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多发性先天性关节挛缩症和产伤性臂丛神经病所致上肢运动障碍患儿的认知技能相似损害。

Similar Cognitive Skill Impairment in Children with Upper Limb Motor Disorders Due to Arthrogryposis Multiplex Congenita and Obstetrical Brachial Plexus Palsy.

机构信息

Centre for Cognition & Decision Making, Institute for Cognitive Neurosceince, National Research University Higher School of Economics, 101000 Moscow, Russia.

Federal State Budgetary Institution, The Turner Scientific Research Institute for Children's Orthopedics under the Ministry of Health of the Russian Federation, 196603 St. Petersburg, Russia.

出版信息

Int J Environ Res Public Health. 2023 Jan 19;20(3):1841. doi: 10.3390/ijerph20031841.

Abstract

Arthrogryposis multiplex congenita (AMC) and obstetrical brachial plexus palsy (OBPP) are motor disorders with similar symptoms (contractures and the disturbance of upper limb function). Both conditions present as flaccid paresis but differ from each other in the pathogenesis: AMC is a congenital condition, while OBPP results from trauma during childbirth. Despite this difference, these diseases are identical in terms of their manifestations and treatment programmes. We compared the cognitive skills of children with AMC and OBPP diagnoses with those of healthy children; we also compared the motor skills of impaired children with those of healthy ones. The patients in both groups significantly differed from the healthy children with regard to psychological parameters, such as 'visual memory capacity' and 'thinking'. Moreover, the two groups with children with AMC and OBPP significantly differed from each other in motor skill parameters, such as 'delayed motor development', 'general motor development', and the 'level of paresis'. Upper limb motor function in the OBPP children was less impaired compared to that of the AMC children. However, we did not find any significant differences in cognitive deficits between the AMC children and the OBPP children. This may indicate that motor impairment is more significant than the underlying cause for the development of cognitive impairment; however, the factors causing this phenomenon require further study (e.g., social environment, treatment, and rehabilitation programme).

摘要

先天性多发性关节挛缩症(AMC)和产伤性臂丛神经麻痹(OBPP)是两种具有相似症状(挛缩和上肢功能障碍)的运动障碍。这两种情况都表现为弛缓性瘫痪,但在发病机制上有所不同:AMC 是一种先天性疾病,而 OBPP 则是由于分娩过程中的创伤引起的。尽管存在这种差异,但这两种疾病在临床表现和治疗方案上是相同的。我们比较了 AMC 和 OBPP 诊断患儿与健康儿童的认知技能,还比较了有运动障碍的患儿与健康儿童的运动技能。这两组患者在心理参数方面与健康儿童有显著差异,如“视觉记忆能力”和“思维”。此外,患有 AMC 和 OBPP 的两组患儿在运动技能参数方面也存在显著差异,如“运动发育迟缓”、“一般运动发育”和“瘫痪程度”。与 AMC 患儿相比,OBPP 患儿的上肢运动功能受损程度较低。然而,我们没有发现 AMC 患儿和 OBPP 患儿之间在认知缺陷方面存在显著差异。这可能表明运动障碍比认知障碍的根本原因更重要;然而,导致这种现象的因素需要进一步研究(例如,社会环境、治疗和康复方案)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb27/9914233/9a67515799a1/ijerph-20-01841-g001.jpg

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