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Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
Published on: January 11, 2016
Visual field function in school-aged children with spastic unilateral cerebral palsy related to different patterns of
Lena Jacobson1, Agneta Rydberg, Ann-Christin Eliasson
1Clinical Neuroscience, Ophthalmology and Vision, Karolinska Institutet, Stockholm, Sweden. lena.jacobson@karolinska.se
Insights
Visual field deficits in children with unilateral cerebral palsy (CP) correlate with brain lesion type. Early brain damage may allow for plasticity, preserving visual fields, while later damage can cause severe visual impairment.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatrics
Background:
- Unilateral cerebral palsy (CP) can affect visual development.
- Understanding the relationship between brain structure and visual function is crucial for early intervention.
Purpose of the Study:
- To investigate the correlation between visual field function and brain morphology in children diagnosed with unilateral CP.
Main Methods:
- Visual field function was assessed using confrontation technique and Goldmann perimetry in 29 children with unilateral CP (GMFCS level I).
- Brain imaging was utilized to determine the type and extent of cerebral lesions.
- Children's motor function was classified using GMFCS and Manual Ability Classification System.
Main Results:
- Eighteen children exhibited subnormal visual field function, with six having severely restricted fields.
- Lesion types included malformation, white matter damage of immaturity (WMDI), and cortical-subcortical lesions.
- Visual field deficits correlated with lesion patterns, particularly in cortical-subcortical lesions and extensive malformations or WMDI.
Conclusions:
- Brain plasticity in the immature brain may preserve visual fields in cases of malformation and WMDI.
- Later occurring brain lesions were more frequently associated with severely restricted visual fields.
- Confrontation visual field testing effectively identified severe deficits, while Goldmann perimetry detected relative defects.
Aim:
To relate visual field function to brain morphology in children with unilateral cerebral palsy (CP).
Method:
Visual field function was assessed using the confrontation technique and Goldmann perimetry in 29 children (15 males, 14 females; age range 7-17y, median age 11y) with unilateral CP classified at Gross Motor Function Classification System (GMFCS) level I and Manual Ability Classification System levels I to III. The type and extent of brain lesions were determined using cerebral imaging.
Results:
Eighteen children had subnormal visual field function. The visual fields were severely restricted in six. The underlying brain lesions were malformation (n=7), white matter damage of immaturity (WMDI; n=13), and cortical-subcortical lesions (n=9). Visual field function could be correlated with the pattern of brain damage in children with cortical-subcortical lesions or extensive lesions caused by malformation or WMDI. Total homonymous hemianopia was common in the cortical-subcortical group but rare in children with malformation or WMDI. Five children had normal visual field function despite having malformation or WMDI involving parts of the brain usually encompassing the visual system.
Interpretation:
Visual field function may be preserved by plasticity of the immature brain in children with malformation and WMDI. Severely restricted visual fields were more often associated with lesions occurring later in the developing brain. All children with severely restricted visual fields were identified by the confrontation technique. Goldmann perimetry was a suitable method to identify relative visual field defects.
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