Neuropediatrics 2021; 52(S 01): S1-S53
DOI: 10.1055/s-0041-1739683
Freier Vortrag

Nonverbal Intelligence in Unilateral Perinatal Stroke with and without Epilepsies

A. Gschaidmeier
1   Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tubingen, Germany
2   Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Klinik Vogtareuth, Germany
,
Magdalena Heimgärtner
1   Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tubingen, Germany
,
Lukas Schnaufer
1   Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tubingen, Germany
3   Experimental Pediatric Neuroimaging, Children's Hospital and Department of Neuroradiology, University Hospital Tubingen, Germany
,
Pablo Hernáiz Driever
4   Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Germany
,
Marko Wilke
1   Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tubingen, Germany
3   Experimental Pediatric Neuroimaging, Children's Hospital and Department of Neuroradiology, University Hospital Tubingen, Germany
,
Karen Lidzba
1   Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tubingen, Germany
5   Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital Inselspital, Bern University Hospital, University of Bern, Switzerland
,
Martin Staudt
1   Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tubingen, Germany
2   Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Klinik Vogtareuth, Germany
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Background: The risk factors for impaired cognitive development after unilateral perinatal stroke are poorly understood. Nonverbal intelligence seems to be at particular risk, since language can shift to the right hemisphere and may thereby reduce the capacity of the right hemisphere for its original functions.

Pharmaco-refractory epilepsies, a frequent complication of perinatal strokes, can lead to dramatically impaired intelligence. Yet, the role of well-controlled epilepsies is less well understood. Here, we investigated whether well-controlled epilepsies, motor impairment, lesion size, lesion side, and lateralization of language functions influence nonverbal functions.

Methods: We recruited 8 patients with well-controlled epilepsies (9–26 years), 15 patients without epilepsies (8–23 years), and 23 healthy controls (8–27 years). All underwent the motor-independent test of nonverbal intelligence, which excludes biased results due to hand motor impairment. Language lateralization was determined with functional MRI, lesion size with MRI-based volumetry, hand motor impairment with the Jebson-Taylor Hand Function Test.

Results: Patients with epilepsies showed significantly lower nonverbal intelligence (Md = 89.5, IQR = 13.5) than controls (Md = 103, IQR = 17). In contrast, patients without epilepsies (Md = 97, IQR = 15.0) performed within the range of typically developing children. A multiple regression analysis revealed only epilepsy as a significant risk factor for impaired nonverbal functions.

Conclusion: In patients with unilateral perinatal strokes without epilepsies, the neuroplastic potential of one healthy hemisphere is able to support the development of normal nonverbal cognitive abilities, regardless of lesion size, lesion side, or language lateralization. In contrast, epilepsy substantially reduces this neuroplastic potential; even seizure-free patients exhibit below-average nonverbal cognitive functions.



Publication History

Article published online:
28 October 2021

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