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Updated: May 10, 2026
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
Cognitive outcome in childhood after unilateral perinatal brain injury
Lenny M van Buuren1, Niek E van der Aa, Harmke C Dekker
1Department of Paediatric Neuropsychology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Insights
Children with periventricular haemorrhagic infarction (PVHI) or perinatal arterial ischaemic stroke (PAIS) show below-average cognitive outcomes. Early developmental assessments and brain imaging can help predict these outcomes, though prediction remains challenging.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Pediatric Stroke
Background:
- Periventricular haemorrhagic infarction (PVHI) and perinatal arterial ischaemic stroke (PAIS) are significant causes of brain injury in neonates.
- Understanding the long-term cognitive sequelae of these conditions is crucial for early intervention and support.
Purpose of the Study:
- To evaluate the cognitive outcomes in children with PVHI or PAIS.
- To correlate cognitive findings with early developmental assessments and neonatal neuroimaging.
- To identify potential predictors of cognitive outcome in this population.
Main Methods:
- A cohort of 50 children (21 with PVHI, 29 with PAIS) underwent comprehensive neuropsychological assessments.
- Assessments included tests of intelligence, memory, visual-motor integration, comprehension, attention, reaction time, and executive function.
- Early development was assessed using the Griffiths Mental Development Scale at 24 months.
Main Results:
- Children with PVHI demonstrated below-average early Griffiths scores and Full-Scale IQ (FSIQ) scores.
- Children with PAIS had normal early Griffiths scores but below-average FSIQ scores at school age.
- PVHI-related cognitive outcomes correlated with maternal education and ventricular dilatation; PAIS outcomes were associated with basal ganglia/thalami involvement and epilepsy.
Conclusions:
- Cognitive outcomes for children with PVHI and PAIS are generally below average, though often within one standard deviation.
- While challenging, early predictors of cognitive outcome can be identified, aiding in prognostication.
- Neonatal brain imaging and early developmental assessments offer insights into later cognitive function.
Aim:
The aim of the study was to assess cognitive outcome in children with periventricular haemorrhagic infarction (PVHI) or perinatal arterial ischaemic stroke (PAIS) and relate these findings to early developmental outcome and neonatal magnetic resonance imaging findings.
Method:
A neuropsychological assessment was performed in 50 children (26 males, 24 females) with unilateral PVHI (n=21) or PAIS (n=29) at a median age of 11 years 9 months (range 6-20y). This included tests for intelligence, verbal memory, visual-motor integration, word comprehension, attention, reaction times, and executive function. The Griffiths Mental Development Scale was used for early developmental assessment at 24 months (range 18-32mo).
Results:
In children with PVHI, both the early Griffiths scores (mean 87; 95% CI 83-92) and the Full-scale IQ (FSIQ) scores at school age (mean 86; 95% CI 78-94) were below the test mean of 100. In the PAIS group, early Griffiths scores were within the normal range (mean 98; 95% CI 93-104), but at school age FSIQ scores were below average (mean 87; 95% CI 80-94). In children with PVHI, FSIQ scores correlated with the level of maternal education and were lower after ventricular dilatation, whereas both involvement of the basal ganglia and thalami and development of postneonatal epilepsy were associated with lower cognitive outcome in children who had experienced PAIS.
Interpretation:
Cognitive outcome after PVHI or PAIS is below average, but still within 1SD for most children. Prediction of cognitive outcome remains challenging, but some early predictors can be recognized.
