Recovery of executive skills following paediatric traumatic brain injury (TBI): A 2 year follow-up
Recovery of executive skills following paediatric traumatic brain injury (TBI): A 2 year follow-up
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DOI：
10.1080/02699050400004823
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发表时间：
2005-06-01
期刊：
影响因子：
1.9
通讯作者：
Catroppa, C
中科院分区：
文献类型：
--
作者：
Anderson, V;Catroppa, C
主要目标：执行功能（EF）中断可能是创伤性脑损伤（TBI）的结果，在额叶区域直接损伤的背景下或与这些区域和其他脑区域之间的连接中断有关。在儿童时期TBI之后，EF的调查很少，并且几乎没有证据表明在受伤后的几年中可能的恢复轨迹。本研究的目的是（i）检查损伤严重程度和EF之间是否存在剂量反应关系;（ii）记录损伤后2年内EF的恢复情况;（iii）确定EF领域结果的任何其他预测因素。研究设计：本研究采用前瞻性纵向设计，受试者在损伤时招募，并随访2年。该研究检查了一组69名儿童的EF，这些儿童患有轻度，中度或重度TBI。EF的四个组成部分进行了评估：（一）注意力控制;（二）规划，目标设定和解决问题;（三）认知灵活性;和（四）abstract reasoning.Outcomes和results：结果表明，虽然严重TBI的儿童在急性期损伤后表现最差，他们表现出最大的EF恢复超过24个月的时间。无论如何，功能缺陷仍然是最严重的，这组受伤后2年。结果表明，EF和技能的差异恢复的多维性，以下儿童TBI。受伤前的能力和受伤的年龄被确定为EF和功能skills.Conclusions的显着预测因素：儿童在年轻时持续严重的TBI是特别容易受到损害的EF。虽然这些困难确实显示出受伤后随着时间的推移有所恢复，但长期缺陷仍然存在，并可能影响持续的发展。
Primary objective: Disruptions to executive function (EF) may occur as a result of traumatic brain injury (TBI), in the context of direct damage to frontal regions or in association with disruption of connections between these areas and other brain regions. Little investigation of EF has occurred following TBI during childhood and there is little evidence of possible recovery trajectories in the years post-injury. The present study aimed to (i) examine whether a dose-response relationship exists between injury severity and EF; (ii) document recovery of EF in the 2 years post-injury and (iii) determine any additional predictors of outcome in the domain of EF.Research design: The study employed a prospective, longitudinal design, with participants recruited at time of injury and followed over a 2-year period.Methods and procedures: The study examined EF in a group of 69 children who had sustained a mild, moderate or severe TBI. Four components of EF were assessed: (i) attentional control; (ii) planning, goal setting and problem solving; (iii) cognitive flexibility; and (iv) abstract reasoning.Outcomes and results: Results showed that, while children with severe TBI performed most poorly during the acute stage post-injury, they exhibited greatest recovery of EF over a 24-month period. Regardless, functional deficits remained most severe for this group 2 years post-injury. Results demonstrated the multi-dimensional nature of EF and the differential recovery of skills, following childhood TBI. Pre-injury ability and age at injury were identified as significant predictors of EF and functional skills.Conclusions: Children sustaining severe TBI at a young age are particularly vulnerable to impairments in EF. While these difficulties do show some recovery with time since injury, long-term deficits remain and may impact on ongoing development.