Spinal lesion level in spina bifida: a source of neural and cognitive heterogeneity
| Autor: | James M. Drake, Michael E. Brandt, Jon A. Frederick, John P. Laurent, Grace Villarreal, David J. Francis, Susan E. Blaser, Irene Townsend, Kim Copeland, Susan Inwood, Maureen Dennis, Hope Northrup, Jack M. Fletcher, H. Julia Hannay, Amy Boudousquie, Larry A. Kramer |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Telencephalon medicine.medical_specialty Meningomyelocele Adolescent Psychometrics Developmental Disabilities Intelligence Statistics as Topic Splenium Audiology Neuropsychological Tests Lesion Central nervous system disease Cerebellum Intellectual Disability Intellectual disability medicine Image Processing Computer-Assisted Attention deficit hyperactivity disorder Humans Child Neurologic Examination Intelligence quotient business.industry Spina bifida Learning Disabilities Neuropsychology Brain General Medicine medicine.disease Magnetic Resonance Imaging Cerebrospinal Fluid Shunts Surgery Spinal Cord Attention Deficit Disorder with Hyperactivity Data Interpretation Statistical Female medicine.symptom business Hydrocephalus |
| Zdroj: | Journal of neurosurgery. 102 |
| ISSN: | 0022-3085 |
| Popis: | Object. The aim of this study was to evaluate whether the level of a spinal lesion is associated with variations in anomalous brain development and neurobehavioral outcomes in children suffering from the meningomyelocele form of spina bifida and hydrocephalus (SBM-H). Methods. Two hundred sixty-eight children with SBM-H were divided into upper (T-12 and above; 82 patients) and lower (L-1 and below; 186 patients) lesion-level groups. Magnetic resonance images were qualitatively coded by radiologists and quantitatively segmented for cerebrum and cerebellum volumes. Psychometric assessments of handedness, intelligence, academic skills, and adaptive behavior were compared between lesion-level groups and also used to determine the number of children who met research-based criteria for mental retardation, attention deficit hyperactivity disorder, and learning disabilities. The magnetic resonance images obtained in children with upper-level spinal lesions demonstrated more qualitative abnormalities in the midbrain and tectum, pons, and splenium, although not in the cerebellum, compared with images obtained in children with lower-level spinal lesions. Upper-level lesions were also associated with reductions in cerebrum and cerebellum volumes, lower scores on measures of intelligence, academic skills, and adaptive behavior, and with a higher frequency of individuals meeting the criteria for mental retardation. Hispanic children (who were also more economically disadvantaged) were more likely to have upper-level lesions and poorer neurobehavioral outcomes, but lesion-level effects were generally independent of ethnicity. Conclusions. A higher level of spinal lesion in SBM-H is a marker for more severe anomalous brain development, which is in turn associated with poorer neurobehavioral outcomes in a wide variety of domains that determine levels of independent functioning for these children at home and school. |
| Databáze: | OpenAIRE |
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