Anderson V A, Morse S A, Klug G, Catroppa C, Haritou F, Rosenfeld J, Pentland L
Department of Psychology, University of Melbourne, Parkville, Victoria, Australia.
J Int Neuropsychol Soc. 1997 Nov;3(6):568-80.
It has been argued that young children's brains are "plastic," and may sustain substantial brain insult with little loss of function. Recent research suggests that this notion may not apply for generalized cerebral pathology. The present study aimed to evaluate this proposition using a sample of 73 young children, divided into 3 groups: severe head injury (HI; N = 17); mild-moderate HI (N = 32); and noninjured controls (N = 24). Preinjury screening established equivalence across groups for age, sex, preinjury ability, behavioral adjustment, socioeconomic status, and family functioning. Children were evaluated as soon as possible postinjury, and again 12 months postinjury, in three domains: intellectual ability, language, and memory. Results indicated that severe HI was associated with substantial, persisting difficulties in all areas. In contrast, children with mild-moderate HI experienced fewer difficulties, and often performed similarly to controls, both acutely and 12 months postinjury. There was no evidence of differential recovery of function associated with injury severity, with performance increments consistent across groups and probably due to either age-appropriate developmental gains, or test-related practice effects. Poorer outcome at 12 months postinjury was predicted by injury severity primarily, with earlier age at injury, and premorbid ability associated with outcome in specific domains.
有人认为幼儿的大脑具有“可塑性”，可能承受严重的脑部损伤而功能损失很小。最近的研究表明，这一观点可能不适用于全身性脑病理学。本研究旨在通过73名幼儿样本评估这一命题，将其分为3组：重度头部损伤（HI；N = 17）；轻度至中度HI（N = 32）；以及未受伤的对照组（N = 24）。损伤前筛查确定了各组在年龄、性别、损伤前能力、行为调整、社会经济地位和家庭功能方面的等效性。在受伤后尽快对儿童进行评估，并在受伤后12个月再次评估，评估三个领域：智力、语言和记忆。结果表明，重度HI与所有领域的严重且持续的困难相关。相比之下，轻度至中度HI的儿童遇到的困难较少，在受伤后即刻和12个月时的表现通常与对照组相似。没有证据表明与损伤严重程度相关的功能恢复存在差异，各组的表现提升一致，可能是由于与年龄相符的发育进步或与测试相关的练习效应。受伤后12个月时较差的结果主要由损伤严重程度预测，受伤时年龄较小以及病前能力与特定领域的结果相关。
