A matched lesion analysis of childhood versus adult-onset brain injury due to unilateral stroke - Another perspective on neural plasticity and recovery of social functioning

被引:52
作者
Mosch, SC
Max, JE
Tranel, D
机构
[1] Univ Calif San Diego, Dept Psychiat, Childrens Hosp, San Diego, CA 92123 USA
[2] Ctr Hlth, San Diego, CA 92123 USA
[3] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA
[4] Univ Iowa, Coll Med, Dept Neurol, Div Cognit Neurosci, Iowa City, IA USA
关键词
brain injury; unilateral stroke; neural plasticity; social functioning; pediatric stroke; adult stroke;
D O I
10.1097/01.wnn.0000152207.80819.3c
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Background: The literature on neuroplasticity lacks a direct comparison of chronic neuropsychological and social outcomes following brain damage acquired in childhood versus adulthood, when lesions are matched across adults and children for size and location. Methods: We paired adults and children with similar unilateral stroke lesions and then compared chronic neuropsychological and social outcomes. Quantitative comparisons were conducted, as well as qualitative analyses of each subject pair, focusing on specific domains of cognitive impairment and changes in social functioning. Results: We found that learning and memory impairments were most common in both children and adults. Left hemisphere-lesioned children were normal on speech/language ratings, whereas their adult counterparts were borderline impaired. Impairments in social functioning were highly associated with hemispheric side of damage in adults, but not in children: Specifically, adults with right hemisphere lesions developed social defects much more frequently than adults with left hemisphere lesions, whereas this asymmetry was not evident in the children. Most importantly, though, was the overarching finding of a high degree of similarity between chronic neuropsychological and social function outcomes in adults and children with similarly located brain lesions due to unilateral stroke. Conclusions: On balance, the findings suggest that lesion location and size are prepotent factors determining neuropsychological and social recovery from stroke.
引用
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页码:5 / 17
页数:13
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