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Abstract
The developing brain is remarkably plastic as it changes in response to a wide range of experiences including sensory and motor experience, psychoactive drugs, peer relationships, parent-infant interactions, gonadal hormones, intestinal flora, diet, and injury. There are sensitive periods for many of these experiences, including cerebral injury. Comparisons across mammalian species (humans, monkeys, cats, rats, mice) show a sensitive period for good outcomes from cerebral injury around the time of intense synaptogenesis. This period is postnatal in humans, cats, and rats, but prenatal in monkeys, reflecting the differences in neuronal development at birth across species. In addition, there appears to be a sensitive period prenatally during the time of maximum cortical neurogenesis and possibly during adolescence as well, although these periods are not as well studied as the period related to synaptogenesis and to date only examined in rats. Here we review the evidence for sensitive periods related to brain injury across species and propose mechanisms that may underlie the plasticity during these periods.
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Affiliation(s)
- Bryan Kolb
- Department of Neuroscience, University of Lethbridge, Lethbridge, AB, Canada.
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Beuriat PA, Cristofori I, Richard N, Bardi L, Loriette C, Szathmari A, Di Rocco F, Leblond P, Frappaz D, Faure-Conter C, Claude L, Mottolese C, Desmurget M. Cerebellar lesions at a young age predict poorer long-term functional recovery. Brain Commun 2020; 2:fcaa027. [PMID: 32954287 PMCID: PMC7425375 DOI: 10.1093/braincomms/fcaa027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 12/12/2022] Open
Abstract
Early studies on long-term functional recovery after motor and premotor lesions showed better outcomes in younger monkeys than in older monkeys. This finding led to the widespread belief that brain injuries cause less impairment in children than adults. However, this view has limitations and a large body of evidence now indicates that cerebral damages can be more harmful when inflicted at young age, during critical periods of neural development. To date, this issue has been mainly investigated in the context of focal and diffuse cortical lesions. Much less is known about the potential influence of early cerebellar damages. Several studies exist in survivor of posterior fossa tumours. However, in these studies, critical confounders were not always considered and contradictory conclusions were provided. We studied the impact or early cerebellar damage on long-term functional recovery in three groups of 15 posterior fossa survivors, comparable with respect to their tumour characteristics (type, size and location) but operated at different ages: young (≤7 years), middle (>7 and ≤13 years) and older (>13 years). Daily (health-related quality of life scale, performance status scale), motor (International Cooperative Ataxia Rating Scale, Pegboard Purdue Test) and cognitive (full-scale intelligence quotient) functioning were assessed. A general linear model controlling for age at surgery, radiotherapy, preservation of deep cerebellar nuclei, tumour volume and delay between surgery and assessment was used to investigate significant variations in outcome measures. Early age at surgery, lesion of deep cerebellar nuclei and postoperative radiotherapy had a significant, independent negative influence on long-term recovery. Tumour volume and delay between surgery and assessment had no statistically detectable impact. The negative influence of early age at surgery was significant in all domains: daily functioning (health-related quality of life scale, performance status scale), motor functioning (International Cooperative Ataxia Rating Scale, Pegboard Purdue Test) and cognitive functioning (full-scale intelligence quotient). These results support the existence of an early critical period of development during which the cerebellar ‘learning machine’ is of critical importance. Although the extent to which the early deficits here observed can be reversed needs now to be established, our data plead for the implementation of prompt and intense rehabilitation interventions in children operated before 7 years of age.
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Affiliation(s)
- Pierre-Aurélien Beuriat
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.,Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 69500 Bron, France
| | - Irene Cristofori
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Nathalie Richard
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Lara Bardi
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Celia Loriette
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Alexandru Szathmari
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.,Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 69500 Bron, France
| | - Federico Di Rocco
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.,Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 69500 Bron, France
| | - Pierre Leblond
- Department of Pediatric Hematology and Oncology, Institut d'hématologie et d'oncologie Pédiatrique, 69008 Lyon, France
| | - Didier Frappaz
- Department of Pediatric Hematology and Oncology, Institut d'hématologie et d'oncologie Pédiatrique, 69008 Lyon, France
| | - Cécile Faure-Conter
- Department of Pediatric Hematology and Oncology, Institut d'hématologie et d'oncologie Pédiatrique, 69008 Lyon, France
| | - Line Claude
- Department of Radiotherapy, Centre Léon Bérard, 69008 Lyon, France
| | - Carmine Mottolese
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.,Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 69500 Bron, France
| | - Michel Desmurget
- Institute of Cognitive Science Marc Jeannerod, CNRS/UMR 5229, 69500 Bron, France.,Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
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Duval J, Braun CMJ, Montour-Proulx I, Daigneault S, Rouleau I, Bégin J. Brain lesions and IQ: recovery versus decline depends on age of onset. J Child Neurol 2008; 23:663-8. [PMID: 18539991 DOI: 10.1177/0883073808314161] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A growing literature suggests that early lesions are associated with poorer IQ outcome. Those studies covered a restricted age range in pediatric populations only and did not control for important moderator variables. The present investigation studied IQ change in brain-lesioned children and adults (age 0 to 84 years). Altogether, 725 cases with a documented unilateral focal lesion were gathered from hospital charts and from published cases in the literature, including 240 with repeated IQ testing. Multiple regression analyses isolated the contribution of age at lesion onset to IQ change. Important mediator variables included were lesion side, site, volume, etiology, and so on. An early lesion was significantly associated with poorer postlesion IQ in time and with decline of IQ in time. Later onset lesions were associated with better postlesion IQ and recovery in time. The so-called Kennard principle is refuted, with regard to IQ.
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Affiliation(s)
- Julie Duval
- Université du Québec à Montréal, Département de psychologie, Montréal, Québec, Canada
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Hessen E, Nestvold K, Anderson V. Neuropsychological function 23 years after mild traumatic brain injury: a comparison of outcome after paediatric and adult head injuries. Brain Inj 2008; 21:963-79. [PMID: 17729049 DOI: 10.1080/02699050701528454] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PRIMARY OBJECTIVE To the authors' knowledge no study comparing very long-term neuropsychological outcome after mild paediatric and adult traumatic brain injury (TBI) has been published. The primary objective of this study was to compare neuropsychological outcome 23 years after mainly mild paediatric and adult TBI. RESEARCH DESIGN The study was a neuropsychological follow-up 23 years after a prospective head injury study conducted at a Norwegian public hospital. METHODS AND PROCEDURES One hundred and nineteen patients were assessed with a comprehensive neuropsychological test battery. Of these, 45 were paediatric TBI and 74 were adult TBI. MAIN OUTCOMES AND RESULTS Both the paediatric and adult groups obtained scores in the normal range. In the paediatric group significant relationships were found between head injury severity and current neuropsychological function. The most important predictors of poor outcome were length of post-traumatic amnesia (PTA) and a combination of PTA and EEG pathology within 24 hours of injury. No influence of pre- and post-injury risk factors on current neuropsychological function was evident. CONCLUSIONS The findings indicate that children sustaining complicated mild TBI may be more vulnerable to development of chronic mild neuropsychological dysfunction than adults sustaining similar head injuries.
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Affiliation(s)
- Erik Hessen
- Department of Neurology, Akershus University Hospital, Oslo, Norway.
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