Beyond the motor impairment in dyskinetic cerebral palsy: neuropsychological and connectome-based approach
[eng] The term cerebral palsy (CP) encompasses a group of disorders of movement and/or posture and of motor function due to a non-progressive injury, interference or abnormality in an immature or developing brain. These motor disorders are often accompanied by disturbances of sensation, perception,...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2018 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/128026 |
| Acceso en línea: | https://hdl.handle.net/2445/128026 http://hdl.handle.net/10803/665520 |
| Access Level: | acceso abierto |
| Palabra clave: | Paràlisi cerebral Neuropsicologia Diagnosi per la imatge Cerebral palsy Neuropsychology Diagnostic imaging |
| Sumario: | [eng] The term cerebral palsy (CP) encompasses a group of disorders of movement and/or posture and of motor function due to a non-progressive injury, interference or abnormality in an immature or developing brain. These motor disorders are often accompanied by disturbances of sensation, perception, cognition, communication, behaviour or epilepsy, and it has been shown that these deficits may have a greater impact on the quality of life of these people than the motor impairment itself. Taking into account the classification of CP according to the type of motor involvement, dyskinetic CP is identified as a rare subtype (between 3% and 15% of all CP cases) characterized by abnormal patterns of posture and/or movement, accompanied by involuntary, uncontrolled, recurrent and, occasionally, stereotyped movements. This type of CP has been mainly associated with a perinatal hypoxic-ischemic event in children born at term or near term and in neonates with kernicterus. It has been shown that dyskinetic CP is one of the most disabling forms of CP, not only because of its association with greater motor impairment but also because of a greater presence and severity of associated deficits, such as speech and communication impairments. It should be noted that studies analysing this type of CP are still scarce, probably due to their lower frequency and greater severity. Cognitive and neuroimaging studies are specially rare, probably because most neuropsychological evaluations require manual dexterity and/or verbal responses, and neuroimaging studies involve the acquisition of MRI sequences in which the person must remain still. Therefore, the main goals of this thesis are: 1) to identify an objective measure of intelligence adequate for the great heterogeneity that exists in CP, 2) to describe the cognitive profile of a relatively large sample of people with dyskinetic CP, and 3) analyse the state of the cerebral white matter of this population through a connectome approach. To this end, a total of 52 subjects with dyskinetic CP and 52 typically-developing controls were included in the study and were administered a neuropsychological battery that included general cognitive performance (using the Raven’s progressive matrices - colour version, the Peabody picture vocabulary test and the Wechsler's nonverbal scale) and five specific cognitive domains (attention, visual perception, language, learning and memory and executive functioning). Finally, an structural MRI was acquired. |
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