Tower of London performance in relation to Magnetic Resonance Imaging following closed head injury in children.

Abstract

To investigate the relationship of severity of pediatric closed head injury (CHI), the contribution of frontal lobe lesions, and age at testing (6-10 years old vs. 11-15 years old) to cognitive deficit, 134 head-injured patients were given the Tower of London (TOL) task and underwent magnetic resonance imaging. Eighty-nine normal controls were given the TOL for comparison. Severity of CHI and age at testing were strongly related to cognitive performance on the TOL, including the frequency of breaking the rules. Volume of frontal lobe lesion (but not extrafrontal lesion) contributed to the prediction of performance on the TOL even after severity of injury was taken into account. Luria (1966) proposed that formulating a plan of action, monitoring problem-solving behaviors by verbal regulation, and verifying goal attainment are among the distinct capacities of the prefrontal region, a view that has received support from case reports of adults (Cicerone & Woods, 1987;Eslinger & Damasio, 1985) and investigation of patients following frontal excisions for intractable epilepsy (Petrides & Milner, 1982). Major gains in cognitive functions, such as planning and flexibility in reasoning, in 6-to 12-year-old children have been attributed to maturation of the prefrontal region (

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Which Executive Functioning Deficits Are Associated With AD/HD, ODD/CD and Comorbid AD/HD+ODD/CD?

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