Neglect-like characteristics of developmental disregard in children with cerebral palsy revealed by event related potentials

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• 作者：Ingar M Zielinski (1)
  Bert Steenbergen (1) (3)
  C Marjolein Baas (1)
  Pauline BM Aarts (2)
  Marijtje LA Jongsma (1)
  
  1. Behavioural Science Institute ; Radboud University Nijmegen ; PO Box 9104 ; Nijmegen ; 6500 ; HE ; The Netherlands
  3. School of Psychology ; Australian Catholic University ; 115 Victoria Pde ; Melbourne ; VIC 3450 ; Australia
  2. Department of Pediatric Rehabilitation ; Sint Maartenskliniek ; PO Box 9011 ; Nijmegen ; 6500 ; GM ; The Netherlands
  
• 关键词：Unilateral cerebral palsy ; Developmental disregard ; Cognitive control ; EEG ; Event ; related potentials ; Executive functions ; Neglect ; Visuo ; spatial attention
• 刊名：BMC Neurology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：1,848 KB
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• 刊物主题：Neurology; Neurochemistry; Neurosurgery;
• 出版者：BioMed Central
• ISSN：1471-2377

文摘

Background Children with unilateral Cerebral Palsy (CP) often show diminished awareness of the remaining capacity of their affected upper limb. This phenomenon is known as Developmental Disregard (DD). DD has been explained by operant conditioning. Alternatively, DD can be described as a developmental delay resulting from a lack of use of the affected hand during crucial developmental periods. We hypothesize that this delay is associated with a general delay in executive functions (EF) related to motor behavior, also known as motor EFs. Methods Twenty-four children with unilateral CP participated in this cross-sectional study, twelve of them diagnosed with DD. To test motor EFs, a modified go/nogo task was presented in which cues followed by go- or nogo-stimuli appeared at either the left or right side of a screen. Children had to press a button with the hand corresponding to the side of stimulus presentation. Apart from response accuracy, Event-Related Potentials (ERPs) extracted from the ongoing EEG were used to register covert cognitive processes. ERP N1, P2, N2, and P3 components elicited by cue-, go-, and nogo-stimuli were further analyzed to differentiate between different covert cognitive processes. Results Children with DD made more errors. With respect to the ERPs, the P3 component to go-stimuli was enhanced in children with DD. This enhancement was related to age, such that younger children with DD showed stronger enhancements. In addition, in DD the N1 component to cue- and go-stimuli was decreased. Conclusions The behavioral results show that children with DD experience difficulties when performing the task. The finding of an enhanced P3 component to go-stimuli suggests that these difficulties are due to increased mental effort preceding movement. As age in DD mediated this enhancement, it seems that this increased mental effort is related to a developmental delay. The additional finding of a decreased N1 component in DD furthermore suggests a general diminished visuo-spatial attention. This effect reveals that DD might be a neuropsychological phenomenon similar to post-stroke neglect syndrome that does not resolve during development. These findings suggest that therapies aimed at reducing neglect could be a promising addition to existing therapies for DD.