Developmental Neuropsychology of Cognition in Children with Severe Brain Dysfunction

研究对象为6名在严重残疾儿童医院住院的严重脑功能障碍儿童。通过测量听觉诱发电位（ABR、MLR、SVR）来评估脑功能状态。心脏对环境刺激的反应反映了认知系统的活跃方面。因此，基于这些反应的信息，可以估计严重脑功能障碍儿童的认知能力。在这些受试者中，从心率的短暂变化（相位变化）和长期变化（强直变化）两方面研究了听觉刺激对心脏的反应。结果如下：1。在脑干功能障碍的受试者中，从abr的波形推断，听觉刺激几乎观察不到强直性和相位性HR反应。在脑干功能正常的受试者中，观察到HR反应方向的发育转移。即随着hr的时间变异性的增加，阶段性加速反应（防御性反射）变得明显，然后逐渐出现减速反应（定向反射）。在发育的进一步阶段，观察到对信号刺激的“第二次”加速反应。这些反应被认为是积极注意的发生。考虑到心脏对环境刺激的反应水平尚不成熟，有可能估计严重脑功能障碍儿童认知功能的可塑性方面。

The subjects were 6 children with severe brain dysfunction, who were resident in hospitals for severely handicapped children. Through measuring auditory evoked potentials(ABR, MLR, SVR), the functional state of brain were estimated.Cardiac responses to enviromental stimuli reflect the active aspects of cognitive system. Therefore, based on the information about these responses, it is possible to estimate cognition in children with severe brain sysfunction.About these subjects, cardiac responses to auditory stimuli were examined regarding both aspects of transient changes (phasic) and long-lasting changes(tonic) of heart rates(HRs). Results were as follows :1. In subjects with brainstem dysfunction, infered from waveforms of ABRs, tonic and phasic HR responses were hardly observed to auditory stimuli.2. In subjects with normal functions of brainstem, developmental shift in the direction of HR responses were observed. Namely phasic accelerating responses (defensive reflexes) became to be clear with increasing temporal variability of HRs, and then occurrences of decelerating responses(orienting reflexes) gradually insereased. In the further stage of development, "the second" accelerating responses to signal stimuli were observed. These responses were regarded as occurences of active attention.Considering the immature level of cardiac responses to enviromental stimuli, it might be possible estimate the aspect of plasticity in the cognitive function of children with severe brain dysfunction.