Profiles of cold executive function performance among pediatric acquired brain injury

To compare cold executive functioning (EF) among children with perinatal ischemic stroke (PAS), traumatic brain injury (TBI), and brain tumors (BT), and to delineate distinct neuropsychological profiles across these acquired brain injury (ABI) subtypes.

A cross-sectional neuropsychological assessment was conducted on children aged 6 to 18 years divided into three study groups: PAS (n = 22), TBI (n = 17), and BT (n = 11) with each participant matched to a control (1:1) based on age, gender, and educational attainment resulting in three control groups. Participants were screened for 'intellectual impairment' as per Raven's Progressive Matrices. Standardized tests measuring planning (Rey Osterrieth Complex Figure test), sustained attention (Color Cancelation Test), focused attention (Color Trails Test), working memory (Digit Span), verbal fluency (Phonemic fluency test), visuo-constructive (Block Design), and visuo-conceptual tasks (Picture Completion Test) were administered. Group comparisons were conducted using non-parametric and ANCOVA analyses with age and gender adjustments.

A heterogeneous pattern of cold executive dysfunction across the three ABI etiologies was found. Trends indicate TBI > BT > PAS for attention and working memory; for verbal fluency PAS > TBI > BT; and BT > TBI > PAS for planning. Age controlled post hoc differences reveal significant dysfunction in PAS group for planning, visuo-conceptual and visuo-constructive abilities. Post hoc effects controlled for gender revealed significant dysfunction for visuo-conceptual and visuo-constructive ability.

Distinct executive function profiles were observed across ABI subtypes, with PAS associated with the most pervasive impairments, TBI with selective deficits, and BT with targeted planning difficulties. These findings highlight the importance of tailored cognitive rehabilitation strategies based on ABI subtype.