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Cognitive outcome of children with early-onset hemiparesis
1Department of Child Neurology, Children's Hospital, University of Tartu, Estonia. anneliko@cut.ee
Insights
Children with early-onset unilateral brain lesions and hemiparesis show cognitive delays. Lesion side, active epilepsy, and male gender significantly impact outcomes in these pediatric patients.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatric Neurology
Background:
- Early-onset unilateral brain lesions can lead to hemiparesis in children.
- Understanding the cognitive sequelae of these lesions is crucial for targeted interventions.
- Congenital versus acquired lesions may have differential impacts on neurodevelopment.
Purpose of the Study:
- To investigate the cognitive outcomes in children with early-onset unilateral brain lesions and hemiparesis.
- To compare cognitive performance between children with left-sided and right-sided brain lesions.
- To identify factors influencing cognitive outcome, including lesion type, epilepsy, and gender.
Main Methods:
- Neuropsychological evaluation using the NEPSY test battery.
- Study included 37 children with hemiparesis and 13 healthy, age- and sex-matched controls.
- Comparison of cognitive functions based on lesion laterality (left vs. right hemisphere).
Main Results:
- Children with left-sided lesions showed delays in phonologic and language functions.
- Children with right-sided lesions performed worse in visual-spatial and somatosensory skills.
- Active epilepsy and male gender were associated with more affected cognitive outcomes; no difference between congenital and acquired lesions.
Conclusions:
- Unilateral brain lesions in early childhood are associated with widespread cognitive impairments.
- Cognitive deficits are lateralized, affecting language/phonology for left lesions and visuospatial/somatosensory functions for right lesions.
- Factors such as lesion side, active epilepsy, and male gender are significant predictors of cognitive outcome in pediatric hemiparesis.
Abstract:
The aim of this study was to examine the cognitive outcome of children with congenital and acquired early-onset unilateral brain lesions associated with hemiparesis. The neuropsychologic evaluation was done using the NEPSY test battery on 37 children with hemiparesis and 13 sex- and age-matched healthy controls. Compared to the controls, children with left-sided brain lesions had significant delay in phonologic and language functions, while children with right-sided brain lesions performed more poorly in visual and spatial skills and in somatosensory functions. There were more left-handed children in the former (6 of 23) than in the latter (1 of 14) group. There was no significant difference in cognitive outcome between children with congenital and acquired lesions. The cognitive outcome of boys and that of children with active epilepsy was more affected. Overall, the patients showed impairment in many cortical functions and diffuse cognitive delay compared to controls and the side of lesion, active epilepsy, and male gender were significant factors in predicting cognitive outcome.