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Cerebral lateralization and cognitive deficits after congenital hemiparesis
1Department of Paediatrics, University of Tartu, Unit of Neurology, Children's Clinic of Tartu University Clinics, Tartu, Estonia.
Insights
Handedness and brain lesion location significantly impact cognitive function in children with congenital hemiparesis. Neuropsychological assessment combined with handedness reveals brain reorganization patterns after early brain insult.
Area of Science:
- Neuroscience
- Developmental Psychology
- Clinical Psychology
Background:
- Congenital insults can lead to cerebral palsy and affect brain lateralization.
- Understanding the relationship between handedness, brain organization, and cognitive function is crucial for early intervention.
Purpose of the Study:
- To investigate the relationship between handedness, cerebral lateralization, and cognitive performance in children with congenital hemiparesis.
- To determine if handedness can predict cognitive deficits and brain reorganization patterns.
Main Methods:
- Studied 56 children with congenital hemiparesis and 14 controls using the NEPSY (a developmental neuropsychological assessment) test battery.
- Assessed handedness, lesion location (left or right hemisphere), and cognitive performance.
Main Results:
- Left-handedness was prevalent in hemiparetic children (41%) and those with left hemisphere lesions (72%).
- Contralateral handedness correlated with diffuse cognitive deficits, including language and memory impairments.
- Ipsilateral handedness was associated with milder, side-specific cognitive dysfunctions, such as attention and spatial problems.
Conclusions:
- Handedness is a reliable indicator of cerebral reorganization following early brain insult.
- Combining handedness with neuropsychological assessments aids in understanding cognitive outcomes in children with hemiparesis.
Abstract:
The purpose of this study was to investigate whether and how handedness is related to the processes of cerebral lateralization and cognitive performance in children with congenital insult. Fifty-six children (31 males and 25 females) with congenital hemiparesis and 14 control subjects were investigated. Of these children, 32 had a left hemisphere lesion, and 24 children had a right hemisphere lesion. There were 30 right-handed, 23 left-handed, and three ambidextrous children in the study group. The neuropsychologic assessment was performed using the NEPSY (a developmental neuropsychological assessment of child development) test battery. We found that 41% of the hemiparetic children and 72% of the children with a left hemisphere lesion were left-handed. In children contralateral to lesion handedness (no evidence of interhemispheric transfer of functions), we found diffuse cognitive deficits with impaired language abilities and poor visuomotor and narrative memory processing. In contrast, children with ipsilateral to brain lesion handedness (interhemispheric transfer of functions) demonstrated minimal or moderate side-specific cognitive dysfunction. Right-handed children with a right hemisphere lesion had attention, spatial, and short-term memory problems; left-handed children with a left hemisphere lesion had receptive language and visuomotor difficulties. Handedness combined with neuropsychologic assessment is a reliable indicator of the processes of cerebral reorganization after early brain insult.