A matched lesion analysis of childhood versus adult-onset brain injury due to unilateral stroke - Another perspective on neural plasticity and recovery of social functioning
A matched lesion analysis of childhood versus adult-onset brain injury due to unilateral stroke - Another perspective on neural plasticity and recovery of social functioning
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DOI：
10.1097/01.wnn.0000152207.80819.3c
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发表时间：
2005-03-01
影响因子：
1.4
通讯作者：
Tranel, D
中科院分区：
文献类型：
--
作者：
Mosch, SC;Max, JE;Tranel, D
背景：关于神经可塑性的文献缺乏对儿童和成人获得的脑损伤后的慢性神经心理和社会后果的直接比较，成人和儿童的脑损伤在大小和位置上是匹配的。方法：我们将具有相似单侧中风病变的成人和儿童配对，然后比较慢性神经心理和社会结果。结果：我们发现学习和记忆障碍在儿童和成人中都是最常见的。患有左半球病变的儿童在言语/语言评分上是正常的，而他们的成年对应儿童则处于边缘受损状态。社会功能障碍在成人中与大脑半球损害高度相关，但在儿童中不是：具体地说，患有右半球损害的成年人比患有左半球损害的成年人更容易发生社会缺陷，而这种不对称性在儿童中并不明显。然而，最重要的是，最重要的发现是，成人和儿童的慢性神经心理和社会功能结果高度相似，因为单侧中风导致的脑损伤部位相似。结论：总的来说，研究结果表明，病变的位置和大小是决定中风后神经心理和社会恢复的主要因素。
Background: The literature on neuroplasticity lacks a direct comparison of chronic neuropsychological and social outcomes following brain damage acquired in childhood versus adulthood, when lesions are matched across adults and children for size and location.Methods: We paired adults and children with similar unilateral stroke lesions and then compared chronic neuropsychological and social outcomes. Quantitative comparisons were conducted, as well as qualitative analyses of each subject pair, focusing on specific domains of cognitive impairment and changes in social functioning.Results: We found that learning and memory impairments were most common in both children and adults. Left hemisphere-lesioned children were normal on speech/language ratings, whereas their adult counterparts were borderline impaired. Impairments in social functioning were highly associated with hemispheric side of damage in adults, but not in children: Specifically, adults with right hemisphere lesions developed social defects much more frequently than adults with left hemisphere lesions, whereas this asymmetry was not evident in the children. Most importantly, though, was the overarching finding of a high degree of similarity between chronic neuropsychological and social function outcomes in adults and children with similarly located brain lesions due to unilateral stroke.Conclusions: On balance, the findings suggest that lesion location and size are prepotent factors determining neuropsychological and social recovery from stroke.