Visuospatial Attention and Saccadic Inhibitory Control in Children With Cerebral Palsy
Claudio Maioli1, Luca Falciati1, Jessica Galli1,2
1Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Insights
Children with cerebral palsy (CP) exhibit significant executive function and inhibitory control deficits, particularly in visuospatial attention. These impairments, though evident in childhood, show recovery into adolescence.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Cerebral palsy (CP) is a non-progressive neurological disorder resulting from early brain injury.
- CP often involves non-motor impairments, including deficits in executive functions and attention.
- Understanding these cognitive challenges is crucial for targeted interventions in affected children.
Purpose of the Study:
- To investigate visuospatial attention and inhibitory control in children with spastic cerebral palsy (CP).
- To assess oculomotor task performance in children with CP and normal/mild cognitive impairment.
- To compare executive functions in children with CP to typically developing children (TDC).
Main Methods:
- Employed oculomotor tasks, including a simple visually-guided saccade task and a cue-target task.
- Participants included ten children with spastic CP and thirteen age-matched typically developing children (TDC).
- The cue-target task involved valid and invalid cue conditions to assess attentional capture and inhibition.
Main Results:
- Children with CP demonstrated severe executive deficits in sustained attention and task compliance.
- Saccadic inhibitory control was significantly impaired in CP, affecting responses to both stimulus-driven and goal-directed attention.
- Impairments showed spatial selectivity, and while low-level visuospatial attention was preserved, higher-level executive functions were compromised.
Conclusions:
- Early brain injury in CP leads to executive skill and inhibitory control impairments manifesting in childhood.
- These deficits, particularly in visuospatial attention, impact oculomotor responses.
- Evidence suggests a recovery trajectory towards normal levels during adolescence.
Abstract:
Cerebral palsy (CP) is a non-progressive syndrome due to a pre-, peri- or post-natal brain injury, which frequently involves an impairment of non-motor abilities. The aim of this article was to examine visuospatial attention and inhibitory control of prepotent motor responses in children with CP showing a normal IQ or mild cognitive impairment, measuring their performance in oculomotor tasks. Ten children (9-16-year-old) with spastic CP and 13 age-matched, typically developing children (TDC) participated in the study. Subjects performed a simple visually-guided saccade task and a cue-target task, in which they performed a saccade towards a peripheral target, after a non-informative visual cue was flashed 150 ms before the imperative target, either at the same (valid) or at a different (invalid) spatial position. Children with CP showed severe executive deficits in maintaining sustained attention and complying with task instructions. Furthermore, saccadic inhibitory control appeared to be significantly impaired in the presence of both stimulus-driven and goal-directed captures of attention. In fact, patients showed great difficulties in suppressing saccades not only to the cue stimuli but also to the always-present target placeholders, which represented powerful attentional attractors that had to be covertly attended throughout the task execution. Moreover, impairment did not affect in equal manner the whole visual field but showed a marked spatial selectivity in each individual subject. Saccade latencies in the cue-target task were faster in the valid than in the invalid condition in both child groups, indicating the preservation of low-level visuospatial attentive capabilities. Finally, this study provides evidence that these impairments of executive skills and in inhibitory control, following early brain injuries, manifest in childhood but recover to virtually normal level during adolescence.
