROKEAHA.120.032955. Epub 2021 Apr 8.
Childhood and adolescence coincide with rapid maturation of distributed brain networks supporting social cognition; however, little is known about the impact of early ischemic brain insult on the acquisition of these skills. This study aimed to examine the influence of arterial ischemic stroke (AIS) on facial emotion recognition and theory of mind (ToM) abilities of children and adolescents initially recruited to a single-center, prospective longitudinal study of recovery following AIS.
The study involved 67 participants, including 30 children with AIS (mean time since stroke=5 years) and 37 age-matched typically developing controls who were assessed on measures of cognitive ToM, facial emotion recognition, and affective ToM. Acute clinical magnetic resonance imaging, including diffusion-weighted imaging sequences, were used to evaluate prospective structure-function relationships between acute lesion characteristics (size, location, and arterial territories affected) and long-term social cognitive abilities.
Relative to age-matched typically developing controls, children with AIS showed significantly worse performance on measures of basic facial emotion processing, cognitive ToM, and affective ToM. In univariate models, poorer ToM was associated with larger infarcts, combined cortical-subcortical pathology, and involvement of multiple arterial territories. In multivariate analyses, larger lesions and multiterritory infants were predictive of ToM processing but not facial emotion recognition. Poorer cognitive ToM predicted less frequent prosocial behavior and increased peer problems.
Social cognitive skills appear vulnerable to disruption from early ischemic brain insult. In the first study to examine social cognition in a prospective cohort of children with AIS, our findings suggest that acute magnetic resonance imaging-based lesion characteristics may have predictive value for long-term social cognitive outcomes and may assist to identify children at elevated risk for social cognitive dysfunction.
儿童期和青春期与支持社会认知的分布式大脑网络的快速成熟相吻合；然而，对于早期缺血性脑损伤对这些技能的获得的影响知之甚少。本研究旨在检查动脉缺血性中风（AIS）对儿童和青少年面部情绪识别和心理理论（ToM）能力的影响，这些儿童和青少年最初被招募到一项关于 AIS 后恢复的单中心前瞻性纵向研究中。
该研究涉及 67 名参与者，包括 30 名 AIS 儿童（中风后平均时间=5 年）和 37 名年龄匹配的正常发育对照者，他们接受了认知 ToM、面部情绪识别和情感 ToM 测试。急性临床磁共振成像，包括弥散加权成像序列，用于评估急性病变特征（大小、位置和受影响的动脉区域）与长期社会认知能力之间的前瞻性结构-功能关系。
与年龄匹配的正常发育对照组相比，AIS 儿童在基本面部情绪处理、认知 ToM 和情感 ToM 测试中的表现明显较差。在单变量模型中，较差的 ToM 与较大的梗死、皮质下联合病变以及多个动脉区域受累有关。在多变量分析中，较大的病变和多区域病变与 ToM 处理有关，但与面部情绪识别无关。较差的认知 ToM 预测亲社会行为频率较低和同伴问题增加。
社会认知技能似乎容易受到早期缺血性脑损伤的破坏。在对 AIS 儿童进行前瞻性队列研究中首次检查社会认知，我们的发现表明，基于急性磁共振成像的病变特征可能对长期社会认知结果具有预测价值，并可能有助于识别社会认知功能障碍风险较高的儿童。
