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Childhood acquired brain injury (ABI) is associated with poorer life outcomes. Increasing numbers of children and young people are surviving severe brain injury and returning to mainstream schools with multiple impairments. It is widely acknowledged that for these children, their school becomes by default their rehabilitation centre. International studies of this transition and a recent UK government report criticize educators' inconsistent implementation of support strategies, lack of educator training and poor communication between clinicians, educators, child and family. The educators' perspectives of the return‐to‐school are, however, not well represented in the literature. This study therefore explored the experiences of educators in the UK (N = 10) who had recently facilitated a return‐to‐school of a child with ABI aged 8–12 (N = 5) using semi‐structured interviews analysed by data‐driven thematic analysis. The findings highlight common experiences: a continuum of intensive problem‐solving with heavy reliance on the Special Educational Needs Coordinator; educators valuing collaboration with clinical specialists in context over general 'training'; uncertainty over the validity of implementing support strategies from prior teaching experience; uncertainty about how to support the child's emotional needs; and frustration with UK statutory processes for Special Educational Needs and Disabilities. Recommendations are made for changes to practice and future research. [ABSTRACT FROM AUTHOR]

In the present study the walking pattern of 10 children with developmental coordination disorder (DCD) was investigated and compared to that of 10 typically developing, matched control children. All children walked at a similar velocity that was scaled to the length of the leg on a motor-driven treadmill. Three-dimensional kinematics were recorded with a motion capture digital camera system. The spatiotemporal parameters of the gait pattern revealed that children with DCD walked with shorter steps and at a higher frequency than the typically developing children. In addition, the children with DCD exhibited a body configuration that demonstrated increased trunk inclination during the entire gait cycle and enhanced during the entire gait cycle. At toe-off a less pronounced plantar flexion of the ankle was observed in children with DCD. In conclusion, it appeared that children with DCD make adaptations to their gait pattern on a treadmill to compensate for problems with neuromuscular and/or balance control. These adaptations seem to result in a safer walking strategy where the compromise between equilibrium and propulsion is different compared to typically developing children. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine the effects of balance training with visual feedback on stance and gait in school-age children with hemiplegic cerebral palsy. Ten participants between 5 and 11 years of age were assigned to either the training or the control group according to an aged-stratified randomization. The training corresponded to three sessions per week during six weeks. Stance and gait parameters, based on force plate data, were assessed three times in both groups: (a) at the beginning of the study (before training); (b) after six weeks; (c) after ten weeks. Spatial and temporal parameters were calculated. The results for stance showed that the training improved the performances on the tasks that were trained. More interesting, the results for gait showed that the walking pattern became more symmetrical after the training. [ABSTRACT FROM AUTHOR]

The effect of amplitude incongruence (small circles-large circles) and form incon­gruence (circles-lines) on the performance of the affected and non-affected arm was examined in 12 children with hemiplegic cerebral palsy in bimanual rhythmic drawing tasks. Amplitude and form incongruence are assumed to be associated with aspects of movement execution and movement planning, respectively. The follow­ing questions were addressed: Does amplitude or form incongruence in bimanual coordination result in: (a) accommodation of the affected or non-affected arm, or both, (b) an increase of temporal variability of drawing movements of the affected or non-affected arm, and (c) a decrease of bimanual coordination stability? Form incongruence resulted in accommodation of both affected and non-affected arm in a similar way found in non-disabled participants. Despite this accommodation, the temporal variability of both affected and non-affected arm was increased, and coordination stability decreased, because the spatial trajectories of affected and non-affected arm were still rather dissimilar. Amplitude incongruence resulted in accommodation of either the affected arm (large circles required) or non-affected arm (small circles required), and in an increase or decrease of temporal variability of the affected arm, depending on the degree of spatial similarity of the trajec­tories of affected and non-affected arm. These findings suggest that in children with hemiplegic cerebral palsy aspects of movement execution, but not aspects of movement planning are affected by the "hemiplegic" condition. [ABSTRACT FROM AUTHOR]

Abstract Traumatic brain injury (TBI) during early childhood is associated with a particularly high risk of developing social behavior impairments, including deficits in social cognition that manifest as reduced social interactions, with profound consequences for the individuals' quality of life. A number of pre-injury, post-injury, and injury-related factors have been identified or hypothesized to determine the extent of social behavior problems after childhood TBI. These include variables associated with the individual themselves (e.g. age, genetics, the injury severity, and extent of white matter damage), proximal environmental factors (e.g. family functioning, parental mental health), and more distal environmental factors (e.g. socioeconomic status, access to resources). In this review, we synthesize the available evidence demonstrating which of these determinants influence risk versus resilience to social behavior deficits after pediatric TBI, drawing upon the available clinical and preclinical literature. Injury-related pathology in neuroanatomical regions associated with social cognition and behaviors will also be described, with a focus on findings from magnetic resonance imaging and diffusion tensor imaging. Finally, study limitations and suggested future directions are highlighted. In summary, while no single variable can alone accurately predict the manifestation of social behavior problems after TBI during early childhood, an increased understanding of how both injury and environmental factors can influence social outcomes provides a useful framework for the development of more effective rehabilitation strategies aiming to optimize recovery for young brain-injured patients. [ABSTRACT FROM AUTHOR]

Background: Action-planning and execution deficits in children with hemiplegic cerebral palsy (HCP) are potentially due to deficits in the integration of sensory information, such as vision, with motor output.Aims: To determine differences in anticipatory visual patterns in children with HCP compared to typically developing (TD) children, and to assess visuomotor coordination in children with HCP.Methods and Procedures: We included 13 children with HCP (Age = 6.8 + 2.9 yrs) and 15 TD children (Age = 5.8 + 1.1 yrs). The experimental task used in this study is a valid action-planning task, which consisted of initially reaching and grasping an object placed at a fixed position, followed by placing the object in a random target position. Visual patterns were recorded using a head-mounted eye-tracker system and arm movements were recorded using motion capture (120 Hz).Outcomes and Results: Children with HCP had delayed anticipatory gaze time and longer latency than TD children during the planning and execution phases. Children with HCP also had a higher frequency of gaze shifts, longer reaction times (RT) and movement times (MT) than TD children.Conclusions and Implications: Children with HCP may have deficits in anticipatory vision, which potentially affected planning and executing a goal-directed action. Therapeutic interventions focusing on improving visuomotor coordination may improve the motor performance in children with HCP. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the effects of live and video form action observation training (AOT) on upper limb (UL) movement acceleration and function in children with cerebral palsy (CP).Methods: In total, 12 children (7 boys, 5 girls) with CP participated in this study. The children were allocated randomly to live (experimental) and video (control) AOT groups. All children completed 20 treatment sessions, each 30 minutes in duration, 5 days per week for a month. Mediolateral (ML) and vertical (VT) acceleration data, Jebsen-Taylor Hand Function (JTHF) scores, and Box and Block Test (BBT) scores were obtained at baseline and at 4 weeks after the intervention.Results: ML and VT movement acceleration and JTHF scores were significantly lower in the live group (p< 0.05). The BBT score was significantly higher in the live than in the video group (p< 0.05).Conclusions: Our findings suggest that live AOT is more effective than video AOT for improving UL movement acceleration and function. Clinically, our findings offer important insights for clinicians when planning AOT interventions to reduce UL movement acceleration and improve UL function. [ABSTRACT FROM AUTHOR]

Objective: The main purpose of this study was to measure the peak acceleration of the upper limb (UL) during reaching, and to calculate correlations between peak acceleration data and functional test results in children with cerebral palsy (CP).Methods: We recruited 15 children with CP (8 boys and 7 girls) and measured peak acceleration and function as revealed by the Jebsen Taylor Hand Function Test (JTHF), the Quality of Upper Extremity Skills Test (QUEST), the Box and Blocks Test (BBT), and the ABILHAND-Kids questionnaire. We calculated correlations between peak acceleration data and scores on the functional tests.Results: The peak acceleration of the more-affected UL was significantly higher than that of the less-affected UL (p< 0.05). The peak acceleration data were positively correlated with JTHFT scores. On the other hand, the peak acceleration data were negatively correlated with QUEST, BBT, and ABILHAND-Kids scores. The test-retest reliability of the peak acceleration was excellent, with an intra-class correlation coefficient (ICC) 0.87-0.98.Conclusions: Peak acceleration data correlated with UL functional test results; as this proved to be reliable, the tri-axial accelerometer is a clinically useful assessment tool for evaluating UL movement. Therefore, our results suggest that measurement of acceleration using a tri-axial accelerometer is appropriate when clinicians quantify UL movement during therapeutic rehabilitation in clinical settings. [ABSTRACT FROM AUTHOR]

Key points: Traumatic brain injury (TBI) in children remains a leading cause of death and disability and it remains poorly understood why children have worse outcomes and longer recover times. TBI has shown to alter cortical excitability and inhibitory drive onto excitatory neurons, yet few studies have directly examined changes to cortical interneurons. This is addressed in the present study using a clinically relevant model of severe TBI (controlled cortical impact) in interneuron cell type specific Cre‐dependent mice. Mice subjected to controlled cortical impact exhibit specific loss of parvalbumin (PV) but not somatostatin immunoreactivity and cell density in the peri‐injury zone. PV interneurons are primarily of a fast‐spiking (FS) phenotype that persisted in the peri‐injury zone but received less frequent inhibitory and stronger excitatory post‐synaptic currents. The targeted loss of PV‐FS interneurons appears to be distinct from previous reports in adult mice suggesting that TBI‐induced pathophysiology is dependent on the age at time of impact. Abstract: Paediatric traumatic brain injury (TBI) is a leading cause of death and disability in children. Traditionally, ongoing neurodevelopment and neuroplasticity have been considered to confer children with an advantage following TBI. However, recent findings indicate that the paediatric brain may be more sensitive to brain injury. Inhibitory interneurons are essential for proper cortical function and are implicated in the pathophysiology of TBI, yet few studies have directly investigated TBI‐induced changes to interneurons themselves. Accordingly, in the present study, we examine how inhibitory neurons are altered following controlled cortical impact (CCI) in juvenile mice with targeted Cre‐dependent fluorescence labelling of interneurons (Vgat:Cre/Ai9 and PV:Cre/Ai6). Although CCI failed to alter the number of excitatory neurons or somatostatin‐expressing interneurons in the peri‐injury zone, it significantly decreased the density of parvalbumin (PV) immunoreactive cells by 71%. However, PV:Cre/Ai6 mice subjected to CCI showed a lower extent of fluorescence labelled cell loss. PV interneurons are predominantly of a fast‐spiking (FS) phenotype and, when recorded electrophysiologically from the peri‐injury zone, exhibited intrinsic properties similar to those of control neurons. Synaptically, CCI induced a decrease in inhibitory drive onto FS interneurons combined with an increase in the strength of excitatory events. The results of the present study indicate that CCI induced both a loss of PV interneurons and an even greater loss of PV expression. This suggests caution is required when interpreting changes in PV immunoreactivity alone as direct evidence of interneuronal loss. Furthermore, in contrast to reports in adults, TBI in the paediatric brain selectively alters PV‐FS interneurons, primarily resulting in a loss of interneuronal inhibition. [ABSTRACT FROM AUTHOR]

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This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10). More recent research has focused on optimal resuscitation practices for babies with cardiorespiratory depression, such as delayed cord clamping after establishment of ventilation and resuscitation in air. Around a quarter of infants with asystole at 10 min after birth who are subsequently cooled have normal outcomes, suggesting that individualised decision making on stopping resuscitation is needed, based on access to intensive treatment unit and early cooling. The full benefit of cooling appears to have been exploited in our current treatment protocols of 72 hours at 33.5°C; deeper and longer cooling showed adverse outcome. The challenge over the next 5-10 years will be to assess which adjunct therapies are safe and optimise hypothermic brain protection in phase I and phase II trials. Optimal care may require tailoring treatments according to gender, genetic risk, injury severity and inflammatory status. [ABSTRACT FROM AUTHOR]

Whole exome sequencing enables scanning a large number of genes for relatively low costs. The authors investigate its use for previously undiagnosed pediatric neurological patients. This retrospective cohort study performed whole exome sequencing on 57 patients of “Magen” neurogenetic clinics, with unknown diagnoses despite previous workup. The authors report on clinical features, causative genes, and treatment modifications and provide an analysis of whole exome sequencing utility per primary clinical feature. A causative gene was identified in 49.1% of patients, of which 17 had an autosomal dominant mutation, 9 autosomal recessive, and 2 X-linked. The highest rate of positive diagnosis was found for patients with developmental delay, ataxia, or suspected neuromuscular disease. Whole exome sequencing warranted a definitive change of treatment for 5 patients. Genetic databases were updated accordingly. In conclusion, whole exome sequencing is useful in obtaining a high detection rate for previously undiagnosed disorders. Use of this technique could affect diagnosis, treatment, and prognostics for both patients and relatives. [ABSTRACT FROM AUTHOR]

The study was aimed at documenting the relationship between Glasgow coma score with imaging findings on computed tomography in children with traumatic brain injury. Un-necessary radiation exposure can be detrimental in pediatric age group and can lead to an increased risk of radiation induced malignancies. Patients and Methods: This retrospective study was conducted in Department of Radiology Lahore from 15.8.11 to 15.11.11. It included 48 children who presented in emergency department with history of fall or trauma to head. These patients underwent computed tomography using standard imaging protocols. All the data was analyzed by using SPSS version 17. Results: A total of 48 patients from 6 months to 15 years of age with history of fall or trauma to head who underwent CT scan were included in study. 20 (42%) patients revealed normal study. Extra/intra axial bleed is noted in 11 (23%), evidence of cerebral edema was noted in 4 (8%) patients. 9 (19%) patients had fracture of skull bones and cephalhematoma was noted among 4 (8%) patients. Imaging findings were seen in majority of the patients with GCS less than 13/15. Conclusion: Neuroimaging can serve as a useful guide regarding management of traumatic brain injury however un-necessary radiation exposure is detrimental in pediatric age group. A correlation between GCS and decision regarding imaging can serve as an effective approach to decrease rates of neuroimaging after pediatric head trauma. [ABSTRACT FROM AUTHOR]

Introduction Health-related quality of life (HRQOL) instruments are increasingly being used to evaluate interventions and therapy outcomes in children and adolescents with cerebral palsy (CP). A variety of psychometrically sound and validated generic and disease-specific instruments are available. A third type of instrument, the chronicgeneric instrument, pertains to features of HRQOL that are shared by various chronic conditions. The DISABKIDS family of questionnaires consists of a chronic-generic core measure (DCGM-37) and several condition-specific modules, among these, a CP module (CPM). The objective of this article was to describe the performance and, specifically, the validity of the DCGM-37 and CPM in children and adolescents with CP. Methods Psychometric properties of the DCGM-37 and the CPM are presented. The discriminant validity was assessed compared with generic measures of HRQOL regarding different levels of impairment (physical independence; developmental delay). Results A total of 86 patients with CP (mean age 13 years, range 7-19 years) and 78 main caretakers participated in this study. The DCGM-37 and CPM showed much better discriminative ability as compared with generic questionnaires. Conclusions The DCGM-37 and CPM were able to differentiate between patients with different levels of impairment and can be recommended for treatment evaluation and group comparison in clinical studies of children and adolescents with CP. [ABSTRACT FROM AUTHOR]

Objective The neurohabilitation treatment has been shown to be a successful method for decreasing the sequelae of perinatal brain damage (PBD) in Hungarian population. The goal of this pilot trial was to introduce this procedure by describing the results of its application in infants with PBD as demonstrated by clinical, developmental and MRI studies. As this procedure has proved to be useful, according the declaration of Helsinki, no control clinical trial was permitted. Participants Infants younger than 2 months of corrected age (CA) with prenatal and/or perinatal risk factors for brain damage. Two groups were considered. One group was treated using the “neurohabilitation” method ( n = 20), and the other was not treated ( n = 13) because treatment was voluntarily discontinued after the initial evaluation. Evaluations were carried out prior to 2 months of CA and at 6–8 years of age. All children showed abnormal clinical and MRI characteristics in the first study. Results The treated group had a higher percentage (90%) of children with normal outcome than did the non-treated group (38%; OR = 2.37, CI 95% = 1.2–4.7; p < 0.005). In this latter group, only one out of five (20%) children born at or before 34 weeks of gestational age had a normal outcome. In contrast, eight out of nine treated preterm infants had normal outcomes (8/9 = 89%, OR = 4.45, CI 95% = 0.7–26; p = 0.017). Conclusions This pilot trial confirms previous studies suggesting that Neurohabilitation decreases the neurological and cognitive sequelae of preterm and at-term infants with PBD. [ABSTRACT FROM AUTHOR]

In adults, glial fibrillary acidic protein (GFAP) has been shown to out-perform S100β in detecting intracranial lesions on computed tomography (CT) in mild traumatic brain injury (TBI). This study examined the ability of GFAP and S100β to detect intracranial lesions on CT in children and youth involved in trauma. This prospective cohort study enrolled a convenience sample of children and youth at two pediatric and one adult Level 1 trauma centers following trauma, including both those with and without head trauma. Serum samples were obtained within 6 h of injury. The primary outcome was the presence of traumatic intracranial lesions on CT scan. There were 155 pediatric trauma patients enrolled, 114 (74%) had head trauma and 41 (26%) had no head trauma. Out of the 92 patients who had a head CT, eight (9%) had intracranial lesions. The area under the receiver operating characteristic curve (AUC) for distinguishing head trauma from no head trauma for GFAP was 0.84 (0.77-0.91) and for S100β was 0.64 (0.55-0.74; p<0.001). Similarly, the AUC for predicting intracranial lesions on CT for GFAP was 0.85 (0.72-0.98) versus 0.67 (0.50-0.85) for S100β ( p=0.013). Additionally, we assessed the performance of GFAP and S100β in predicting intracranial lesions in children ages 10 years or younger and found the AUC for GFAP was 0.96 (95% confidence interval [CI] 0.86-1.00) and for S100β was 0.72 (0.36-1.00). In children younger than 5 years old, the AUC for GFAP was 1.00 (95% CI 0.99-1.00) and for S100β 0.62 (0.15-1.00). In this population with mild TBI, GFAP out-performed S100β in detecting head trauma and predicting intracranial lesions on head CT. This study is among the first published to date to prospectively compare these two biomarkers in children and youth with mild TBI. [ABSTRACT FROM AUTHOR]

Brain lesions after traumatic brain injury (TBI) are heterogeneous, rendering outcome prognostication difficult. The aim of this study is to investigate whether early magnetic resonance imaging (MRI) of lesion location and lesion volume within discrete brain anatomical zones can accurately predict long-term neurological outcome in children post-TBI. Fluid-attenuated inversion recovery (FLAIR) MRI hyperintense lesions in 63 children obtained 6.2±5.6 days postinjury were correlated with the Glasgow Outcome Scale Extended-Pediatrics (GOS-E Peds) score at 13.5±8.6 months. FLAIR lesion volume was expressed as hyperintensity lesion volume index (HLVI)=(hyperintensity lesion volume / whole brain volume)×100 measured within three brain zones: zone A (cortical structures); zone B (basal ganglia, corpus callosum, internal capsule, and thalamus); and zone C (brainstem). HLVI-total and HLVI-zone C predicted good and poor outcome groups ( p<0.05). GOS-E Peds correlated with HLVI-total ( r=0.39; p=0.002) and HLVI in all three zones: zone A ( r=0.31; p<0.02); zone B ( r=0.35; p=0.004); and zone C ( r=0.37; p=0.003). In adolescents ages 13-17 years, HLVI-total correlated best with outcome ( r=0.5; p=0.007), whereas in younger children under the age of 13, HLVI-zone B correlated best ( r=0.52; p=0.001). Compared to patients with lesions in zone A alone or in zones A and B, patients with lesions in all three zones had a significantly higher odds ratio (4.38; 95% confidence interval, 1.19-16.0) for developing an unfavorable outcome. [ABSTRACT FROM AUTHOR]

Much progress has been made toward behavioral and pharmacological intervention in intellectual disability, which was once thought too difficult to treat. Down syndrome (DS) research has shown rapid advances, and clinical trials are currently underway, with more on the horizon. Here, we review the literature on the emergent profile of cognitive development in DS, emphasizing that treatment approaches must consider how some "end state" impairments, such as language deficits, may develop from early alterations in neural systems beginning in infancy. Specifically, we highlight evidence suggesting that there are pre- and early postnatal alterations in brain structure and function in DS, resulting in disturbed network function across development. We stress that these early alterations are likely amplified by Alzheimer's disease (AD) progression and poor sleep. Focusing on three network hubs (prefrontal cortex, hippocampus, and cerebellum), we discuss how these regions may relate to evolving deficits in cognitive function in individuals with DS, and to their language profile in particular. [ABSTRACT FROM AUTHOR]

Introduction Unilateral visuospatial deficits have been observed in children with brain damage. While the effectiveness of prism adaptation for treating unilateral neglect in adult stroke patients has been demonstrated previously, the usefulness of prism adaptation in a pediatric population is still unknown. The present study aims at evaluating the feasibility of prism adaptation in children with unilateral brain lesion and comparing the validity of a game procedure designed for child-friendly paediatric intervention, with the ecological task used for prism adaptation in adult patients. Methods Twenty-one children with unilateral brain lesion randomly were assigned to a prism group wearing prismatic glasses, or a control group wearing neutral glasses during a bimanual task intervention. All children performed two different bimanual tasks on randomly assigned consecutive days: ecological tasks or game tasks. The efficacy of prism adaptation was measured by assessing its after-effects with visual open loop pointing (visuoproprioceptive test) and subjective straight-ahead pointing (proprioceptive test). Results Game tasks and ecological tasks produced similar after-effects. Prismatic glasses elicited a significant shift of visuospatial coordinates which was not observed in the control group. Conclusion Prism adaptation performed with game tasks seems an effective procedure to obtain after-effects in children with unilateral brain lesion. The usefulness of repetitive prism adaptation sessions as a therapeutic intervention in children with visuospatial deficits and/or neglect, should be investigated in future studies. [ABSTRACT FROM AUTHOR]

Background: Respiratory and speech problems are commonly observed in children with cerebral palsy (CP). The purpose of this study was to identify if inclination of seat surface could influence respiratory ability and speech production in children with spastic diplegic CP. Methods: Sixteen children with spastic diplegic CP, ages 6 to 12 years old, participated in this study. The subjects' respiratory ability (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximum phonation time (MPT)) were measured in three sitting conditions: a seat surface inclined 0°, anterior 15°, and posterior 15°. Results: FVC was significantly different across three inclinations of seat surface, F(2, 45) = 3.81, P = 0.03. In particular, the subjects' FVC at a seat surface inclined anterior 15° was significantly greater than at a seat surface inclined posterior 15° (P < 0.05). However, FEV1, PEF, and MPT were not significantly affected by seat surface inclination (P > 0.05). Conclusions: The results suggest that anterior inclination of seat surface may provide a positive effect on respiratory function in children with spastic diplegic CP. [ABSTRACT FROM AUTHOR]

Imitative learning has long been established as extremely important for early development. However, neural mechanisms involved in early imitative behaviours are still areas of active research. Neurophysiological and brain-imaging studies have been recently performed that provide initial evidence of brain activation associated with action observation in the first months of life. In this review we examine all studies exploring the effects of action observation on brain function assessed by means of non-invasive brain-mapping techniques. Seventeen papers were selected as a result of our literature search. The strongest evidence for a neural signature of action observation comes from studies exploring the desynchronization of the μ-rhythm, which was reported for both occluded and visible goal-directed grasp, and was correlated with the totality of the infant's own action experience. The effects of action observation were reported on event-related potentials (ERPs) or near infrared spectroscopy. Taken together, these studies suggest that, in early infancy, a direct visual-motor matching process is already detectable as early as 6 months, suggesting a matching between action perception and execution already in infancy. If confirmed by future studies, these findings will shed light on the mechanisms of early motor development and imitation, and will be key to informing novel rehabilitation strategies in infants with congenital brain damage. [ABSTRACT FROM AUTHOR]

The brain veins of infants are in a complex phase of remodelling in the perinatal period. Magnetic resonance venography and susceptibility-weighted imaging, together with high-resolution Doppler ultrasound, have provided new tools to aid study of venous developmental anatomy and disease. This review aims to provide a comprehensive background of vein development and perinatal venous lesions in preterm and term-born infants, and to encourage further research in both the fetus and the newborn infant, with the aim of preventing or mitigating parenchymal injury related to diseases involving veins. [ABSTRACT FROM AUTHOR]

Many authors have discussed the effects of visual stimulations on visual functions, but there is no research about the effects on using vision in everyday activities (i.e. functional vision). Children with perinatal brain damage can develop cerebral visual impairment with preserved visual functions (e.g. visual acuity, contrast sensitivity) but poor functional vision. Objective: Our aim was to discuss the importance of assessing and stimulating functional vision in children with perinatal brain damage. Methods: We assessed visual functions (grating visual acuity, contrast sensitivity) and functional vision (the ability of maintaining visual attention and using vision in communication) in 99 children with perinatal brain damage and visual impairment. All children were assessed before and after the visual stimulation program. Results: Our first assessment results showed that children with perinatal brain damage had significantly more problems in functional vision than in basic visual functions. During the visual stimulation program both variables of functional vision and contrast sensitivity improved significantly, while grating acuity improved only in 2.7% of children. We also found that improvement of visual attention significantly correlated to improvement on all other functions describing vision. Conclusions: Therefore, functional vision assessment, especially assessment of visual attention is indispensable in early monitoring of child with perinatal brain damage. [ABSTRACT FROM AUTHOR]

This paper discusses the reception in the Netherlands of Minimal Brain Damage/Dysfunction (MBD) and related labels for normally gifted children with learning disabilities and behavioural problems by child scientists of all sorts from the 1950s up to the late 1980s, when MBD was replaced with Attention Deficit Hyperactivity Disorder (ADHD). Unlike what has been suggested, as compared to ADHD, MBD turns out to have been all but a rare diagnosis for children who were not handicapped more seriously than modern ADHD-children. MBD, moreover, has contributed considerably to the status of the child sciences which focused on the development of remedial teaching and behaviour modification techniques, particularly clinical child psychology and special education studies. In this case the diminishing influence of child psychiatry, as against these rapidly developing academic specialisms, was only temporal. With the help of the media and parent organizations Ritalin's regime marched in by the late 1980s. [ABSTRACT FROM AUTHOR]

Aims The aims of the study were to investigate (1) the impact of age at brain insult on functional outcome and (2) the influence of insult and environmental factors on cognitive and behavioural outcomes. Method The study was a cross-sectional, retrospective observational study, involving 138 children (76 males, 62 females; mean age 13y 1mo, SD 1y 11mo, range 10-16y) with magnetic resonance imaging ( MRI) evidence of focal brain insult sustained from the first trimester of pregnancy to adolescence. Children underwent MRI and intellectual, executive, behavioural, and social evaluation. Outcome predictors were insult (lesion location, laterality, and extent, history of seizures, age at insult) and environmental (social risk and family function) factors. Results Focal insult before the age of 3 years was associated with poorer outcomes than insult after the age of 3 years across all domains. For IQ outcomes, insult characteristics and seizures were highly predictive. For executive and behavioural domains, family function and social risk had the greatest impact. Earlier age at insult predicted poorer social competence. Interpretation Focal brain insult before age 3 years has devastating consequences for children's development. Findings suggest that greater emphasis should be placed on providing early intervention for children who sustain early focal brain insults. [ABSTRACT FROM AUTHOR]

The prefrontal cortex (PFC), especially the medial sector, plays a crucial role in emotional processing. Damage to this region results in impaired processing of emotional information, perhaps attributable to an inability to initiate and maintain attention toward emotional materials, a process that is normally automatic. Childhood onset damage to the PFC impairs emotional processing more than adult-onset PFC damage. The aim of this work was to study the involvement of the PFC in attention to emotional stimuli, and to explore how age at lesion onset affects this involvement. To address these issues, we studied both the emotional and attentional modulation of the startle reflex. Our sample was composed of 4 patients with childhood-onset PFC damage, 6 patients with adult-onset PFC damage, and 10 healthy comparison participants. Subjects viewed 54 affective pictures; acoustic startle probes were presented at 300 ms after picture onset in 18 pictures (as an index of attentional modulation) and at 3,800 ms after picture onset in 18 pictures (as an index of emotional modulation). Childhood-onset PFC patients did not show attentional or emotional modulation of the response, in contrast to adult-onset PFC damage and comparison participants. Early onset damage to the PFC results, therefore, in more severe dysfunction in the processing of affective stimuli than adult-onset PFC damage, perhaps reflecting limited plasticity in the neural systems that support these processes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the brain damage of term neonates with evidence of a preceding hypoxic sentinel event using eSWAN prospectively. Methods: The study was approved by the institutional research ethics committee. Among the neonates who were examined during the first 8 days after birth with conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI) and eSWAN, 39 neonates with a preceding acute hypoxic sentinel event were divided into two groups: the hypoxic ischaemic encephalopathy (HIE) group and the high-risk group. Twenty-five neonates were normal control subjects. Conventional MRI, DWI, and T2* and R2* maps from eSWAN were assessed. T2* and R2* values from T2* and R2* maps were calculated in predefined regions in the HIE and high-risk groups and then compared with those in control subjects. Results: The neonates in the HIE and high-risk groups showed a high percentage of cerebral oedema and periventricular white-matter (PWM) lesions. Cerebral oedema and haemorrhagic lesions of PWM were more highly visible on the T2* map compared with conventional MRI: cerebral oedema was illustrated as a high T2* area and haemorrhagic lesions had a significantly lower T2* on the T2* map. Lower R2* values of lentiform nuclei (LN) and a higher T2* and lower R2* of frontal white matter (FWM) were found in neonates in the HIE group relative to those of normal controls. The T2* value of LN in the high-risk group was higher than that of the normal controls. Conclusions: The T2* map from eSWAN is useful in detecting cerebral oedema and haemorrhagic lesions of PWM in neonates. The measurement of T2* and R2* values is helpful in assessing the LN and FWM damage in neonates following a hypoxic sentinel event. [ABSTRACT FROM AUTHOR]