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Rozaire J, Paquin C, Henry L, Agopyan H, Bard-Pondarré R, Naaim A, Duprey S, Chaleat-Valayer E. A systematic review of instrumented assessments for upper limb function in cerebral palsy: current limitations and future directions. J Neuroeng Rehabil 2024; 21:56. [PMID: 38622731 PMCID: PMC11020208 DOI: 10.1186/s12984-024-01353-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Recently, interest in quantifying upper limb function in cerebral palsy has grown. However, the lack of reference tasks and protocols, have hindered the development of quantified movement analysis in clinical practice. This study aimed to evaluate existing instrumented assessments of upper limb function in cerebral palsy, with a focus on their clinical applicability, to identify reasons for the lack of adoption and provide recommendations for improving clinical relevance and utility. METHODS A systematic review was conducted by a multidisciplinary team of researchers and clinicians (Prospero CRD42023402382). PubMed and Web of Science databases were searched using relevant keywords and inclusion/exclusion criteria. RESULTS A total of 657 articles were initially identified, and after the selection process, 76 records were included for analysis comprising a total of 1293 patients with cerebral palsy. The quality assessment of the reviewed studies revealed a moderate overall quality, with deficiencies in sample size justification and participant information. Optoelectronic motion capture systems were predominantly used in the studies (N = 57/76). The population mainly consisted of individuals with spastic cerebral palsy (834/1293) with unilateral impairment (N = 1092/1293). Patients with severe functional impairment (MACS IV and V) were underrepresented with 3.4% of the 754 patients for whom the information was provided. Thirty-nine tasks were used across the articles. Most articles focused on unimanual activities (N = 66/76) and reach or reach and grasp (N = 51/76). Bimanual cooperative tasks only represented 3 tasks present in 4 articles. A total of 140 different parameters were identified across articles. Task duration was the most frequently used parameter and 23% of the parameters were used in only one article. CONCLUSION Further research is necessary before incorporating quantified motion analysis into clinical practice. Existing protocols focus on extensively studied populations and rely on costly equipment, limiting their practicality. Standardized unimanual tasks provide limited insights into everyday arm use. Balancing methodological requirements and performance evaluation flexibility is a challenge. Exploring the correlation between outcome parameters and therapeutic guidance could facilitate the integration of quantified movement assessment into treatment pathways.
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Affiliation(s)
- Julie Rozaire
- Service de Médecine Physique et de Réadaptation, Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, Hôpital de Jour, Lyon, France
- LBMC UMR_T9406, Univ Lyon, Univ Gustave Eiffel, Université Claude Bernard Lyon 1, Lyon, France
| | - Clémence Paquin
- LBMC UMR_T9406, Univ Lyon, Univ Gustave Eiffel, Université Claude Bernard Lyon 1, Lyon, France
- Texisense, Torcy, France
| | - Lauren Henry
- LBMC UMR_T9406, Univ Lyon, Univ Gustave Eiffel, Université Claude Bernard Lyon 1, Lyon, France
| | - Hovannes Agopyan
- Service de Médecine Physique et de Réadaptation, Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, Hôpital de Jour, Lyon, France
| | - Rachel Bard-Pondarré
- Service de Médecine Physique et de Réadaptation, Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, Hôpital de Jour, Lyon, France
| | - Alexandre Naaim
- LBMC UMR_T9406, Univ Lyon, Univ Gustave Eiffel, Université Claude Bernard Lyon 1, Lyon, France.
| | - Sonia Duprey
- LBMC UMR_T9406, Univ Lyon, Univ Gustave Eiffel, Université Claude Bernard Lyon 1, Lyon, France
| | - Emmanuelle Chaleat-Valayer
- Service de Médecine Physique et de Réadaptation, Centre Médico-Chirurgical de Réadaptation des Massues Croix-Rouge française, Hôpital de Jour, Lyon, France
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García-Castro MI, Menor J, Alvarez-Carriles JC. Differential neuropsychological profiles in children and adolescents with motor disability in an inclusive educational setting. Child Neuropsychol 2024:1-25. [PMID: 38221861 DOI: 10.1080/09297049.2024.2304377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/29/2023] [Indexed: 01/16/2024]
Abstract
The aim of this study was to determine the potential cognitive impairment associated with motor disability in a group of children attending regular schools and to analyze whether there were different cognitive profiles according to the type of motor disability they presented. The study had 87 participants, 31 healthy and 56 with three types of motor disability: Neuromuscular Diseases (NMD Group), Cerebral Palsy-Hemiparesis (CP- HPx Group) and Cerebral Palsy-Diplegia (CP-DP). Ages ranged from 6 to 18 years and they had medium and medium-high socioeconomic and cultural levels. All participants attended regular state-funded and independent schools in an inclusive modality. The neuropsychological assessment included the following cognitive domains: processing speed, working memory, verbal and visual episodic memory, language, visuo-perception and constructive praxis and executive functioning. A second analysis was performed with the groups with CP: one based on the severity of gross motor impairment (GMFCS-E&R scale) and the other based on the levels of manual dexterity (MACS scale). ANCOVAs were performed controlling for age and processing speed in the three analyses. The group with CP-HPx was shown to be the most cognitively impaired of the three groups, with significant deficits in visuo-perception, verbal working memory, and visuo-spatial memory. Subjects with greater gross motor dysfunction (GMFCS-E&R) did not show the greatest cognitive impairment, while those with worse manual dexterity (MACS) exhibited greater cognitive impairment. Children and adolescents with motor disabilities, a priori cognitively normal, present different levels of cognitive impairment. This should be considered when planning educational adaptations for this infant-juvenile population.
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Affiliation(s)
- M Isabel García-Castro
- Physical Disability Unit, Regional Team of Attention to Students with Specific, Educational Support Needs, Regional Ministry of Education of the Principality of Asturias, Oviedo, Spain
| | - Julio Menor
- Department of Psychology, University of Oviedo, Spain
| | - Juan C Alvarez-Carriles
- Department of Psychology, University of Oviedo, Spain
- Clinical Neuropsychology Unit, Liaison Psychiatry Service, Central University Hospital of Asturias, Oviedo, Spain
- Institute of Health Research of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
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Asano D, Takeda M, Nobusako S, Morioka S. Error analysis of Raven's Coloured Progressive Matrices in children and adolescents with cerebral palsy. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:655-667. [PMID: 37016552 DOI: 10.1111/jir.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/09/2023] [Accepted: 03/24/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Analysis of the errors in the Raven's Coloured Progressive Matrices (RCPM) has been previously performed for children with intellectual disabilities but has not been investigated for those with cerebral palsy (CP). This study aimed to investigate whether the types and positions of errors made by individuals with CP differed from those made by typically developing (TD) controls. METHODS Forty-five participants with CP aged 4-18 years and 30 TD children aged 3-9 years underwent RCPM testing. We first compared the RCPM performance and error characteristics between the groups and then examined the association between RCPM and the severity of CP and receptive vocabulary in the CP group. RESULTS The results showed that while mean total scores in the two groups were comparable, the types and positions of errors made by individuals with CP differed from those of TD controls. The development of non-verbal intelligence in children with CP increased with age; when controlling for age, non-verbal intelligence was significantly correlated with all three functional levels of CP severity and receptive vocabulary. CONCLUSIONS This study provides valuable insights into the problem-solving strategies employed by children with CP.
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Affiliation(s)
- D Asano
- Department of Rehabilitation, Japan Baptist Hospital, Kyoto, Japan
| | - M Takeda
- Department of Rehabilitation, Beppu Developmental Medical Center, Oita, Japan
| | - S Nobusako
- Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, Japan
| | - S Morioka
- Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, Japan
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Callahan M, Matson JL, Tevis C. Developmental Functioning of Infants and Toddlers with Neurodevelopmental Disorders. Dev Neurorehabil 2023; 26:89-100. [PMID: 36628488 DOI: 10.1080/17518423.2023.2166615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The current study aimed to investigate developmental functioning in infants and toddlers with autism spectrum disorder (ASD), seizures, cerebral palsy (CP), and atypical development. METHODS An ANOVA was utilized to investigate the differences between neurodevelopmental group on BDI-2 developmental quotient and a MANOVA was used to investigate the differences between the groups and five developmental domains. RESULTS The results indicated statistically significant differences in overall developmental functioning and each subdomain of the BDI-2. DISCUSSION These findings provide the basis for further research to investigate comorbidities of the three neurodevelopmental disorders and parse out the impact of intellectual disability (ID).
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Affiliation(s)
- Megan Callahan
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Johnny L Matson
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Celeste Tevis
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Karlsson P, Honan I, Warschausky S, Kaufman JN, Henry G, Stephenson C, Webb A, McEwan A, Badawi N. A validation and acceptability study of cognitive testing using switch and eye-gaze control technologies for children with motor and speech impairments: A protocol paper. Front Psychol 2022; 13:991000. [PMID: 36225713 PMCID: PMC9549908 DOI: 10.3389/fpsyg.2022.991000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022] Open
Abstract
Despite the importance of knowing the cognitive capabilities of children with neurodevelopmental conditions, less than one-third of children with cerebral palsy participate in standardized assessments. Globally, approximately 50% of people with cerebral palsy have an intellectual disability and there is significant risk for domain-specific cognitive impairments for the majority of people with cerebral palsy. However, standardized cognitive assessment tools are not accessible to many children with cerebral palsy, as they require manual manipulation of objects, verbal response and/or speeded response. As such, standardised assessment may result in an underestimation of abilities for children with significant motor and/or speech impairment. The overall aim of the project is to examine and compare the psychometric properties of standardised cognitive assessment tools that have been accommodated for use with either a switch device or eye-gaze control technologies, with the specific aims to: (1) Examine the psychometric properties (measurement agreement and validity) of accommodated assessment tools by comparing the performance of typically developing children on six cognitive assessment tools administered via standardised versus accommodated (switch or eye-gaze control) administration; (2) Describe and compare the performance and user experience of children with cerebral palsy on six accommodated cognitive assessments administered via switch or eye-gaze control technologies. Secondary aims are to: (1) Describe the completion rates and time to complete assessments of participants in each group; (2) Within the group with cerebral palsy, examine the effects of condition-specific characteristics (type of cerebral palsy, functional levels, and pain) and demographics (age, socio-demographic) on participation. This protocol paper describes a two-phase validation and acceptability study that utilizes a mixed-model design. This study will collect concurrent data from 80 typically developing children and 40 children with cerebral palsy, who use switch or eye-gaze control technology as alternate access communication methods. The set of instruments will measure receptive vocabulary, fluid reasoning, sustained attention, vision perception, visuospatial working memory and executive functions. Data analyses will be conducted using SPSS v. 25 and R v 4.1.0. SPSS Sample Power 3 was used for power computation and allows for a 10% drop out rate. Quantitative descriptive statistics, measurement agreement data plotting, bivariate and multiple regressions analysis will be conducted using appropriate methods.
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Affiliation(s)
- Petra Karlsson
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia
- *Correspondence: Petra Karlsson,
| | - Ingrid Honan
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia
| | - Seth Warschausky
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, United States
| | - Jacqueline N. Kaufman
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, United States
| | - Georgina Henry
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia
| | - Candice Stephenson
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia
| | - Annabel Webb
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia
| | - Alistair McEwan
- School of Biomedical Engineering, The University of Sydney, Sydney, NSW, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, The Children’s Hospital at Westmead, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia
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Bordenave D, McCune L. Grunt Vocalizations in Children With Disabilities: Relationships With Assessed Cognition and Language. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4138-4148. [PMID: 34644506 DOI: 10.1044/2021_jslhr-21-00202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The purpose of this study was to investigate the relationship of the grunt vocalizations to cognitive and expressive language status in children with disabilities. Children with typical development produce communicative grunts at the onset of referential word production and comprehension at 14-16 months of age and continue to use this vocalization for communication as they develop language. Method All grunt vocalizations produced by 26 children with disabilities (mental age: 3-56 months; communicative age: 47-69 months) were identified from video-recorded seminaturalistic play sessions. Grunts were identified as accompanying effort or attention or as communicative bids. Participants were grouped as prelinguistic, emergent, language delay, and language competent based on standardized assessments of cognitive and language level. The Mann-Whitney U test (1947) compared groups to determine the relationships between grunt production and cognitive and language status. Results As hypothesized, participants in the language delay group produced significantly more communicative grunts than those in the language competent group (W = 39, p = .028 < .05). The children with a cognitive and language level lower than 9 months (prelinguistic group) failed to produce communicative grunts. Conclusions The results document grunt production in children with disabilities in the same contexts as typical children and support the hypothesized relationship between assessed cognition and language and communicative grunt production. These results require replication. This vocalization, if recognized in treatment, may unlock verbal communication in many nonverbal children with disabilities. Future longitudinal research should include controlled intervention to determine the potential effectiveness of building broader communicative skills on this simple vocalization.
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Affiliation(s)
| | - Lorraine McCune
- Rutgers University, The State University of New Jersey, New Brunswick
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Martinec S, Cesarec G, Tomečak Krilić AM, Radošević T, Bakran Ž, Mejaški Bošnjak V. FUNCTIONAL CLASSIFICATION OF CHILDREN WITH CEREBRAL PALSY IN KRAPINA-ZAGORJE COUNTY. Acta Clin Croat 2021; 60:282-289. [PMID: 34744279 PMCID: PMC8564855 DOI: 10.20471/acc.2021.60.02.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/03/2019] [Indexed: 11/30/2022] Open
Abstract
The aim was to study functional abilities and to create functional classification of children with cerebral palsy (CP) in Krapina-Zagorje County, based on the classification of gross and fine motor skills and associated impairments. Classification was performed according to the SCPE (Surveillance of Cerebral Palsy in Europe) criteria. We used standardized and complementary functional classification systems for cerebral palsy to create a functional profile. Research included 44 children with CP in the age range of 4 to 18 years. The results showed that the majority of children had bilateral spastic CP (63.6%), followed by unilateral spastic (22.7%) while the representation of dyskinetic CP was 9.09% and ataxic CP 4.55%. Based on the classification of gross and fine motor skills, 43.2% of children had the ability to walk, 11% of children could walk with assistive mobility devices, while 45.4% of children had a low functional level. The study also analyzed the associated impairments where higher classification score of motor impairment correlated with the severity of impairment. The results showed that children with dyskinetic CP and severe motor impairment could have mild cognitive impairment. We systematically present the neuropsychological and functional profile according to the CP type.
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Affiliation(s)
| | - Gordana Cesarec
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Marija Tomečak Krilić
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tomislav Radošević
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Žarko Bakran
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vlatka Mejaški Bošnjak
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
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Molinini RM, Koziol NA, Marcinowski EC, Hsu LY, Tripathi T, Harbourne RT, McCoy SW, Lobo MA, Bovaird JA, Dusing SC. Early motor skills predict the developmental trajectory of problem solving in young children with motor delays. Dev Psychobiol 2021; 63:e22123. [PMID: 33942902 DOI: 10.1002/dev.22123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The purpose of this study was to quantify the relationship between early motor skills, such as sitting, and the development of problem-solving skills in children with motor delays. METHODS Motor (Gross Motor Function Measure) and problem-solving (Assessment of Problem-Solving in Play) skills of 134 children 7-16 months adjusted age at baseline with motor delay were assessed up to 5 times over 12 months. Participants were divided into two groups: mild and significant motor delay. RESULTS Motor and problem-solving scores had large (r's = 0.53-0.67) and statistically significant (p's > .01) correlations at all visits. Baseline motor skills predicted baseline and change in problem solving over time. The associations between motor and problem-solving skills were moderated by level of motor delay, with children with significant motor delay generally having stronger associations compared to those with mild motor delay. CONCLUSIONS These findings suggest that overall baseline motor skills are predictive of current and future development of problem-solving skills and that children with significant motor delay have a stronger and more stable association between motor and problem-solving skills over time. This highlights that children with motor delays are at risk for secondary delays in problem solving, and this risk increases as degree of motor delay increases.
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Affiliation(s)
- Rebecca M Molinini
- Motor Development Lab, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Natalie A Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Emily C Marcinowski
- School of Kinesiology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Lin-Ya Hsu
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Tanya Tripathi
- Pediatric and Rehabilitation Laboratory, The Ohio State University, Columbus, Ohio, USA
| | - Regina T Harbourne
- Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Sarah W McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Michele A Lobo
- Move to Learn Innovation Lab, Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
| | - James A Bovaird
- Educational Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Stacey C Dusing
- Motor Development Lab, Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
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Ramos-Sánchez CP, Kortekaas D, Van Biesen D, Vancampfort D, Van Damme T. The Relationship between Motor Skills and Intelligence in Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:1189-1199. [DOI: 10.1007/s10803-021-05022-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 01/23/2023]
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Fluss J, Lidzba K. Cognitive and academic profiles in children with cerebral palsy: A narrative review. Ann Phys Rehabil Med 2020; 63:447-456. [DOI: 10.1016/j.rehab.2020.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/11/2020] [Accepted: 01/29/2020] [Indexed: 12/19/2022]
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Early Brain Damage Affects Body Schema and Person Perception Abilities in Children and Adolescents with Spastic Diplegia. Neural Plast 2019; 2019:1678984. [PMID: 31531012 PMCID: PMC6721097 DOI: 10.1155/2019/1678984] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/24/2019] [Indexed: 11/17/2022] Open
Abstract
Early brain damage leading to cerebral palsy is associated to core motor impairments and also affects cognitive and social abilities. In particular, previous studies have documented specific alterations of perceptual body processing and motor cognition that are associated to unilateral motor deficits in hemiplegic patients. However, little is known about spastic diplegia (SpD), which is characterized by motorial deficits involving both sides of the body and is often associated to visuospatial, attentional, and social perception impairments. Here, we compared the performance of a sample of 30 children and adolescents with SpD (aged 7-18 years) and of a group of age-matched controls with typical development (TD) at two different tasks tapping on body representations. In the first task, we tested visual and motor imagery abilities as assessed, respectively, by the object-based mental rotation of letters and by the first-person transformations for whole-body stimuli. In the second task, we administered an inversion effect/composite illusion task to evaluate the use of configural/holistic processing of others' body. Additionally, we assessed social perception abilities in the SpD sample using the NEPSY-II battery. In line with previously reported visuospatial deficits, a general mental imagery impairment was found in SpD patients when they were engaged in both object-centered and first-person mental transformations. Nevertheless, a specific deficit in operating an own-body transformation emerged. As concerns body perception, while more basic configural processing (i.e., inversion effect) was spared, no evidence for holistic (i.e., composite illusion) body processing was found in the SpD group. NEPSY-II assessment revealed that SpD children were impaired in both the theory of mind and affect recognition subtests. Overall, these findings suggested that early brain lesions and biased embodied experience could affect higher-level motor cognition and perceptual body processing, thus pointing to a strict link between motor deficits, body schema alterations, and person processing difficulties.
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Laporta-Hoyos O, Ballester-Plané J, Leiva D, Ribas T, Miralbell J, Torroja-Nualart C, Russi ME, Toro-Tamargo E, Meléndez-Plumed M, Gimeno F, Macaya A, Pueyo R. Executive function and general intellectual functioning in dyskinetic cerebral palsy: Comparison with spastic cerebral palsy and typically developing controls. Eur J Paediatr Neurol 2019; 23:546-559. [PMID: 31202597 DOI: 10.1016/j.ejpn.2019.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 11/17/2022]
Abstract
AIM To comprehensively describe intellectual and executive functioning (EF) in people with dyskinetic cerebral palsy (DCP), by comparing their performance with that of: 1) age- and sex-matched typically developing controls (TDC); and 2) participants with spastic cerebral palsy (SCP) matched for age, sex, term/preterm and gross motor function classification system (GMFCS). METHOD This cross-sectional study was conducted by the University of Barcelona in collaboration with five institutions. Participants were people with DCP (n = 52; 24 females, median age 20.5 y: 5mo, interquartile range [IQR] = 13.75 y: 7mo; GMFCS I-V). As comparison groups, participants with SCP (n = 20; 10 females, median age = 20.5 y: 5.5mo, IQR = 13.75 y 9mo; GMFCS I-V) and TDC (n = 52; 24 females, median age = 20 y: 4mo, IQR = 12 y 7mo) were included. Intelligence and EF were assessed using common tests in all participants. RESULTS Both CP groups had lower intelligence than TDC and performed poorer in almost all EF tasks. Intelligence was higher in DCP than SCP (z = -2.51, p = 0.01). Participants with DCP also performed significantly better in goal-setting tasks (z = 2.27, p = 0.03) and information processing (z = -2.54, p = 0.01) than those with SCP. CONCLUSION People with DCP present lower general intellectual functioning and poorer EF across multiple domains than typically developing controls. People with DCP have higher general intellectual functioning and better EF than people with SCP when levels of motor severity are similar.
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Affiliation(s)
- Olga Laporta-Hoyos
- Institut de Neurociències, Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Júlia Ballester-Plané
- Institut de Neurociències, Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
| | - Teresa Ribas
- Institut de Neurociències, Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
| | - Júlia Miralbell
- Institut de Neurociències, Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
| | - Clara Torroja-Nualart
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
| | - Maria Eugenia Russi
- Servei de Neurologia, Hospital Universitari Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Esther Toro-Tamargo
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Mar Meléndez-Plumed
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Francisca Gimeno
- Serveis de Salut i Rehabilitació, Associació de la Paràlisi Cerebral (ASPACE), Camí Tres Pins 31-35, 08038, Barcelona, Spain
| | - Alfons Macaya
- Grup de Recerca en Neurologia Pediàtrica, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Roser Pueyo
- Institut de Neurociències, Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.
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Kavlak E, Tekin F. Examining various factors affecting communication skills in children with cerebral palsy. NeuroRehabilitation 2019; 44:161-173. [PMID: 30856125 DOI: 10.3233/nre-182580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Cerebral palsied children may have difficulties in acting as senders and/or receivers in the communication process. The aim of this study is examining that which maternal and child-related factors affect the communication skills of cerebral palsied children. METHODS 188 cerebral palsy diagnosed children ages between 2-18 years were assessed by Communication Function Classification System for communication skills. Maternal factors such as occupation, and educational status, and child-related factors such as gender, time of birth, clinical type of cerebral palsy, origin period of cerebral palsy; also daily living activities and gross motor functions of children were included in the assessment for examining how they affect the communication skills of cerebral palsied children. RESULTS Lower maternal age, higher gross motor function level, ataxic type and hemiparetic involvement (p < 0,05); educational status, maternal unemployment, female gender, and premature birth (p > 0,05) affected positively on the communication skills. There were no effects of delivery method (p > 0,05). CONCLUSIONS Communication skills of cerebral palsied children are affected by maternal age, educational status, occupation, and child's gender, birth term, origin period of cerebral palsy, clinical type of cerebral palsy, extremity involvement, motor development level and gross motor function. But the method of delivery has no effect on the communication functions of cerebral palsied children.
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Affiliation(s)
- Erdoğan Kavlak
- Pamukkale University School of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Fatih Tekin
- Pamukkale University School of Physical Therapy and Rehabilitation, Denizli, Turkey
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Reid SM, Meehan EM, Arnup SJ, Reddihough DS. Intellectual disability in cerebral palsy: a population-based retrospective study. Dev Med Child Neurol 2018; 60:687-694. [PMID: 29667705 DOI: 10.1111/dmcn.13773] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2018] [Indexed: 11/26/2022]
Abstract
AIM A population-based observational study design was used to describe the epidemiology of intellectual disability in cerebral palsy (CP) in terms of clinical and neuroimaging associations, and to report the impact of intellectual disability on utilization of health services and length of survival. METHOD Population CP registry data were used to retrospectively assess the frequency of intellectual disability and strength of associations between intellectual disability and mobility, epilepsy, vision, hearing, communication, and neuroimaging patterns (n=1141). Data linkage was undertaken to assess usage of hospital inpatient and emergency department services. Survival analysis was performed in a 30-year birth cohort (n=3248). RESULTS Intellectual disability, present in 45% of the cohort, was associated with non-ambulation (47% vs 8%), later walking (mean 2y 7mo vs 1y 9mo), hypotonic (8% vs 1%) or dyskinetic (9% vs 5%) CP, a quadriplegic pattern of motor impairment (42% vs 5%), epilepsy (52% vs 12%), more emergency and multi-day hospital admissions, and reduced 35-year survival (96% vs 71%). Grey matter injuries (13% vs 6%), malformations (18% vs 6%), and miscellaneous neuroimaging patterns (12% vs 4%) were more common in people with intellectual disability. INTERPRETATION Intellectual disability adds substantially to the overall medical complexity in CP and may increase health and mortality disparities. WHAT THIS STUDY ADDS Cerebral maldevelopments and grey matter injuries are associated with higher intellectual disability rates. Health care is more 'crisis-driven' and 'reactive' in children with co-occurring intellectual disability. Length of survival is reduced in individuals with CP and co-occurring intellectual disability.
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Affiliation(s)
- Susan M Reid
- Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Elaine M Meehan
- Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Sarah J Arnup
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Dinah S Reddihough
- Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Victoria, Australia
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15
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Schölderle T, Staiger A, Ziegler W. The feasibility of assessing speech and non-speech function of the speech apparatus in adults with cerebral palsy. CLINICAL LINGUISTICS & PHONETICS 2018; 32:876-887. [PMID: 29580108 DOI: 10.1080/02699206.2018.1455224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This short note reports on observations concerning the feasibility of a set of speech and non-speech assessment tasks in an investigation of dysarthria in 21 adults (15 males/6 females; median 23 years) with cerebral palsy and concomitant cognitive impairment. The participants were assessed with nine tasks representing standard components of clinical dysarthria assessment (i.e. six speech and three non-speech tasks). The tasks were evaluated for their feasibility on the basis of common clinical criteria. Our results indicated that, overall, speech tasks were more feasible than non-speech tasks. Several participants showed signs of dysexecutive behaviour on some of the non-speech tasks, but not on the speech tasks. The current note provides tentative clues regarding the impact of cognitive deficits on the feasibility of assessment tasks in the diagnosis of dysarthria.
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Affiliation(s)
- Theresa Schölderle
- a Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing , Ludwig-Maximilians-University , Munich , Germany
| | - Anja Staiger
- a Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing , Ludwig-Maximilians-University , Munich , Germany
| | - Wolfram Ziegler
- a Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing , Ludwig-Maximilians-University , Munich , Germany
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Abstract
PURPOSE To explore factors contributing to variability in cognitive functioning in children with cerebral palsy (CP). METHOD A geographical cohort of 70 children with CP was assessed with tests of language comprehension, visual-spatial reasoning, attention, working memory, memory, and executive functioning. Mean age was 9;9 years (range 5;1-17;7), 54.3% were girls, and 50.0% had hemiplegic, 25.7% diplegic, 12.9% quadriplegic, and 11.4% dyskinetic CP. For the participants with severe motor impairments, assessments were adapted for gaze pointing. A cognitive quotient (CQ) was computed. RESULTS Mean CQ was 78.5 (range 19-123). Gross motor functioning, epilepsy, and type of brain injury explained 35.5% of the variance in CQ (F = 10.643, p = .000). CONCLUSION Twenty-four percent had an intellectual disability, most of them were children with quadriplegic CP. Verbal comprehension and perceptual reasoning scores did only differ for the 21% with an uneven profile, of whom two-thirds had challenges with perceptual reasoning.
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Affiliation(s)
- Kristine Stadskleiv
- a Department of Clinical Neurosciences for Children, Oslo University Hospital , Oslo , Norway
| | - Reidun Jahnsen
- a Department of Clinical Neurosciences for Children, Oslo University Hospital , Oslo , Norway.,b Department of Research, Sunnaas Rehabilitation Hospital , Nesodden , Norway
| | - Guro L Andersen
- c Vestfold Hospital Trust, The Cerebral Palsy Register of Norway , Tønsberg , Norway.,d Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
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17
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Cognitive functioning in dyskinetic cerebral palsy: Its relation to motor function, communication and epilepsy. Eur J Paediatr Neurol 2018; 22:102-112. [PMID: 29108712 DOI: 10.1016/j.ejpn.2017.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/25/2017] [Accepted: 10/15/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cerebral palsy (CP) is a disorder of motor function often accompanied by cognitive impairment. There is a paucity of research focused on cognition in dyskinetic CP and on the potential effect of related factors. AIM To describe the cognitive profile in dyskinetic CP and to assess its relationship with motor function and associated impairments. METHOD Fifty-two subjects with dyskinetic CP (28 males, mean age 24 y 10 mo, SD 13 y) and 52 typically-developing controls (age- and gender-matched) completed a comprehensive neuropsychological assessment. Gross Motor Function Classification System (GMFCS), Communication Function Classification System (CFCS) and epilepsy were recorded. Cognitive performance was compared between control and CP groups, also according different levels of GMFCS. The relationship between cognition, CFCS and epilepsy was examined through partial correlation coefficients, controlling for GMFCS. RESULTS Dyskinetic CP participants performed worse than controls on all cognitive functions except for verbal memory. Milder cases (GMFCS I) only showed impairment in attention, visuoperception and visual memory. Participants with GMFCS II-III also showed impairment in language-related functions. Severe cases (GMFCS IV-V) showed impairment in intelligence and all specific cognitive functions but verbal memory. CFCS was associated with performance in receptive language functions. Epilepsy was related to performance in intelligence, visuospatial abilities, visual memory, grammar comprehension and learning. CONCLUSION Cognitive performance in dyskinetic CP varies with the different levels of motor impairment, with more cognitive functions impaired as motor severity increases. This study also demonstrates the relationship between communication and epilepsy and cognitive functioning, even controlling for the effect of motor severity.
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Inuggi A, Bassolino M, Tacchino C, Pippo V, Bergamaschi V, Campus C, De Franchis V, Pozzo T, Moretti P. Ipsilesional functional recruitment within lower mu band in children with unilateral cerebral palsy, an event-related desynchronization study. Exp Brain Res 2017; 236:517-527. [DOI: 10.1007/s00221-017-5149-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 12/08/2017] [Indexed: 12/24/2022]
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Gonnade N, Lokhande V, Ajij M, Gaur A, Shukla K. Phenol Versus Botulinum Toxin A Injection in Ambulatory Cerebral Palsy Spastic Diplegia: A Comparative Study. J Pediatr Neurosci 2017; 12:338-343. [PMID: 29675072 PMCID: PMC5890553 DOI: 10.4103/jpn.jpn_123_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of this study is to compare the treatment effectiveness of botulinum toxin type A (BTX-A) and phenol blocks in the management of lower limb spasticity and to measure improvement in gross motor functional outcome in children with cerebral palsy (CP). This is a hospital-based prospective, noncontrolled randomized study that took place in a tertiary care center. A total of 61 ambulatory children with CP spastic diplegia, aged from 4 to 10 years, were randomly divided into two groups and included in this study. Twenty-eight children with CP received BTX-A injections and 33 received phenol motor point blocks. The measures performed were as follows: outcome assessment spasticity by the Modified Ashworth scale (MAS), active range of motion (AROM) of lower limb joint by goniometer, and functional improvement by Gross Motor Function Measures (GMFM). Postinjection follow-up done at 2, 6, 12, 24, and 48 weeks. Significant improvement in reduction of spasticity, increased AROM of all joints of lower limbs, and improvement in functional outcome were observed in CP with spastic diplegia after BTX-A injections as compared with the phenol motor point block group. There was no significant side effect after BTX-A injections as compared with phenol injections. BTX-A injections showed superior treatment effects in the reduction of spasticity and improvement in AROM and functional outcome measures with spastic diplegia as compared with phenol blocks. BTX-A injections also revealed fewer clinical side effects and were well tolerated by children with CP.
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Affiliation(s)
- Nitesh Gonnade
- Assistant Professor in Physical Medicine and Rehabilitation, All India Institute of Medical sciences, Jodhpur, Rajasthan, India
| | - Vaibhav Lokhande
- Senior resident in Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mohammed Ajij
- Department of Paediatrics, Sawai Mansingh Medical college, Jaipur, Rajasthan, India
| | - Anil Gaur
- Director of All India Institute of Physical Medicine and Rehabilitation, Mumbai, India
| | - Kamalakant Shukla
- Assistant Professor, Departments of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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20
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Lee D, Pae C, Lee JD, Park ES, Cho SR, Um MH, Lee SK, Oh MK, Park HJ. Analysis of structure-function network decoupling in the brain systems of spastic diplegic cerebral palsy. Hum Brain Mapp 2017; 38:5292-5306. [PMID: 28731515 DOI: 10.1002/hbm.23738] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/08/2017] [Accepted: 07/13/2017] [Indexed: 12/13/2022] Open
Abstract
Manifestation of the functionalities from the structural brain network is becoming increasingly important to understand a brain disease. With the aim of investigating the differential structure-function couplings according to network systems, we investigated the structural and functional brain networks of patients with spastic diplegic cerebral palsy with periventricular leukomalacia compared to healthy controls. The structural and functional networks of the whole brain and motor system, constructed using deterministic and probabilistic tractography of diffusion tensor magnetic resonance images and Pearson and partial correlation analyses of resting-state functional magnetic resonance images, showed differential embedding of functional networks in the structural networks in patients. In the whole-brain network of patients, significantly reduced global network efficiency compared to healthy controls were found in the structural networks but not in the functional networks, resulting in reduced structural-functional coupling. On the contrary, the motor network of patients had a significantly lower functional network efficiency over the intact structural network and a lower structure-function coupling than the control group. This reduced coupling but reverse directionality in the whole-brain and motor networks of patients was prominent particularly between the probabilistic structural and partial correlation-based functional networks. Intact (or less deficient) functional network over impaired structural networks of the whole brain and highly impaired functional network topology over the intact structural motor network might subserve relatively preserved cognitions and impaired motor functions in cerebral palsy. This study suggests that the structure-function relationship, evaluated specifically using sparse functional connectivity, may reveal important clues to functional reorganization in cerebral palsy. Hum Brain Mapp 38:5292-5306, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Dongha Lee
- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.,BK21 PLUS Project for Medical Science, Korea
| | - Chongwon Pae
- BK21 PLUS Project for Medical Science, Korea.,Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Doo Lee
- Department of Radiology and Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea
| | - Eun Sook Park
- Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung-Rae Cho
- Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min-Hee Um
- BK21 PLUS Project for Medical Science, Korea
| | - Seung-Koo Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Maeng-Keun Oh
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae-Jeong Park
- BK21 PLUS Project for Medical Science, Korea.,Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Cognitive Science, Yonsei University, Seoul, Republic of Korea.,Center for Systems and Translational Brain Sciences, Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea
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21
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Kurmanaviciute R, Stadskleiv K. Assessment of verbal comprehension and non-verbal reasoning when standard response mode is challenging: A comparison of different response modes and an exploration of their clinical usefulness. COGENT PSYCHOLOGY 2017. [DOI: 10.1080/23311908.2016.1275416] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Ramune Kurmanaviciute
- Labour and Service Department, Norwegian Labour and Welfare Organisation (NAV), P.O. 308, Alnabru, N-0614 Oslo, Norway
| | - Kristine Stadskleiv
- Department of Child Neurology, Oslo University Hospital, PO 4956, Nydalen, N–0424 Oslo, Norway
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22
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M Piovesana A, Ross S, Lloyd O, Whittingham K, Ziviani J, Ware RS, Boyd RN. Randomized controlled trial of a web-based multi-modal therapy program for executive functioning in children and adolescents with unilateral cerebral palsy. Disabil Rehabil 2016; 39:2021-2028. [PMID: 27665941 DOI: 10.1080/09638288.2016.1213899] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose state: Determine the efficacy of Move-it-to-improve-it (Mitii™), a multi-modal web-based program, in improving Executive Function (EF) in children with unilateral cerebral palsy (UCP). METHOD Participants (n = 102) were matched in pairs then randomized to: intervention (Mitii™ for 20 weeks; n = 51; 26 males; mean age = 11 years 8 months (SD = 2 years 4 months); Full Scale IQ = 84.65 (SD = 15.19); 28 left UCP; GMFCS-E&R (I = 20, II = 31) or waitlist control (n = 50; 25 males; mean age = 11 years 10 months (SD = 2 years 5 months); Full Scale IQ = 80.75 (SD = 19.81); 20 left UCP; GMFCS-E&R (I = 25, II = 25). Mitii™ targeted working memory (WM), visual processing (VP), upper limb co-ordination and physical activity. EF capacity was assessed: attentional control (DSB; WISC-IV); cognitive flexibility (inhibition and number-letter sequencing DKEFS); goal setting (D-KEFs Tower Test); and information processing (WISC-IV Symbol Search and Coding). EF performance was assessed via parent report (BRIEF). Groups were compared at 20 weeks using linear regression (SPSS 21). RESULTS There were no significant between group differences in attentional control (DSB; p = 0.20;CI= -0.40,1.87); cognitive flexibility (Inhibition, p = 0.34; CI= -0.73,2.11; number/letter sequencing, p = 0.17; CI= -0.55,2.94); problem solving (Tower; p = 0.28; CI= -0.61,2.09), information processing (Symbol; p = 0.08; CI= -0.16, 2.75; Coding; p = 0.07; CI= -0.12,2.52) or EF performance (p = 0.13; CI= -10.04,1.38). CONCLUSION In a large RCT, MitiiTM did not lead to significant improvements on measures of EF or parent ratings of EF performance in children with UCP. Implications for rehabilitation A large RCT of the multi-modal web based training; Move It to Improve It (MitiiTM) improves motor processing, visual perception, and physical capacity but does demonstrate statistically significant improvements or clinical significance in executive function in children with mild to moderate unilateral cerebral palsy (UCP). MitiiTM training completed by an intervention group was highly variable with few children reaching the target dosage of 60 h. Technical issues including server and internet connectively problems lead to disengagement with the program. Web-based training delivered in the home has the potential to increase therapy dose and accessibility, however, MitiiTM needs to be tailored to include tasks involving goal-setting, more complex problem solving using multi-dimensional strategies, mental flexibility, switching between two cognitively demanding tasks, and greater novelty in order to increase the cognitive component and challenge required to drive changes in EF.
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Affiliation(s)
- Adina M Piovesana
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
| | - Stephanie Ross
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
| | - Owen Lloyd
- b Queensland Paediatric Rehabilitation Service , Children's Health Queensland , South Brisbane , QLD , Australia
| | - Koa Whittingham
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
| | - Jenny Ziviani
- c Children's Applied Health Research , Queensland Health , Brisbane , QLD , Australia.,d School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , QLD , Australia
| | - Robert S Ware
- e School of Population Health , The University of Queensland , Brisbane , QLD , Australia.,f Queensland Children's Medical Research Institute, The University of Queensland , Brisbane , QLD , Australia
| | - Roslyn N Boyd
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland, Centre for Children's Health Research , South Brisbane , QLD , Australia
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23
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Gosling AS. Recent advances in the neuroimaging and neuropsychology of cerebral palsy. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:55-63. [DOI: 10.1080/21622965.2015.1074914] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Delacy MJ, Reid SM. Profile of associated impairments at age 5 years in Australia by cerebral palsy subtype and Gross Motor Function Classification System level for birth years 1996 to 2005. Dev Med Child Neurol 2016; 58 Suppl 2:50-6. [PMID: 26777873 DOI: 10.1111/dmcn.13012] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 11/30/2022]
Abstract
AIM To describe the distribution of impairments among persons with cerebral palsy (CP) in a large Australian cohort. METHOD Records of persons on the Australian Cerebral Palsy Register (ACPR) (n=3466) born from 1996 to 2005 were reviewed to extract year of birth, sex, CP subtype, Gross Motor Function Classification System (GMFCS) level, and impairments in vision, hearing, speech, intellect, and epilepsy. The distributions of GMFCS levels and CP subtype were plotted, and the proportions of each level of impairment were tabulated and presented as stacked graphs within the GMFCS and CP subtype distributions. RESULTS The proportions of persons with CP with each associated impairment increased with increasing GMFCS level. Compared with other spastic CP subtypes, individuals with spastic quadriplegia had higher frequencies of all associated impairments. Other than epilepsy, which was most prevalent in persons with spastic quadriplegia (53%), all impairments were most frequent in non-spastic CP subtypes. Hearing impairment was recorded for 21% of persons with dyskinesia whereas the hypotonic subtype had the highest prevalence of visual impairment (57%), intellectual impairment (90%), and speech impairment (95%). INTERPRETATION Distributions of associated impairments across all GMFCS levels and CP subtypes in a large cohort are presented in formats suitable for clinical use and discussion with families.
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Affiliation(s)
- Michael J Delacy
- Queensland Cerebral Palsy Register, CPL - Choice, Passion, Life, Brisbane, QLD, Australia
| | - Susan M Reid
- Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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Sherwell S, Reid SM, Reddihough DS, Wrennall J, Ong B, Stargatt R. Measuring intellectual ability in children with cerebral palsy: can we do better? RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2558-2567. [PMID: 25005064 DOI: 10.1016/j.ridd.2014.06.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 06/11/2014] [Accepted: 06/19/2014] [Indexed: 06/03/2023]
Abstract
Standard intelligence tests such as the WPPSI-III have limitations when testing children with motor impairment. This study aimed to determine the proportion of children with cerebral palsy with sufficient verbal and motor skills to complete the WPPSI-III, to determine their comparative ability to complete tasks with and without a significant motor component, and to investigate short forms of the WPPSI-III as alternatives. Participants were 78 of 235 eligible 4-5 year old children with cerebral palsy resident in the Australian state of Victoria. Verbal IQ (VIQ), Performance IQ (PIQ), and Full-scale IQ (FSIQ) were determined using the WPPSI-III. Initial screening for pointing and verbal abilities determined which tests were attempted. The impact of speed was investigated by comparing scores on the Block Design subtest with and without an imposed time limit. FSIQ scores were calculated from two short forms of the WPPSI-III and compared to the full form. On screening, 16 children had inadequate pointing (14) and verbal abilities (2). FSIQ was obtained in 62 (82%) children. Strong associations were seen between completion of the entire test battery and topographical pattern, level of manual ability and level of gross motor function. Scores on subtests requiring manual ability were depressed relative to other scores. Children performed better using short forms of the WPPSI-III and, for a minority, when time limits were disregarded. In summary, children with cerebral palsy often lack the fine and gross motor skills necessary to complete the WPPSI-III, scoring relatively poorly on tasks requiring a fine motor response. Using short-form estimations of FSIQ comprised of subtests without a significant fine motor component has the potential to increase a child's FSIQ by approximately 5 points. These findings have important clinical implications when assessing a child with both motor and cognitive limitations.
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Affiliation(s)
- Sarah Sherwell
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Psychological Science, LaTrobe University, Melbourne, Australia
| | - Susan M Reid
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia.
| | - Dinah S Reddihough
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia; Department of Developmental Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Jacquie Wrennall
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
| | - Ben Ong
- Psychological Science, LaTrobe University, Melbourne, Australia
| | - Robyn Stargatt
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Psychological Science, LaTrobe University, Melbourne, Australia
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Gofer-Levi M, Silberg T, Brezner A, Vakil E. Cognitive procedural learning among children and adolescents with or without spastic cerebral palsy: the differential effect of age. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1952-1962. [PMID: 24858793 DOI: 10.1016/j.ridd.2014.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 04/02/2014] [Accepted: 04/09/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Children learn to engage their surroundings skillfully, adopting implicit knowledge of complex regularities and associations. Probabilistic classification learning (PCL) is a type of cognitive procedural learning in which different cues are probabilistically associated with specific outcomes. Little is known about the effects of developmental disorders on cognitive skill acquisition. METHODS Twenty-four children and adolescents with cerebral palsy (CP) were compared to 24 typically developing (TD) youth in their ability to learn probabilistic associations. Performance was examined in relation to general cognitive abilities, level of motor impairment and age. RESULTS Improvement in PCL was observed for all participants, with no relation to IQ. An age effect was found only among TD children. CONCLUSIONS Learning curves of children with CP on a cognitive procedural learning task differ from those of TD peers and do not appear to be age sensitive.
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Affiliation(s)
- M Gofer-Levi
- The Department of Psychology, Bar Ilan University, Ramat-Gan 52900, Israel.
| | - T Silberg
- The Department of Psychology, Bar Ilan University, Ramat-Gan 52900, Israel; The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
| | - A Brezner
- The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
| | - E Vakil
- The Department of Psychology, Bar Ilan University, Ramat-Gan 52900, Israel.
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Van Rooijen M, Verhoeven L, Smits DW, Dallmeijer AJ, Becher JG, Steenbergen B. Cognitive precursors of arithmetic development in primary school children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:826-832. [PMID: 24529861 DOI: 10.1016/j.ridd.2014.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 01/13/2014] [Accepted: 01/17/2014] [Indexed: 06/03/2023]
Abstract
The aim of this study was to examine the development of arithmetic performance and its cognitive precursors in children with CP from 7 till 9 years of age. Previous research has shown that children with CP are generally delayed in arithmetic performance compared to their typically developing peers. In children with CP, the developmental trajectory of the ability to solve addition- and subtraction tasks has, however, rarely been studied, as well as the cognitive factors affecting this trajectory. Sixty children (M=7.2 years, SD=.23 months at study entry) with CP participated in this study. Standardized tests were administered to assess arithmetic performance, word decoding skills, non-verbal intelligence, and working memory. The results showed that the ability to solve addition- and subtraction tasks increased over a two year period. Word decoding skills were positively related to the initial status of arithmetic performance. In addition, non-verbal intelligence and working memory were associated with the initial status and growth rate of arithmetic performance from 7 till 9 years of age. The current study highlights the importance of non-verbal intelligence and working memory to the development of arithmetic performance of children with CP.
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Affiliation(s)
- M Van Rooijen
- Radboud University Nijmegen, Behavioural Science Institute, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
| | - L Verhoeven
- Radboud University Nijmegen, Behavioural Science Institute, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
| | - D W Smits
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| | - A J Dallmeijer
- Department of Rehabilitation Medicine, VU University Medical Center, Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
| | - J G Becher
- Department of Rehabilitation Medicine, VU University Medical Center, Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
| | - B Steenbergen
- Radboud University Nijmegen, Behavioural Science Institute, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
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Luttikhuizen dos Santos ES, de Kieviet JF, Königs M, van Elburg RM, Oosterlaan J. Predictive value of the Bayley scales of infant development on development of very preterm/very low birth weight children: a meta-analysis. Early Hum Dev 2013; 89:487-96. [PMID: 23597678 DOI: 10.1016/j.earlhumdev.2013.03.008] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/17/2013] [Accepted: 03/19/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS The Bayley scales of infant development (BSID) is the most widely used measure to assess neurodevelopment of very preterm (gestational age ≤32 weeks) and very low birth weight (VLBW, ≤1500 g) infants in the first three years of life. This meta-analysis determines the predictive value of the mental developmental index (MDI) and the psychomotor developmental index (PDI)/motor composite, collectively referred to as Bayley motor scale, of the BSID-I, -II and Bayley-III for later cognitive and motor functioning in very preterm/VLBW children. METHODS Cochrane Library, PubMed, PsychINFO and CINAHL were searched for English-language peer-reviewed studies published before March 2013. Studies were included if they reported odds ratios or correlations between the MDI or Bayley motor scale scores obtained in the first three years of life, and standardized cognitive or motor assessment obtained later in life in very preterm/VLBW children. Meta-analytic methods were applied to aggregate available data. RESULTS A total of 16 studies met inclusion criteria. Across 14 studies (n=1330 children), MDI scores were strongly predictive for later cognitive functioning, r=0.61 (95% CI: 0.57-0.64), explained variance 37%, p<.001. The relationship between MDI scores and later cognitive function was not mediated by birth weight (p=.56), gestational age (p=.70), and time interval between assessments (p=.55). Across five studies (n=555 children), Bayley motor scale scores were moderately predictive for later motor function, r=0.34 (95% CI: 0.26-0.42), explained variance 12%, p<.001. CONCLUSIONS In very preterm/VLBW children, MDI scores explain 37% of the variance in later cognitive functioning, whereas Bayley motor scale scores explain 12% of later motor function. Thus a large proportion of the variance remains unexplained, underlining the importance of enhancing prediction of developmental delay in very preterm children.
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Kwon TG, Yi SH, Kim TW, Chang HJ, Kwon JY. Relationship between gross motor function and daily functional skill in children with cerebral palsy. Ann Rehabil Med 2013; 37:41-9. [PMID: 23525125 PMCID: PMC3604233 DOI: 10.5535/arm.2013.37.1.41] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 09/03/2012] [Indexed: 12/05/2022] Open
Abstract
Objective To investigate the relationship between gross motor function and daily functional skill in children with cerebral palsy (CP) and to explore how this relationship is moderated by the Gross Motor Function Classification System, Bimanual Fine Motor Function (BFMF), neuromotor types, and limb distribution of CP. Methods A cross-sectional survey of 112 children with CP (range, 4 years to 7 years and 7 months) was performed. Gross motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66) and functional skill was assessed with the Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS). Results GMFM-66 scores explained 49.7%, 67.4%, and 26.1% of variance in the PEDI-FSS scores in the self-care, mobility, and social function domains, respectively. Significant moderation by the distribution of palsy and BFMF classification levels II, III, and IV was found in the relationship between GMFM-66 and PEDI-FSS self-care. Further significant moderation by the distribution of palsy was also observable in the relationship between GMFM-66 and PEDI-FSS mobility. Conclusion These findings suggest that limb distribution and hand function must be considered when evaluating gross motor function and functional skills in children with CP, especially in unilateral CP.
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Affiliation(s)
- Tae Gun Kwon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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30
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van Rooijen M, Verhoeven L, Smits DW, Ketelaar M, Becher JG, Steenbergen B. Arithmetic performance of children with cerebral palsy: the influence of cognitive and motor factors. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:530-537. [PMID: 22119702 DOI: 10.1016/j.ridd.2011.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 10/25/2011] [Accepted: 10/25/2011] [Indexed: 05/31/2023]
Abstract
Children diagnosed with cerebral palsy (CP) often show difficulties in arithmetic compared to their typically developing peers. The present study explores whether cognitive and motor variables are related to arithmetic performance of a large group of primary school children with CP. More specifically, the relative influence of non-verbal intelligence, working memory, word decoding capacities, gross- and fine motor skills on arithmetic performance is examined using structural equation modeling. One-hundred sixteen primary school children with a formal diagnosis of CP participated (76 males, M = 7; 3 years, SD = 3 months). In agreement with previous studies our results showed that the cognitive and motor predictors were all positively correlated to each other. Furthermore, in the cognitive model, non-verbal intelligence and word decoding were related to arithmetic in primary school. Our combined model (that included both motor and cognitive variables) showed that word decoding and fine motor skills were the strongest predictors of arithmetic performance. To conclude, this study was the first to show the influence of word decoding and fine motor skills on arithmetic performance of children with CP.
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Affiliation(s)
- Maaike van Rooijen
- Radboud University Nijmegen, Behavioural Science Institute, PO Box 9104, 6500 HE Nijmegen, The Netherlands.
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Yoshida S, Hayakawa K, Oishi K, Mori S, Kanda T, Yamori Y, Yoshida N, Hirota H, Iwami M, Okano S, Matsushita H. Athetotic and Spastic Cerebral Palsy: Anatomic Characterization Based on Diffusion-Tensor Imaging. Radiology 2011; 260:511-20. [DOI: 10.1148/radiol.11101783] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pirila S, van der Meere JJ, Rantanen K, Jokiluoma M, Eriksson K. Executive functions in youth with spastic cerebral palsy. J Child Neurol 2011; 26:817-21. [PMID: 21398561 DOI: 10.1177/0883073810392584] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dependent on criteria used, between 35% and 53% of the participants with cerebral palsy fulfilled the criteria of clinically relevant executive function problems as defined by Conners' (1994) Continuous Performance Test. Executive function problems were noticed mainly in participants with bilateral brain lesions and who had been born preterm. Findings highlight the need to check for attention problems in children with cerebral palsy.
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Affiliation(s)
- Silja Pirila
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
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33
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Erickson SJ, Montague EQ, Gerstle MA. Health-related quality of life in children with moderate-to-severe traumatic brain injury. Dev Neurorehabil 2010; 13:175-81. [PMID: 20450467 DOI: 10.3109/17518420903479867] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate health-related quality of life (HRQOL) in a sample of ethnically diverse children with traumatic brain injury (TBI). METHODS Twenty children with moderate-severe TBI and their parents were recruited from a TBI clinic at a paediatric rehabilitation hospital. Children's self-reported HRQOL was assessed with the Pediatric Quality of Life Inventory. Parents completed a parallel proxy measure. RESULTS Children reported significantly lower Psychosocial HRQOL compared to their Total HRQOL, driven largely by low School HRQOL scores. Compared to other paediatric populations, children with TBI reported lower or equivalent HRQOL. Compared with children's self-reports, parents reported even lower HRQOL for their children across primary domains, with fair-to-moderate convergence between informants. CONCLUSIONS Results provide preliminary evidence that children who have suffered moderate-severe TBI experience relatively poor HRQOL, particularly in the School domain. Limited convergence between informants suggests that children and parents perceive HRQOL differently, with parents reporting lower HRQOL.
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Affiliation(s)
- Sarah J Erickson
- University of New Mexico, Department of Psychology, 1 UNM, MSC03 2220, Albuquerque, NM 87131, USA.
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Asbell S, Donders J, Van Tubbergen M, Warschausky S. Predictors of reading comprehension in children with cerebral palsy and typically developing children. Child Neuropsychol 2010; 16:313-25. [PMID: 20455127 DOI: 10.1080/09297041003733588] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Predictors of reading comprehension were evaluated in 41 children with cerebral palsy and 74 typically developing children between the ages of 6 and 12 years. Regression analyses were conducted to determine the relative contributions of measures of phonemic awareness, receptive vocabulary, and general reasoning to variance in reading comprehension. All three independent variables were statistically significant predictors of reading comprehension in both groups of participants. The impact of phonemic awareness on reading comprehension was moderated by age, but only in the typically developing group. Within the group with cerebral palsy, there was an indirect effect of functional expressive ability on reading comprehension, mediated by phonemic awareness. It is concluded that largely the same variables predict reading comprehension in children with cerebral palsy as in typically developing children, but that children with cerebral palsy continue to rely on phonological processing for a more protracted period of time.
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Affiliation(s)
- Shana Asbell
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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35
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Pruitt DW, Tsai T. Common medical comorbidities associated with cerebral palsy. Phys Med Rehabil Clin N Am 2009; 20:453-67. [PMID: 19643347 DOI: 10.1016/j.pmr.2009.06.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The medical issues associated with the diagnosis of cerebral palsy (CP) can have significant interplay with the neuromuscular issues that most physiatrists manage in the clinical setting. Identification and appropriate management of these common comorbidities by the primary care and subspecialist physicians can have significant impact on the quality of life of the patient and family. Some of these issues are prevalent across all gross motor function classification system (GMFCS) levels of severity, whereas others more commonly complicate the care of those children with the more severe GMFCS levels IV and V. Performance of a complete review of systems to address the potentially complex medical comorbidities and subsequent application of appropriate screening tools can assist in achieving optimal outcomes in children with CP and their families.
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Affiliation(s)
- David W Pruitt
- Division of Pediatric Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
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36
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Pakula AT, Van Naarden Braun K, Yeargin-Allsopp M. Cerebral Palsy: Classification and Epidemiology. Phys Med Rehabil Clin N Am 2009; 20:425-52. [DOI: 10.1016/j.pmr.2009.06.001] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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37
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Butcher PR, van Braeckel K, Bouma A, Einspieler C, Stremmelaar EF, Bos AF. The quality of preterm infants' spontaneous movements: an early indicator of intelligence and behaviour at school age. J Child Psychol Psychiatry 2009; 50:920-30. [PMID: 19457048 DOI: 10.1111/j.1469-7610.2009.02066.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-term age is a powerful predictor of their later neurological status. This study investigated whether early spontaneous movements also have predictive value for the intellectual and behavioural problems that children born very preterm often experience. METHODS Spontaneous movement quality was assessed, using Prechtl's method, at 11 to 16 weeks post-term in 65 infants born at <or= 33 weeks of gestation in a single centre. Intelligence and behaviour were assessed with standardised tests at 7 to 11 years of age. Neurological status was assessed with Touwen's test. Multiple regression was used to determine the predictive value of movement quality for intelligence and behavioural problems. The Sobel test was used to determine if neurological status mediated associations found between early movement quality and outcome. RESULTS Spontaneous movement quality at 11 to 16 weeks post-term was significantly, positively associated with later intelligence. The number of normal postural patterns displayed contributed most strongly to the association, which was not mediated by neurological status. Fidgety movements, strong predictors of later neurological dysfunction, were not associated with intelligence. Spontaneous movement quality was not associated with internalising or externalising problems but showed a trend to an association with attention problems. CONCLUSION These findings suggest that, in children born preterm, early spontaneous movement quality has clear prognostic value for neurological and intellectual outcome, and to a lesser extent, for attentional outcome. However, cognitive outcome was associated with the presence of specific, age-appropriate postural patterns, while neurological outcome has been associated with the presence of global movement abnormalities. The presence of specific, age-appropriate postural patterns may reflect the integrity of areas of the brain involved in cognitive processing and the regulation of attention later in childhood. Alternately, it may facilitate cognitive and attentional development.
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Affiliation(s)
- Phillipa R Butcher
- Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands.
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Kulak W, Sobaniec W, Smigielska-Kuzia J, Kubas B, Zawada B, Otapowicz D. An age and gender dependency of metabolite concentrations in basal ganglia in children with spastic diplegia: proton magnetic resonance spectroscopy study. J Child Neurol 2009; 24:73-9. [PMID: 18936194 DOI: 10.1177/0883073808321058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We determined metabolite profile in spastic diplegic children compared to controls in left basal ganglia of brain in using proton magnetic resonance spectroscopy in correlation with age and gender. Twenty-four patients with spastic diplegia and twenty-six healthy children were examined. The relative concentrations of N-acetylaspartate, choline, and myoinositol were measured in relation to creatine and different combinations of metabolites within 8-cm(3) brain voxel. Children with spastic diplegia showed reduced ratios of N-acetylaspartate/creatine, N-acetylaspartate/ choline, and N-acetylaspartate/myoinositol in the basal ganglia compared to the control group. Patients and controls subjects demonstrated a significant age-dependent increase in N-acetylaspartate/creatine, N-acetylaspartate/choline in the basal ganglia. No gender-dependent difference was shown in children with cerebral palsy for all tested metabolite ratios. Gender-related differences because of increased ratio N-acetylaspartate/choline in girls in controls were detected. These results indicate that maturation of brain exists in cerebral palsy and healthy children to a higher degree in healthy children.
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Affiliation(s)
- Wojciech Kulak
- Department of Pediatric Rehabilitation, Medical University of Bialystok, Bialystok, Poland.
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39
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Neurorehabilitation of children with cerebral palsy. HANDBOOK OF CLINICAL NEUROLOGY 2008. [PMID: 18809046 DOI: 10.1016/s0072-9752(07)87032-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
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40
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Nadeau L, Routhier ME, Tessier R. The performance profile on the Wisconsin Card Sorting Test of a group of children with cerebral palsy aged between 9 and 12. Dev Neurorehabil 2008; 11:134-40. [PMID: 17943502 DOI: 10.1080/17518420701688607] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to determine the performance profile of a group of children with cerebral palsy (CP) on the Wisconsin Card Sorting Test (WCST). METHODS The sample consisted of 102 children aged between 9-12, divided into two groups: the clinical group consisted of 52 children with in mainstream class (37 with hemiplegia and 15 with diplegia), while the comparison group comprised 50 children matched for class, gender, age and socioeconomic status. RESULTS The findings showed that children with CP make more non-perseverative errors, they completed fewer categories, required more trials to complete the first category and gave fewer conceptual responses than control children. Children with diplegia are distinguished more from comparison children than children with hemiplegia. CONCLUSION The results suggest a difficulty in initial conceptualization that could be attributable to a slow rate of information processing. Delayed maturation of the nervous system is likely to be implied.
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Affiliation(s)
- Line Nadeau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, Canada.
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Kulak W, Sobaniec W, Smigielska-Kuzia J, Kubas B, Walecki J. Metabolite profile in the basal ganglia of children with cerebral palsy: a proton magnetic resonance spectroscopy study. Dev Med Child Neurol 2006; 48:285-9. [PMID: 16542516 DOI: 10.1017/s0012162206000612] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2005] [Indexed: 12/21/2022]
Abstract
This prospective study determined metabolite profile in the left and right basal ganglia of children with spastic cerebral palsy (CP) compared with children without disabilities, by using proton magnetic resonance spectroscopy (1HMRS). Twenty-three patients with spastic CP (12 males, 11 females; mean age 11y 9mo [SD 4y 2mo], range 4-17y) were examined. Twenty children had spastic diplegia and three had quadriplegia. Twenty-four normally developing children (13 females, 11 males; mean age 10y 3mo [SD 4y 8mo], range 4-17y) served as a comparison group. The relative concentrations of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), and gamma-aminobutyric acid (GABA) were measured relative to creatine (Cr) and different combinations of metabolites within 8cm3 brain voxels. Children with CP showed reduced ratios of NAA:Cr, NAA:Cho, NAA:mI, and GABA:Cr in the basal ganglia relative to a matched comparison group. Patients demonstrated a significant age-dependent increase in NAA:Cr and NAA:Cho in the basal ganglia. No sex-dependent difference was shown in children with CP nor in the comparison group for all tested metabolite ratios. Significant correlation between Apgar score and ratio of mI:Cr in the group with CP was found. None of the tested metabolite ratios were correlated with the severity scale of CP in children with CP. NAA:Cr ratios were negatively correlated with learning disability in patients with CP. Results indicate the association of the metabolite ratios in basal ganglia with learning disability.
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Affiliation(s)
- Wojciech Kulak
- Department of Paediatric Neurology and Rehabilitation, Medical University of Bialystok, Bialystok, Poland.
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Abstract
Cerebral palsy (CP) is a common pediatric disorder occurring in about 2 to 2.5 per 1000 live births. It is a chronic motor disorder resulting from a non-progressive (static) insult to the developing brain. CP is the clinical presentation of a wide variety of cerebral cortical or sub-cortical insults occurring during the first year of life. The commonest cause of CP remains unknown in 50% of the cases; prematurity remains the commonest risk factor. Children with CP suffer from multiple problems and potential disabilities such as mental retardation, epilepsy, feeding difficulties, and ophthalmologic and hearing impairments. Screening for these conditions should be part of the initial assessment. The child with CP is best cared for with an individualized treatment plan that provides a combination of interventions. This requires the provision of a number of family-centered services that make a difference in the lives of these children and their families. Management of spasticity can be challenging with a wide variety of possible therapeutic interventions. The treatment must be goal oriented, such as to assist with mobility, reduce or prevent contractures, improve positioning and hygiene, and provide comfort. Each member of the child's multidisciplinary team, including the child and both parents, should participate in the serial evaluations and treatment planning.
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Affiliation(s)
- Mohammed M S Jan
- Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
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Abstract
Disorders of attention or learning commonly accompany neurodevelopmental disorders. The evaluation and diagnosis of these disorders is complex and does not always follow techniques used for typically developing children. These disorders are often underappreciated and inadequately addressed because they are overshadowed by the neurodevelopmental disorder. Nevertheless, failure to recognize, diagnose, and manage these disorders may result in unsuccessful community integration.
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Affiliation(s)
- Joshua B Ewen
- Johns Hopkins University School of Medicine, Department of Pediatrics, Kennedy Krieger Institute, Baltimore, MD 21205, USA
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Dellatolas G, Filho GN, Souza L, Nunes LG, Braga LW. Manual skill, hand skill asymmetry, and neuropsychological test performance in schoolchildren with spastic cerebral palsy. Laterality 2005; 10:161-82. [PMID: 15849032 DOI: 10.1080/13576500442000012] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Bilateral hand skill assessment with a computerised version of the Peg Moving Task, and neuropsychological testing, were performed in 30 children aged 7 to 8 years with spastic cerebral palsy (CP) and without mental retardation, diplegia (n = 10), right hemiplegia (n = 10), or left hemiplegia (n = 10), and in 30 controls. Compared to controls: (i) 30% of the hemiplegic children showed impairment of the unaffected hand and 70% of the diplegic children showed impairment in both hands; (ii) children with CP were impaired only in oral repetition and in visual-motor tasks. Results of neuropsychological testing were not significantly different between the three groups of children with CP. Right minus left asymmetry in hand skill was not related to neuropsychological testing; however, degree of impairment of the right hand was associated with phonological and metaphonological skills, and of the left hand with visuospatial and counting performance. Hand skill was related to the ability to perform many daily living manual activities. It is concluded that impairment of hand function, rather than the side of the more affected hand, is related to neuropsychological deficits in children with cerebral palsy.
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Abstract
Cerebral palsy (CP) is a common problem, occurring in about 2 to 2.5 per 1000 live births. The diagnosis of CP is based upon a history of abnormal motor development that is not progressive coupled with an examination (e.g. hypertonicity, increased reflexes, clonus) "placing" the lesion in the brain. In order to establish that a brain abnormality exists in children with CP that may, in turn, suggest an etiology and prognosis, neuroimaging is recommended with magnetic resonance imaging preferred to computed tomography. Metabolic and genetic studies should be obtained if there are atypical features in the history or on the examination. Detection of a brain malformation in a child with CP might suggest an underlying genetic or metabolic etiology. As cerebral infarction is high in children with hemiplegic CP, diagnostic testing for coagulation disorders should be considered. However, there is insufficient evidence at present to be precise as to what studies should be ordered. An electroencephalogram is not recommended unless there are features suggestive of epilepsy or a specific epileptic syndrome. As children with CP may have associated deficits of mental retardation, ophthalmologic and hearing impairments, speech and language disorders and oral-motor dysfunction, screening for these conditions should be part of the initial assessment.
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Affiliation(s)
- Barry S Russman
- Department of Pediatrics and Neurology, Oregon Health Sciences University, Portland, OR, USA
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Pueyo R, Junqué C, Vendrell P. Neuropsychologic differences between bilateral dyskinetic and spastic cerebral palsy. J Child Neurol 2003; 18:845-50. [PMID: 14736078 DOI: 10.1177/088307380301801204] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study compared the neuropsychologic performance of 30 adolescents and adults with bilateral dyskinetic, mixed, and spastic cerebral palsy aged between 16 and 38 years. The sample was relatively homogeneous in terms of motor severity; no patients were able to walk unaided. In all subjects, we evaluated the general function of nonverbal reasoning and the following specific neuropsychologic areas: language, visual perception, memory, praxis, and frontal functions. Individuals with dyskinetic cerebral palsy had better auditory comprehension, visuospatial abilities, immediate visual memory, and working verbal memory than those with spastic cerebral palsy. Frontal function was the only cognitive function on which subjects with dyskinetic cerebral palsy had lower scores. We conclude that the neuropsychologic profiles of dyskinetic and spastic cerebral palsy are different.
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Affiliation(s)
- Roser Pueyo
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
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Murphy N, Such-Neibar T. Cerebral palsy diagnosis and management: the state of the art. Curr Probl Pediatr Adolesc Health Care 2003; 33:146-69. [PMID: 12738938 DOI: 10.1016/s1538-5442(03)00002-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nancy Murphy
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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