Proxy-reported quality of life in adolescents and adults with dyskinetic cerebral palsy is associated with executive functions and cortical thickness

Laporta-Hoyos, Olga; Ballester‐Plané, Júlia; Póo, Pilar; Macaya, Alfons; Meléndez-Plumed, Mar; Vázquez, Élida; Delgado, Ignacio; Zubiaurre‐Elorza, Leire; Botellero, Violeta Lozano; Narberhaus, Ana; Toro-Tamargo, Esther; Segarra, Dolors; Pueyo, Roser

doi:10.1007/s11136-016-1433-0

Cited by 25 publications

(28 citation statements)

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“…The laterality observed in cognitive flexibility is not consistent with a previous study in unilateral CP assessing the four executive function domains (Bodimeade et al, 2013) but it was consistent with a previous study of cortical thickness in dyskinetic CP including 28 of the participants included in the present study (Laporta-Hoyos et al, 2017). This interhemispheric difference observed with the WCST has also been previously described in other neurological conditions (Jodzio et al, 2016).…”

Section: Discussionsupporting

confidence: 61%

“…Lesions of the basal ganglia and thalamic systems may impair focused attention and executive function (Bottcher, 2010). These brain lesions are frequently described in people with dyskinetic CP (Bax et al, 2006, Himmelmann and Uvebrant, 2011) but only one study has focused on executive function (executive function) and brain magnetic resonance imaging (MRI) in this CP subtype (Laporta-Hoyos et al, 2017). Although executive functions depend on the integrity of the entire brain, they are mainly mediated by the frontal lobes and its connections with posterior and subcortical brain regions (Anderson, 2008, Bodimeade et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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White matter integrity in dyskinetic cerebral palsy: Relationship with intelligence quotient and executive function

Laporta-Hoyos

Pannek

Ballester‐Plané

et al. 2017

NeuroImage: Clinical

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BackgroundDyskinetic cerebral palsy (CP) is one of the most disabling motor types of CP and has been classically associated with injury to the basal ganglia and thalamus. Although cognitive dysfunction is common in CP, there is a paucity of published quantitative analyses investigating the relationship between white matter (WM) microstructure and cognition in this CP type.AimsThis study aims (1) to compare brain WM microstructure between people with dyskinetic CP and healthy controls, (2) to identify brain regions where WM microstructure is related to intelligence and (3) to identify brain regions where WM microstructure is related to executive function in people with dyskinetic CP and (4) to identify brain regions where the correlations are different between controls and people with CP in IQ and executive functions.Patients and methodsThirty-three participants with dyskinetic CP (mean ± SD age: 24.42 ± 12.61, 15 female) were age and sex matched with 33 controls. Participants underwent a comprehensive neuropsychological battery to assess intelligence quotient (IQ) and four executive function domains (attentional control, cognitive flexibility, goal setting and information processing). Diffusion weighted MRI scans were acquired at 3T. Voxel-based whole brain groupwise analyses were used to compare fractional anisotropy (FA) and of the CP group to the matched controls using a general lineal model. Further general linear models were used to identify regions where white matter FA correlated with IQ and each of the executive function domains.ResultsWhite matter FA was significantly reduced in the CP group in all cerebral lobes, predominantly in regions connected with the parietal and to a lesser extent the temporal lobes. There was no significant correlation between IQ or any of the four executive function domains and WM microstructure in the control group. In participants with CP, lower IQ was associated with lower FA in all cerebral lobes, predominantly in locations that also showed reduced FA compared to controls. Attentional control, goal setting and information processing did not correlate with WM microstructure in the CP group. Cognitive flexibility was associated with FA in regions known to contain connections with the frontal lobe (such as the superior longitudinal fasciculus and cingulum) as well as regions not known to contain tracts directly connected with the frontal lobe (such as the posterior corona radiata, posterior thalamic radiation, retrolenticular part of internal capsule, tapetum, body and splenium of corpus callosum).ConclusionThe widespread loss in the integrity of WM tissue is mainly located in the parietal lobe and related to IQ in dyskinetic CP. Unexpectedly, executive functions are only related with WM microstructure in regions containing fronto-cortical and posterior cortico-subcortical pathways, and not being specifically related to the state of fronto-striatal pathways which might be due to brain reorganization. Further studies of this nature may improve our understanding of the neurobiol...

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

White matter integrity in dyskinetic cerebral palsy: Relationship with intelligence quotient and executive function

Laporta-Hoyos

Pannek

Ballester‐Plané

et al. 2017

NeuroImage: Clinical

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“…children who are not able to use speech as mode of communication) struggle with literacy despite normal cognition . Recently, executive functioning has been the focus in studies of the dyskinetic subtype, but it has not been confirmed that they struggle more in this area than those in the subgroup with spasticity …”

Section: Resultsmentioning

confidence: 99%

“…In this second largest subtype, constituting 6% to 15% of the total population with CP, 4,12 wide variability in standardized scores on tests of non-verbal reasoning and verbal comprehension (55-119) is reported. 60,61 Often 50% to 60% are reported to have an IQ less than 70, 4,5,9 but it varies between as few as 25% 11,62 and as many as 70% to 80%. 8,63 As in spastic CP, normal cognition is also found in those with the most severe motor impairments.…”

Section: Dyskinesiamentioning

confidence: 99%

Cognitive functioning in children with cerebral palsy

Stadskleiv

2020

Develop Med Child Neuro

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PVL Periventricular leukomalaciaChildren with cerebral palsy (CP) have an increased risk of cognitive impairments. This narrative review of the literature discusses assessment of cognition in children with CP, presents the most salient characteristics of cognitive functioning pertaining to each subtype, and discusses the relationships between brain injury, functioning, and intervention from a developmental perspective. A search for original studies of cognitive functioning in children with different subtypes of CP was performed. The search resulted in 81 unique hits. There were few studies with a representative sample of children with CP where all participants were individually assessed. Cognitive functioning in children with the most severe motor impairments were often assumed and not assessed. Furthermore, there was a confounding of IQ below 70 and intellectual disability, possibly leading to an overestimation of the prevalence of intellectual disability. Longitudinal neuropsychological studies, including also very young children and those with the most severe speech and motor impairments, as well as intervention studies, are called for.

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“…Executive functioning is also essential for social problem solving and emotional regulation in children and young people with CP [3,9]. EF has been shown to play an important role in the QOL of people with CP [10].…”

Section: Introductionmentioning

confidence: 99%

Study protocol of a randomized controlled trial of home-based computerized executive function training for children with cerebral palsy

et al. 2020

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Background: Cerebral palsy (CP) is frequently associated with specific cognitive impairments, such as executive dysfunction which are related to participation and quality of life (QOL). The proposed study will examine whether a computerized executive function (EF) training programme could provide superior benefits for executive functioning, participation, QOL and brain plasticity, as compared to usual care. Methods: A single-blind randomized controlled trial (RCT) design will be performed. Thirty children with CP aged 8 to 12 years will participate in a home-based computerized multi-modal executive training programme (12 weeks, 5 days a week, 30 min a day training, total dose = 30 h). Thirty children with CP matched by age, sex, motor and intelligence quotient (IQ) will compose the waitlist group. Cognitive, behavioural, emotional, participation and QOL measures will be obtained at three time points: before, immediately after and 9 months after completing the training. Additionally, structural and functional (resting state) magnetic resonance images (MRI) will be obtained in a subsample of 15 children from each group. Outcomes between groups will be compared following standard principles for RCTs. Discussion: The study will test whether the cognitive training programme exerts a positive effect not only on neuropsychological and daily functioning of children with CP but also on other measures such as participation and QOL. We will also use brain MRI to test brain functional and structural changes after the intervention. If this on-line and home-based training programme proves effective, it could be a cost-effective intervention with short-and long-term effects on EF, participation or QOL in CP.

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Proxy-reported quality of life in adolescents and adults with dyskinetic cerebral palsy is associated with executive functions and cortical thickness

Abstract: Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.

Cited by 25 publications

References 59 publications

White matter integrity in dyskinetic cerebral palsy: Relationship with intelligence quotient and executive function

White matter integrity in dyskinetic cerebral palsy: Relationship with intelligence quotient and executive function

Cognitive functioning in children with cerebral palsy

Study protocol of a randomized controlled trial of home-based computerized executive function training for children with cerebral palsy

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