Relations between cognition and motricity in children with neonatal arterial ischemic stroke
Mr Guillaume THÉBAULTa, Prof Denis BROUILLETb, Dr Sophie MARTINb, Dr Joel FLUSSc, Prof Vincent GAUTHERONd, Dr Stéphane CHABRIERe
a Groupe de Recherche sur la thrombose, EA 3065, Université Jean Monnet, Saint-Etienne - Laboratoire Epsylon, EA 4556, Université Montpellier III, b Laboratoire Epsylon, EA 4556, Université Montpellier III, c Hôpital des Enfants de Genève, d laboratoire de Physiologie de l’Exercice, EA 4338, Université Jean Monnet, Saint-Étienne, e Centre national de référence de l’AVC de l’enfant et Groupe de recherche sur la thrombose, EA3065, Université Jean Monnet, Saint-Étienne
Introduction and Goal
Perinatal arterial ischemic stroke (PAIS) affects one child for 4000 births. The few studies about cognitive development specific to PAIS, showed that cognitive performances in this population don't follow up a normal development (Westmacott et al., 2010 ; Ricci et al., 2008). Based on new data about relation between motricity and cognition (Smits-Engelsman et Hill, 2012), and on the theory of the embodied cognition, led us to hypothesize that cognitive performances would be correlated to the motor performances in children with PAIS.
Patients and Methodology
We tested 77 7 years old children meeting the criteria of neonatal AIS, with a diagnosis before the 28th day of life relying on cerebral imagery. After excluding children with seizure and bi-hemispheric lesion, 56 children participated to our study. The cognitive evaluation was performed with the Wechsler Intelligence Scale for Children (WISC-4), the motor evaluation relied on testing of gross motor of the upper arm (Box and Block Test) and fine prehension test ("Nine Hole Peg Test"). The localisation of the lesion, the economic level of parents, the gender, sensory impairments and the presence of hemiplegia were collected. We analyzed these results with simple linear regression.
The main result of our study is the significative correlation (p<0.03) between scores of the WISC4 (except for working memory index) and motor results. In contrast we did not find any correlation between the scores of the WISC4 and the presence of hemiplegia or with lesion localization.
Many brain networks develop during the first year through sensorimotor experiences, which contribute to the emergence of knowledge. This concept of development, supported by the approach embodied cognition, can explain the correlations between cognition and motor found in our work and in several studies with children with other early neurological damage.
Keywords : Perinatal accident ischémic arteriel stroke ; Developement ; Cognition ; Motor ; Embodied Cognition