Auditory neglect in children following perinatal stroke

Listening with one hemisphere: A review of auditory processing among individuals after hemispheric surgery

The human auditory system consists of both peripheral and central components, both of which play a role but contribute distinctly to overall auditory functioning and can be differentially impacted by pathophysiologic states. Hemispheric surgery (HS), a procedure used for the treatment of drug-resistant epilepsy, involves complete disconnection of the auditory cortex in the operative hemisphere, leaving hearing acuity (peripheral function) intact but having heavy implications for auditory processing (central function). The literature describing pre- and post-operative auditory processing abilities of individuals who have undergone HS is sparse, but the research available provides evidence that several central auditory processes including auditory spatial analysis and temporal processing may be impacted. Deficits noted in standardized testing within the clinical or research environment have concrete functional impacts that may be currently under-appreciated and could lead to under-utilization of appropriate therapeutic strategies and accommodations. This review describes the profile of central auditory processing abilities in patients who have undergone HS by synthesizing available literature and incorporating research in other clinical populations to help fill critical gaps in our understanding of how cerebral disconnection impacts the central auditory system.

A Review of Auditory Attention: Neural Mechanisms, Theories, and Affective Disorders

Attention is a fundamental aspect of human cognitive function and is crucial for essential activities such as learning, social interaction, and routine tasks. Notably, Auditory attention involves complex interactions and collaboration among multiple brain networks. Recognizing the impairment of auditory attention, comprehending its underlying mechanisms, and identifying the activated brain regions essential for the development of treatments and interventions for individuals facing auditory attention deficits, emphasizes the significance of investigating these matters. In the current study, we conducted a review by searching for the full text of 53 articles published related to auditory attention, mechanisms, and networks in databases like Science Direct, Google Scholar, ProQuest, and PubMed using the keywords Attention, Auditory Attention, Auditory Attention Impairment, theories of attention were investigated in the years 2000 to 2023 And focused on articles that provided discussions within this research domain. The studies have demonstrated that auditory attention exceeds being an acoustic attribute and assumes a fundamental role in complex acoustic environments, information processing, and even speech comprehension. In the context of this study, we have conducted a review and summary of the proposed theories related to attention and the brain networks involved in different forms of auditory attention. In conclusion, the integration of auditory attention assessments, behavioral observations, and an understanding of the neural mechanisms and brain regions implicated in auditory attention proves to be an effective approach for the diagnosis and treatment of attention-related disorders.

School-age outcomes of children after perinatal brain injury: a systematic review and meta-analysis

BACKGROUND

Over 3000 children suffer a perinatal brain injury in England every year according to national surveillance. The childhood outcomes of infants with perinatal brain injury are however unknown.

METHODS

A systematic review and meta-analyses were undertaken of studies published between 2000 and September 2021 exploring school-aged neurodevelopmental outcomes of children after perinatal brain injury compared with those without perinatal brain injury. The primary outcome was neurodevelopmental impairment, which included cognitive, motor, speech and language, behavioural, hearing or visual impairment after 5 years of age.

RESULTS

This review included 42 studies. Preterm infants with intraventricular haemorrhage (IVH) grades 3-4 were found to have a threefold greater risk of moderate-to-severe neurodevelopmental impairment at school age OR 3.69 (95% CI 1.7 to 7.98) compared with preterm infants without IVH. Infants with perinatal stroke had an increased incidence of hemiplegia 61% (95% CI 39.2% to 82.9%) and an increased risk of cognitive impairment (difference in full scale IQ -24.2 (95% CI -30.73 to -17.67) . Perinatal stroke was also associated with poorer academic performance; and lower mean receptive -20.88 (95% CI -36.66 to -5.11) and expressive language scores -20.25 (95% CI -34.36 to -6.13) on the Clinical Evaluation of Language Fundamentals (CELF) assessment. Studies reported an increased risk of persisting neurodevelopmental impairment at school age after neonatal meningitis. Cognitive impairment and special educational needs were highlighted after moderate-to-severe hypoxic-ischaemic encephalopathy. However, there were limited comparative studies providing school-aged outcome data across neurodevelopmental domains and few provided adjusted data. Findings were further limited by the heterogeneity of studies.

CONCLUSIONS

Longitudinal population studies exploring childhood outcomes after perinatal brain injury are urgently needed to better enable clinicians to prepare affected families, and to facilitate targeted developmental support to help affected children reach their full potential.

Motor Influence in Developing Auditory Spatial Cognition in Hemiplegic Children with and without Visual Field Disorder

Spatial representation is a crucial skill for everyday interaction with the environment. Different factors seem to influence spatial perception, such as body movements and vision. However, it is still unknown if motor impairment affects the building of simple spatial perception. To investigate this point, we tested hemiplegic children with (HV) and without visual field (H) disorders in an auditory and visual-spatial localization and pitch discrimination task. Fifteen hemiplegic children (nine H and six HV) and twenty with typical development took part in the experiment. The tasks consisted in listening to a sound coming from a series of speakers positioned at the front or back of the subject. In one condition, subjects were asked to discriminate the pitch, while in the other, subjects had to localize the position of the sound. We also replicated the spatial task in a visual modality. Both groups of hemiplegic children performed worse in the auditory spatial localization task compared with the control, while no difference was found in the pitch discrimination task. For the visual-spatial localization task, only HV children differed from the two other groups. These results suggest that movement is important for the development of auditory spatial representation.

Spatial attention in children with perinatal stroke

Spatial neglect is a common feature of right hemisphere damage in adults, but less is known about spatial inattention following early brain damage. We used a Posner-based cueing task to examine hemispatial neglect and aspects of attention in children with perinatal stroke in either left (LH) or right hemisphere (RH) and controls. A visual perception task assessed the speed of visual perception. A spatial attention cueing task (the E-task) measured the ability to discriminate the direction of a target stimulus ("E"), when presented on the left or right side of the screen. This task provided indices of performance for attention orienting, disengagement and reorienting. Children with LH lesions had slowed visual perception compared to controls. Children with RH lesions did not demonstrate similar deficits. On the E-task, groups with both LH and RH lesions demonstrated lower accuracy on both left and right sides compared to controls. Children with LH lesions also showed impaired attention orienting and disengagement on left and right sides compared to controls, while children with RH lesions were most impaired in orienting and disengagement on their contralesional side. Children with LH lesions demonstrated more extensive attentional deficits than children with RH lesions. These results suggest that development of spatial attention may require different neural networks than maintenance of attention.

Visual Neuropsychology in Development: Anatomo-Functional Brain Mechanisms of Action/Perception Binding in Health and Disease

Vision is the main entrance for environmental input to the human brain. Even if vision is our most used sensory modality, its importance is not limited to environmental exploration. Rather it has strong links to motor competences, further extending to cognitive and social aspects of human life. These multifaceted relationships are particularly important in developmental age and become dramatically evident in presence of complex deficits originating from visual aberrancies. The present review summarizes the available neuropsychological evidence on the development of visual competences, with a particular focus on the associated visuo-motor integration skills in health and disease. With the aim of supporting future research and interventional settings, the goal of the present review is to constitute a solid base to help the translation of neuropsychological hypotheses into straightforward empirical investigations and rehabilitation/training protocols. This approach will further increase the impact, ameliorate the acceptance, and ease the use and implementation of lab-derived intervention protocols in real-life situations.