Developmental Neuropsychology of Cognition in Children with Severe Brain Dysfunction

研究对象为6名严重脑功能障碍的儿童，他们都住在重度残疾儿童医院。通过测定听觉诱发电位（ABR，MLR，SVR）来估计脑功能状态，心脏对环境刺激的反应反映了认知系统的活动方面。因此，基于这些反应的信息，它是可能的，以估计严重的脑功能障碍儿童的认知。关于这些科目，心脏对听觉刺激的反应进行了检查，从两个方面的瞬时变化（阶段性）和长期的变化（紧张性）的心率（HR）。结果如下：1.在脑干功能障碍的受试者中，从ABR波形推断，对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反应方向的发育转变。即阶段性加速反应（防御反射）随着心率时变的增加而变得明显，然后减速反应（定向反射）的发生逐渐增加。在进一步的发展阶段，观察到“第二”加速反应的信号刺激。这些反应被认为是主动注意的活动，考虑到心脏对环境刺激的反应的不成熟水平，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.