Childhood brain insult: can age at insult help us predict outcome

被引:199
作者
Anderson, Vicki [1 ,2 ,4 ,5 ]
Spencer-Smith, Megan [1 ,4 ]
Leventer, Rick [1 ,5 ]
Coleman, Lee [3 ]
Anderson, Peter [1 ,4 ]
Williams, Jackie [1 ,4 ]
Greenham, Mardee [1 ]
Jacobs, Rani [1 ,4 ]
机构
[1] Royal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia
[2] Royal Childrens Hosp, Dept Psychol, Melbourne, Vic, Australia
[3] Royal Childrens Hosp, Dept Radiol, Melbourne, Vic, Australia
[4] Univ Melbourne, Sch Behav Sci, Melbourne, Vic 3010, Australia
[5] Univ Melbourne, Dept Paediat, Melbourne, Vic 3010, Australia
基金
澳大利亚研究理事会; 英国医学研究理事会;
关键词
COGNITIVE-DEVELOPMENT; HEAD-INJURY; CHILDREN; LESIONS; PLASTICITY; LANGUAGE; STROKE; RECOVERY; VULNERABILITY; INTELLIGENCE;
D O I
10.1093/brain/awn293
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Until recently, the impact of early brain insult (EBI) has been considered to be less significant than for later brain injuries, consistent with the notion that the young brain is more flexible and able to reorganize in the context of brain insult. This study aimed to evaluate this notion by comparing cognitive and behavioural outcomes for children sustaining EBI at different times from gestation to late childhood. Children with focal brain insults were categorized according to timing of brain insult, represented by six developmental periods: (i) Congenital (n 38): EBI: firstsecond trimester; (ii) Perinatal (n 33); EBI: third trimester to 1 month post-natal; (iii) Infancy (n 23): EBI: 2 months2 years post-birth; (iv) Preschool (n 19): EBI: 36 years; (v) Middle Childhood (n 31): EBI: 79 years; and (vi) Late Childhood (n 19): EBI: after age 10. Groups were similar with respect to injury and demographic factors. Children were assessed for intelligence, academic ability, everyday executive function and behaviour. Results showed that children with EBI were at increased risk for impairment in all domains assessed. Furthermore, children sustaining EBI before age 2 years recorded global and significant cognitive deficits, while children with later EBI performed closer to normal expectations, suggesting a linear association between age at insult and outcome. In contrast, for behaviour, children with EBI from 7 to 9 years performed worse than those with EBI from 3 to 6 years, and more like those with younger insults, suggesting that not all functions share the same pattern of vulnerability with respect to age at insult.
引用
收藏
页码:45 / 56
页数:12
相关论文
共 56 条
[1]   Prefrontal lesions and attentional skills in childhood [J].
Anderson, V ;
Jacobs, R ;
Harvey, AS .
JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY, 2005, 11 (07) :817-831
[2]   Assessing executive functions in children: Biological, psychological, and developmental considerations [J].
Anderson, V .
NEUROPSYCHOLOGICAL REHABILITATION, 1998, 8 (03) :319-349
[3]  
Anderson V, 1997, J Int Neuropsychol Soc, V3, P147
[4]   Functional plasticity or vulnerability after early brain injury? [J].
Anderson, V ;
Catroppa, C ;
Morse, S ;
Haritou, F ;
Rosenfeld, J .
PEDIATRICS, 2005, 116 (06) :1374-1382
[5]   Age at injury as a predictor of outcome following pediatric head injury: A longitudinal perspective [J].
Anderson, V ;
Moore, C .
CHILD NEUROPSYCHOLOGY, 1995, 1 (03) :187-202
[6]   Understanding predictors of functional recovery and outcome 30 months following early childhood head injury [J].
Anderson, VA ;
Catroppa, C ;
Dudgeon, P ;
Morse, SA ;
Haritou, F ;
Rosenfeld, JV .
NEUROPSYCHOLOGY, 2006, 20 (01) :42-57
[7]   Thirty month outcome from early childhood head injury: a prospective analysis of neurobehavioural recovery [J].
Anderson, VA ;
Morse, SA ;
Catroppa, C ;
Haritou, F ;
Rosenfeld, JV .
BRAIN, 2004, 127 :2608-2620
[8]  
[Anonymous], 1963, ORIGINS INTELLIGENCE
[9]   INTELLECTUAL STABILITY IN CHILDREN WITH UNILATERAL BRAIN-LESIONS [J].
ARAM, DM ;
EISELE, JA .
NEUROPSYCHOLOGIA, 1994, 32 (01) :85-95
[10]  
ARAM DM, 1988, LANG COMMUN, P171