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Published on: April 21, 2017
[Formula: see text]Attention and executive functioning profiles in children following perinatal arterial ischemic
Danielle D Bosenbark1,2, Lauren Krivitzky2,3, Rebecca Ichord3,4
1a Department of Psychology , Drexel University , Philadelphia , PA , USA.
Insights
Children with perinatal arterial ischemic stroke (PAIS) show significant attention and executive functioning deficits. Working memory declines with age, and older children have more attention deficit hyperactivity disorder symptoms.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Developmental Psychology
Background:
- Perinatal arterial ischemic stroke (PAIS) is a leading cause of childhood stroke.
- Most children with PAIS experience long-term neurological impairments, affecting motor, language, and cognitive skills.
Purpose of the Study:
- To investigate the attention and executive functioning (EF) profiles in children with PAIS.
- To examine the influence of age and sex on these cognitive outcomes.
Main Methods:
- A cross-sectional study involving 40 children (aged 3-16 years) with a history of PAIS.
- Comprehensive neuropsychological testing assessed seven domains of attention and EF.
- Parental questionnaires evaluated real-world functioning and attention deficit hyperactivity disorder (ADHD) symptoms.
Main Results:
- Participants exhibited significantly lower scores in most attention and EF domains compared to normative data (p < .001), excluding working memory.
- Working memory difficulties correlated with increasing age.
- Older age was linked to a higher prevalence of clinically significant ADHD symptoms.
- No significant association was found between sex and cognitive performance or reported functioning.
Conclusions:
- Children with PAIS demonstrate mild-to-moderate impairments in attention and executive functions.
- Age is a significant factor, with older children experiencing greater working memory challenges and ADHD symptoms.
- Early identification and intervention are crucial for children affected by PAIS to address neurocognitive sequelae.
Abstract:
Perinatal arterial ischemic stroke (PAIS) is a form of childhood stroke; the majority of those affected experience neurologic sequelae, including motor, language and neurocognitive impairments. This study examines the attention and executive functioning (EF) profiles of children following PAIS, as well as the impact of age and sex. In this single-center cross-sectional study, 40 children aged 3 to 16 years (median age 7.2 years; 58% male) who have suffered a PAIS underwent a comprehensive neuropsychological battery to assess attention and EF. Parents completed behavioral questionnaires regarding real-world functioning. Composite scores were calculated for seven attention and EF domains (Attention, Working Memory, Verbal Retrieval, Inhibitory Control, Flexibility/Shifting, Planning/Organization, and Processing Speed). The results for all measured domains of attention and EF are significantly lower in the participants compared to the normative samples (p < .001), with the exception of Working Memory. However, increasing difficulty with Working Memory is associated with developing age. Older age at time of testing is also associated with a higher incidence of clinically-elevated attention deficit hyperactivity disorder (ADHD) symptoms. Sex is not associated with performance measures or parental report of functioning. The participants demonstrate mild-to-moderate attention and EF impairment compared to the normative population. Clinicians, families, and educators should be informed about the neurocognitive sequelae of PAIS and the need for close developmental surveillance in this population to identify vulnerable children and initiate appropriate therapeutic interventions in a timely fashion.
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