Abstract
Long term outcome data on bimanual performance in children with perinatal arterial ischaemic stroke (PAIS) and periventricular haemorrhagic infarction (PVHI) with and without unilateral spastic cerebral palsy (USCP) is sparse. To assess bimanual performance in children with PAIS or PVHI with and without USCP and to explore the relationship with unilateral hand function and full-scale IQ (FSIQ) in a cross-sectional study. Fifty-two children with PAIS (n=27) or PVHI (n=25) participated at a median age of 12 years and 1 month (range 6-20 years). The Bruininks Oseretsky Test of Motor Proficiency-2 (bimanual precision and dexterity subtest), Assisting Hand Assessment, Purdue Pegboard Test and Wechsler Intelligence scale were administered. Bimanual dexterity was worse in children with USCP (p<0.02) without a difference for the pathology groups. In children without USCP (n=21), those with PAIS showed a better bimanual precision compared to children with PVHI (p<0.04). The AHA score and the Purdue Pegboard score of the dominant hand explained 51% of the variance in bimanual precision and dexterity in children with USCP. In absence of USCP, FSIQ together with AHA scores explained 66% of the variance in bimanual precision and FSIQ together with the Purdue Pegboard Test score of the dominant hand, 71% of the variance in bimanual dexterity. Children with PAIS without USCP have a more favourable bimanual hand function compared to children with PVHI. This difference appears to be associated with a preserved FSIQ.
Highlights
Unilateral spastic cerebral palsy (USCP) is a neurological condition that is characterized by motor impairments mainly lateralized to one side of the body, often accompanied by disturbances of sensation, cognition, behaviour and epilepsy.[1]
Twenty-seven children were diagnosed with perinatal arterial ischaemic stroke (PAIS) and 25 children with periventricular haemorrhagic infarction (PVHI) (Table 1)
The diagnosis of PAIS or PVHI was based on magnetic resonance imaging (MRI) performed in the neonatal period
Summary
Unilateral spastic cerebral palsy (USCP) is a neurological condition that is characterized by motor impairments mainly lateralized to one side of the body, often accompanied by disturbances of sensation, cognition, behaviour and epilepsy.[1]. PAIS most often occurs in term born infants, with involvement of the cortex, white matter and sometimes deep grey matter, while PVHI generally affects preterm infants, with mainly white matter involvement and with an onset at a gestational age below 33 weeks.[16] Prematurity itself is associated with motor, cognitive and behavioural disabilities which might affect bimanual performance.[17] several studies in children with USCP showed that children with PAIS have a worse upper limb function compared to PVHI.[18,19]. The AHA score and the Purdue Pegboard score of the dominant hand explained 51% of the variance in bimanual precision and dexterity in children with USCP. This difference appears to be associated with a preserved FSIQ
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