Craft S, Park T S, White D A, Schatz J, Noetzel M, Arnold S
Department of Psychology, Washington University, St. Louis, Mo, USA.
Pediatr Neurosurg. 1995;23(2):68-74; discussion 75. doi: 10.1159/000120939.
Children with cerebral palsy who receive selective dorsal rhizotomy (SDR) for treatment of spasticity may show suprasegmental changes in upper limb function and control of speech musculature. Anecdotal reports suggest that supra-segmental effects may extend to cognitive functions such as attention and language. This study examined the performance of 16 children with spastic diplegic cerebral palsy on tests of visual attention and other cognitive functions 1 day prior to and 6 months following SDR. Children undergoing SDR were compared with 9 children with spastic diplegia, matched for severity of cerebral palsy and amount of therapy, who did not receive SDR, and 24 age- and sex-matched normal children tested at initial and 6-month follow-up sessions. Children with cerebral palsy treated with SDR showed disproportionately greater improvement in specific attentional and cognitive operations than either of the other groups. These results document cognitive changes following SDR which heretofore were reportedly anecdotally. This improvement may be due to improved mood, reduced physical discomfort, increased therapeutic intervention, or possible cortical effects of SDR.
接受选择性背根切断术（SDR）治疗痉挛的脑瘫患儿，其上肢功能和言语肌肉控制可能会出现节段上的变化。轶事报道表明，节段上的影响可能会扩展到诸如注意力和语言等认知功能。本研究考察了16例痉挛型双瘫脑瘫患儿在SDR术前1天和术后6个月时的视觉注意力测试及其他认知功能表现。将接受SDR的患儿与9例痉挛型双瘫患儿（在脑瘫严重程度和治疗量方面相匹配，但未接受SDR）以及24例在初始和6个月随访时进行测试的年龄和性别相匹配的正常儿童进行比较。接受SDR治疗的脑瘫患儿在特定注意力和认知操作方面的改善程度比其他两组都要大得多。这些结果证明了SDR术后的认知变化，此前这些变化据报道只是轶事。这种改善可能是由于情绪改善、身体不适减轻、治疗干预增加或SDR可能产生的皮质效应。
