Neuropsychologic Impairment in Bilateral Cerebral Palsy
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain. Pediatric Neurology
(Impact Factor: 1.7).
02/2009; 40(1):19-26. DOI: 10.1016/j.pediatrneurol.2008.08.003
The lower-than-average cognitive performance of individuals with bilateral cerebral palsy found in previous studies does not always refer to an abnormal performance or clinically significant impairment. We aimed to establish the percentage of persons with bilateral cerebral palsy who present neuropsychologic impairment, and its relationship to perinatal data and motor signs. Forty children, adolescents, and adults (age range, 6-38 years; 15 females and 25 males) with bilateral cerebral palsy were neuropsychologically assessed. Vocabulary was impaired in 85% of participants, language comprehension in 13-48%, visuoperceptual abilities in 60%, visuospatial abilities in 90%, short-term memory in 21-58%, declarative memory in 47-67%, and praxis comprehension in 20%, with executive deficits in 58-74%. Perinatal data (intrauterine growth and birth weight) contributed to explaining memory impairment. Among cerebral palsy subtypes (spastic, mixed, and dyskinetic), forms of impairment differed only in short-term verbal memory. No persons with dyskinetic cerebral palsy experienced impairment in immediate memory or working visual memory. We conclude that visuospatial deficit is the most frequent impairment in people with bilateral cerebral palsy. Moreover, short-term memory impairment seems sensitive to perinatal complications, and differs among bilateral cerebral palsy subtypes.
Available from: Alain Berthoz
- "of sensation , perception, cognition , communication , and behavior " ( Rosenbaum et al . , 2005 ) . Among the accompanying disorders , visual perceptual and visual spatial impairment is particularly relevant ( Ego et al . , 2015 ) , also affecting CBT performance ( Pueyo et al . , 2009 ; Gagliardi et al . , 2011 ) . Strikingly enough , however , psychometric testing is restricted to reaching space and navigational studies involving children with CP are particularly lacking . Locomotor navigation in CP has been recently studied for the first time using the MC methodology ( Belmonti et al . , 2015 ) . That study involve"
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ABSTRACT: Short-term memory develops differently in navigation vs. manual space. The Magic Carpet (MC) is a novel navigation test derived from the Walking Corsi Test and the manual Corsi Block-tapping Task (CBT). The MC requires mental rotations and executive function. In Cerebral Palsy (CP), CBT, and MC scores relate differently to clinical and lesional factors. Hypotheses of this study are: that frontal lesion specifically affect navigation in CP; that brain lesions affect MC cognitive strategies.
Twenty-two children with spastic CP, aged 5 to 14 years, 14 with a unilateral and 8 with a bilateral form, underwent the CBT and the MC. Errors were classified into seven patterns by a recently described algorithm. Brain lesions were quantified according to a novel semi-quantitative MRI scale. Control data were partially drawn from a previous study on 91 typically developing children.
Children with CP performed worse than controls on both tests. Right hemispheric impairment correlated with spatial memory. MC span was reduced less than CBT span and was more selectively related to right middle white-matter and frontal lesions. Error patterns were differently distributed in CP and in typical development, and depended on right brain impairment: children with more extensive right lesions made more positional than sequential errors.
In CP, navigation is affected especially by extensive lesions involving the right frontal lobe. In addition, these are associated with abnormal cognitive strategies. Whereas in typical development positional errors, preserving serial order, increase with age and performance, in CP they are associated with poorer performance and more extensive right-brain lesions. The explanation may lie in lesion side: right brain is crucial for mental rotations, necessary for spatial updating. Left-lateralized spatial memory strategies, relying on serial order, are not efficient if not accompanied by right-brain spatial functions.
Available from: Marcelo Fernandes da Costa
- "Although these previous studies found retrochiasmatic visual pathway impairments and visual acuity loss, no relationship was empirically observed between visual pathway impairments and the reduction of visual acuity . Structural impairment has been suggested in frontal, parietal, and temporal cortical areas based on functional damage in visual tasks, including visuospatial abilities [19-21], ocular posture , and eye movement control during fixation [23,24]. As mentioned above, we found that grating acuity is impaired in SCP children using a sweepVEP paradigm [13-15] and behavioral methods . "
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The aim of the present study was to evaluate color perception thresholds and relate them to the degree of motor impairment in children with spastic cerebral palsy (SCP).
Binocular and monocular chromaticity discrimination thresholds were estimated for the protan, deutan, and tritan color confusion axes in 43 SCP children aged 6–15 years who were classified as tetraplegic (n = 12), diplegic (n = 16), and hemiplegic (n = 15) without ophthalmological complaints. Motor impairment was rated according to the Gross Motor Function Classification System (GMFCS) in five levels of severity.
Analysis of variance showed significantly reduced discrimination in tetraplegic children (p < 0.001) compared with the diplegic, hemiplegic, and control groups. We also found a positive correlation between chromaticity discrimination thresholds and GMFCS ratings in all of the groups.
Chromaticity discrimination thresholds measured psychophysically were reduced for all three color confusion axis in tetraplegic children compared with normal children. Diplegic and hemiplegic children had similar results as normal children. The finding of a correlation between quantified motor impairment and color discrimination losses in SCP patients is a new observation that might help elucidate the causes of color perception loss in these patients. Visual information is essential for the rehabilitation of CP children. Knowledge of the degree of correlation between vision and motor impairment is valuable when planning a rehabilitation program.
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ABSTRACT: Using the pressure-admittance diagram (DPY) as an estimator of the pressure-volume diagram (DPV), the authors obtained ventricular efficiency from the area encompassed by the loop (stroke work, SW) divided by the total PYA area (equivalent to PVA), i.e., the area surrounded by the end-diastolic curve, the systolic segment of the diagram, and the end-systolic line. The basic concept underlying this calculation derives from the linear relationship between cardiac oxygen consumption and PVA, as reported by H. Suga et al. (1981). In five animals under control conditions, values ranged, as expected, from 17.6% to 28.1%, showing a significant increase (p<0.05) after an inotropic maneuver (range: 21.2%-40.0%). The diagrams need not be calibrated in absolute terms, which is an attractive feature.< >
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