Cognitive development after perinatal unilateral infarctions: No evidence for preferential sparing of verbal functions

Gschaidmeier, Alisa; Heimgärtner, Magdalena; Schnaufer, Lukas; Driever, Pablo Hernáiz; Wilke, Marko; Lidzba, Karen; Staudt, Martin

doi:10.1016/j.ejpn.2021.12.007

Cited by 3 publications

(6 citation statements)

References 23 publications

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“…Non-verbal fluid reasoning, however, seems to be more robust. In a previous study focusing on patients with perinatal brain lesions with or without epilepsy, we did not detect a significant difference in verbal function between healthy controls and patients with left hemispheric lesions without epilepsy (8). Our current results seem to contradict this finding, since both our patient groups differed significantly from controls in their language scores.…”

Section: Discussioncontrasting

confidence: 99%

“…Atypical right hemispheric language representation is probably the reason for the relatively good language outcome in these individuals, which is clearly better than the chronic aphasia seen in adults with comparable brain lesions ( 36 ). However, there is also broad evidence that a perinatally acquired brain lesion can impair language function when compared to that of individuals with non-lesioned brains ( 5 , 22 , 37 – 39 ), although the presence of epilepsy may be a decisive factor ( 8 ). The fact that we now show here that individuals with a history of unilateral brain lesions acquired in childhood, and without epilepsy, perform below healthy controls in language tests, therefore is unexpected.…”

Section: Discussionmentioning

confidence: 99%

“…A reason for the different results could, however, be our approach to language testing. In the previous study, we analyzed raw scores of the P-ITPA test for all participants and corrected for age in the analyses ( 8 ). For the current study, we used age-appropriate standard scores for P-ITPA or PPVT.…”

Section: Discussionmentioning

confidence: 99%

“…After perinatal stroke, language development may be delayed, and compared to healthy controls, children after perinatal stroke often score significantly lower on standardized language tests well into middle childhood (5)(6)(7). A large part of this effect, however, can be attributed to epilepsy (5,8). In children without epilepsy, often only subtle deficits in language function are detected (9,10), if any (11).…”

Section: Introductionmentioning

confidence: 99%

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The long-term negative impact of childhood stroke on language

Heimgärtner,

Gschaidmeier,

Schnaufer

et al. 2024

Front. Pediatr.

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ObjectivesThis study aims to investigate the long-term language outcome in children with unilateral childhood stroke in comparison to those with perinatal strokes and typically developing individuals and to explore the impact of lesion-specific modifiers.MethodsWe examined nine patients with childhood stroke, acquired between 0;2 and 16;1 years (CHILD; 3 female, median = 13.5 years, 6 left-sided), 23 patients with perinatal strokes (PERI; 11 female, median = 12.5 years, 16 left-sided), and 33 age-matched typically developing individuals (CONTROL; 15 female, median = 12.33 years). The language outcome was assessed using age-appropriate tasks of the Potsdam Illinois Test of Psycholinguistic Abilities (P-ITPA) or the Peabody Picture Vocabulary Test (PPVT). For group comparisons, study-specific language z-scores were calculated. Non-verbal intelligence was assessed using the Test of Non-verbal Intelligence (TONI-4), language lateralization with functional MRI, and lesion size with MRI-based volumetry.ResultsAll four patients with childhood stroke who initially presented with aphasic symptoms recovered from aphasia. Patients with childhood stroke showed significantly lower language scores than those in the control group, but their scores were similar to those of the patients with perinatal stroke, after adjusting for general intelligence (ANCOVA, language z-score CHILD = −0.30, PERI = −0.38, CONTROL = 0.42). Among the patients with childhood stroke, none of the possible modifying factors, including lesion side, correlated significantly with the language outcome.ConclusionChildhood stroke, regardless of the affected hemisphere, can lead to chronic language deficits, even though affected children show a “full recovery.” The rehabilitation of children and adolescents with childhood stroke should address language abilities, even after the usually quick resolution of clear aphasic symptoms.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The long-term negative impact of childhood stroke on language

Heimgärtner,

Gschaidmeier,

Schnaufer

et al. 2024

Front. Pediatr.

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“…Moreover, at 2-year follow up, outpatient physical therapy was required for 24%, speech therapy for 21%, and occupational therapy for 18% of children. While children with large left-sided perinatal strokes can have normal language development secondary to presumed right hemispheric reorganization [37], poststroke epilepsy was identified as an independent risk factor for deficits in both verbal communication and nonverbal intelligence (e.g., problem solving and abstract reasoning) [38,39].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, causes, and morbidities of stroke in the young

Janas,

Barry,

Lee

2023

Current Opinion in Pediatrics

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Purpose of review The purpose is to describe the latest research on epidemiology, causes, and morbidities of stroke in neonates and children. Recent findings The global incidence of childhood stroke is approximately 2 per 100 000 person-years, which is significantly lower compared to neonates (20–40 per 100 000 live births) and adults (80–90 per 100 000 person-years). Placental abnormalities are a risk factor for perinatal stroke, although cause is usually multifactorial. In children, nonatherosclerotic arteriopathies and arteriovenous malformations are major causes of ischemic and hemorrhagic strokes, respectively. The perinatal period confers a high risk of stroke and can lead to long-term disability, including motor delay, cognitive or speech impairment, and epilepsy. Recent studies suggest that at least 50% of survivors of perinatal stroke have abnormal neurodevelopmental scores in long-term follow up. Childhood stroke is associated with significant morbidity, including epilepsy, motor impairments, and behavioral disability. Recent studies have also identified an association between pediatric stroke and behavioral disorders, such as attention deficit hyperactivity disorder and autism. Summary Perinatal and childhood strokes are important causes of neurological morbidity. Given the low incidence of childhood stroke, prospective research studies on epidemiology, causes, and outcomes remain limited, highlighting the need for continued multisite collaborations.

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Cognitive, academic, executive and psychological functioning in children with spastic motor type cerebral palsy: Influence of extent, location, and laterality of brain lesions

Vermeulen

2022

European Journal of Paediatric Neurology

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Cognitive development after perinatal unilateral infarctions: No evidence for preferential sparing of verbal functions

Cited by 3 publications

References 23 publications

The long-term negative impact of childhood stroke on language

The long-term negative impact of childhood stroke on language

Epidemiology, causes, and morbidities of stroke in the young

Cognitive, academic, executive and psychological functioning in children with spastic motor type cerebral palsy: Influence of extent, location, and laterality of brain lesions

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