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Does early age at brain insult predict worse outcome? Neuropsychological implications

Vicki Anderson1, Rani Jacobs, Megan Spencer-Smith

  • 1Department of Psychology, Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia. vicki.anderson@rch.org.au

Journal of Pediatric Psychology
|December 10, 2009
PubMed

Insights

Early brain insult (EBI) in children under two years old leads to global deficits. Later childhood brain injuries show better neurobehavioral outcomes, challenging traditional views on brain plasticity.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Pediatric Neurology

Background:

  • The prevailing notion suggests that the young brain's plasticity offers better outcomes following early brain insult (EBI).
  • This perspective implies that the brain's ability to reorganize compensates for early damage.

Purpose of the Study:

  • To investigate the neurobehavioral outcomes of children with focal brain insults at various developmental stages.
  • To challenge or support the hypothesis that earlier brain injury leads to better outcomes due to plasticity.

Main Methods:

  • One hundred sixty-four children with MRI-confirmed focal brain insults were categorized into six age-at-injury groups (Congenital to Late Childhood).
  • Standardized neurobehavioral measures were used for comparison.
  • Groups were matched for lesion characteristics and demographics.

Main Results:

  • Children with early brain insult before age 2 exhibited significant global deficits.
  • Children with later brain insults demonstrated neurobehavioral performance closer to average levels.
  • A trend towards better functional outcomes was observed with increasing age at the time of injury.

Conclusions:

  • The findings question the assumed advantages of early brain plasticity.
  • Very early brain insults (before age 2) are associated with poorer neurobehavioral outcomes.
  • Brain injury occurring later in childhood is linked to increasingly better functional outcomes.
Abstract

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