Cerebral palsy update
Cerebral palsy update
复制标题
DOI：
10.1016/j.braindev.2009.03.009
复制
发表时间：
2009-08-01
影响因子：
1.7
通讯作者：
Cans, Christine
中科院分区：
文献类型：
--
作者：
Kraegeloh-Mann, Ingeborg;Cans, Christine
SCPE（欧洲脑性麻痹监测）工作组为欧洲登记册开发了一种关于脑性麻痹的共同语言，共同数据库允许在更大的基础上进行流行率分析。CP患病率随着出生体重的降低和未成熟度的增加而增加。早产后存活率的增加首先也增加了CP率。但在80年代，这种趋势在LBW婴儿中已经逆转，在90年代，VLBW或非常不成熟的婴儿也是如此。极低出生体重或不成熟婴儿组中CP的结局仍然是一个特别值得关注的问题，因为患病率似乎相当稳定，处于较高水平。超过80%的CP是由大脑病变或发育不良引起的，这可以归因于大脑发育的不同时间段。范围和地形决定了CP的临床亚型，也与相关残疾的存在和严重程度有关。因此，CP为研究发育中大脑的可塑性提供了一个模型。单侧损伤后的重组主要是半球间的和同位的。在运动系统中，它涉及同侧神经束的募集;功能似乎是有限的，并在妊娠结束时已经下降。没有明确的证据表明感觉系统发生了实质性的重组。最好的补偿潜力描述语言功能左半球病变。语言功能重组到右半球最终似乎没有受到损害，但是，这是以牺牲主要的右半球功能为代价的。(C)2009爱思唯尔有限公司版权所有。
A common language on CP has been developed for the European registers by the SCPE (Surveillance of Cerebral Palsy in Europe) working group and the common database allows prevalence analyses on a larger basis. CP prevalence increases with lower birthweight and higher immaturity. Increase Of Survival after preterm birth has first also increased CP rates. But already in the 80s this trend was reversed for LBW infants, and in the 90s also for VLBW or very immature infants. The outcome with respect to CP in the group of extremely LBW or immature infants remains a matter of specific concern, as prevalence seems to be rather stable on a high level. CP is caused in more than 80% by brain lesions or maldevelopments which can be attributed to different timing periods of the developing brain. Extent and topography determine the clinical subtype of CP and are related also to the presence and severity of associated disabilities. CP, thus, offers a model to Study plasticity of the developing brain. Reorganisation following unilateral lesions is mainly interhemispheric and homotopic. In the motor system, it involves the recruitment of ipsilateral tracts; functionality seems to be limited and decreases already towards the end of gestation. There is no clear evidence for substantial reorganisation in the sensory system. The best compensatory potential is described concerning language function following left hemispheric lesions. Language function reorganized to the right hemisphere eventually seems not to be impaired, this occurs, however, on the expense of primary right hemispheric functions. (C) 2009 Elsevier B.V. All rights reserved.