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Psychosocial outcome of TBI in children with unilateral frontal lesions

Published online by Cambridge University Press:  01 May 2004

HARVEY S. LEVIN
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas Department of Neurosurgery, Baylor College of Medicine, Houston, Texas Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
LIFANG ZHANG
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
MAUREEN DENNIS
Affiliation:
Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
LINDA EWING-COBBS
Affiliation:
Department of Pediatrics, University of Texas Health Science Center, Houston, Texas
RUSSELL SCHACHAR
Affiliation:
Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
JEFFREY MAX
Affiliation:
Department of Psychiatry, University of California San Diego & Children's Hospital and Health Center, San Diego, California
JULIE A. LANDIS
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
GARLAND ROBERSON
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
RANDALL S. SCHEIBEL
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
DAISY L. MILLER
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
JILL V. HUNTER
Affiliation:
Department of Radiology, Baylor College of Medicine, Houston, Texas

Abstract

To evaluate effects of unilateral frontal lesions on psychosocial and global outcome of traumatic brain injury (TBI) in children, Study 1 compared matched groups of 22 school aged children who had sustained TBI either with or without unilateral frontal lesions. Study 2 evaluated effects of unilateral extrafrontal lesions in 18 TBI patients as compared with 18 nonlesional TBI patients. Communication, Daily Living, and Socialization domains and the Maladaptive Behavior Scale of the Vineland Adaptive Behavior Scales (VABS) were used to assess psychosocial outcome, and the Glasgow Outcome Scale (GOS) measured global outcome. All patients underwent magnetic resonance imaging at least 3 months post injury. Children with frontal lesions had worse scores on the Daily Living and Socialization domains and a higher frequency of maladaptive behavior than those without frontal lesions, but there was no difference in cognitive function. Disability was twice as common in the frontal lesion group relative to children without frontal lesions. Volume of frontal lesion was related to the Socialization domain. Side of lesion had no effect, nor did presence of an extrafrontal lesion (Study 2). Unilateral frontal lesions adversely affect late psychosocial outcome of TBI in children. (JINS, 2004, 10, 305–316.)

Type
Research Article
Copyright
© 2004 The International Neuropsychological Society

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References

REFERENCES

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Anderson, S.W., Bechara, A., Damasio, H., Tranel, D., & Damasio, A.R. (1999). Impairment of social and moral behavior related to early damage in human prefrontal cortex. Nature Neuroscience, 2, 10321037.Google Scholar
Barrash, J., Tranel, D., & Anderson, S.W. (2000). Acquired personality disturbances associated with bilateral damage to the ventromedial prefrontal region. Developmental Neuropsychology, 18, 355381.CrossRefGoogle Scholar
Bechara, A., Damasio, H., & Damasio, A.R. (2000). Emotion, decision making and the orbitofrontal cortex. Cerebral Cortex, 10, 295307.CrossRefGoogle Scholar
Blair, R.J. (2001). Neurocognitive models of aggression, the antisocial personality disorders, and psychopathy. Journal of Neurology, Neurosurgery, and Psychiatry, 71, 727731.CrossRefGoogle Scholar
Blair, R.J. & Cipolotti, L. (2000). Impaired social response reversal. A case of ‘acquired sociopathy’. Brain, 123, 11221141.Google Scholar
Blair, R.J., Morris, J.S., Frith, C.D., Perrett, D.I., & Dolan, R.J. (1999). Dissociable neural responses to facial expressions of sadness and anger. Brain, 122, 883893.CrossRefGoogle Scholar
Bunge, S.A., Ochsner, K.N., Desmond, J.E., Glover, G.H., & Gabrieli, J.D. (2001). Prefrontal regions involved in keeping information in and out of mind. Brain, 124, 20742086.Google Scholar
Catroppa, C. & Anderson, V. (1999). Attentional skills in the acute phase following pediatric traumatic brain injury. Neuropsychology, Development and Cognition. Section C, Child Neurophychology, 5, 251264.Google Scholar
Damasio, A.R. (1996). The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical Transactions of the Royal Society London B: Biological Sciences, 351, 14131420.CrossRefGoogle Scholar
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (1994). CVLT–C: California Verbal Learning Test–Children's Version. San Antonio, TX: The Psychological Corporation.
Dennis, M., Purvis, K., Barnes, M.A., Wilkinson, M., & Winner, E. (2001). Understanding of literal truth, ironic criticism, and deceptive praise following childhood head injury. Brain and Language, 78, 116.Google Scholar
Diamond, A. (2002). Normal development of prefrontal cortex from birth to young adulthood: cognitive functions, anatomy, and biochemistry. In D.T. Stuss & R. T. Knight (Eds.), Principles of frontal lobe function (pp. 466503). New York: Oxford University Press.
Eslinger, P.J. & Damasio, A.R. (1985). Severe disturbance of higher cognition after bilateral frontal lobe ablation: Patient EVR. Neurology, 35, 17311741.CrossRefGoogle Scholar
Eslinger, P.J., Grattan, L.M., Damasio, H., & Damasio, A.R. (1992). Developmental consequences of childhood frontal lobe damage. Archives of Neurology, 49, 764769.CrossRefGoogle Scholar
Ewing-Cobbs, L., Levin, H.S., Eisenberg, H.M., & Fletcher, J.M. (1987). Language functions following closed-head injury in children and adolescents. Journal of Clinical and Experimental Neuropsychology, 9, 575592.CrossRefGoogle Scholar
Fletcher, J.M., Ewing-Cobbs, L., Miner, M.E., Levin, H.S., & Eisenberg, H.M. (1990). Behavioral changes after closed head injury in children. Journal of Consulting and Clinical Psychology, 58, 9398.Google Scholar
Fletcher, J.M., Levin, H.S., Lachar, D., Kusnerik, L., Harward, H., Mendelsohn, D., & Lilly, M.A. (1996). Behavioral outcomes after pediatric closed head injury: Relationships with age, severity, and lesion size. Journal of Child Neurology, 11, 283290.CrossRefGoogle Scholar
Francis, S., Rolls, E., Bowetell, R., McGlone, F., O'Doherty, J., Browning, A., Claire, S., & Smith, E. (1999). The representation of pleasant touch in the brain and its relationship with taste and olfactory areas. Neuroreport, 10, 453459.Google Scholar
Graham, D.I., Ford, I., Adams, J.H., Doyle, D., Lawrence, A.E., McLellan, D.R., & Ng, H.K. (1989). Fatal head injury in children. Journal of Clinical Pathology, 42, 1822.CrossRefGoogle Scholar
Hollingshead, A. (1975). Four Factor Index of Social Status. New Haven, CT: Yale University Press.
Jennett, B. & Bond, M. (1975). Assessment of outcome after severe brain damage. A practical scale. Lancet, 1, 480487.Google Scholar
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., & Ryan, N. (1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980988.Google Scholar
Levin, H.S., Mendelsohn, D., Lilly, M.A., Yeakley, J., Song, J., Scheibel, R.S., Harward, H., Fletcher, J.M., Kufera, J.A., Davidson, K.C., & Bruce, D. (1997). Magnetic resonance imaging in relation to functional outcome of pediatric closed head injury: A test of the Ommaya-Gennarelli model. Neurosurgery, 40, 432440.Google Scholar
Marlowe, W. (1992). The impact of right prefrontal lesion on the developing brain. Brain and Cognition, 20, 205213.CrossRefGoogle Scholar
Price, B.H., Daffner, K.R., Stowe, R.M., & Mesulam, M.M. (1990). The comportmental learning disabilities of early frontal lobe damage. Brain, 113, 13831393.CrossRefGoogle Scholar
Rolls, E.T., Hornak, J., Wade, D., & McGrath, J. (1994). Emotion-related learning in patients with social and emotional changes associated with frontal lobe damage. Journal of Neurology, Neurosurgery, and Psychiatry, 57, 15181524.CrossRefGoogle Scholar
Sattler, J.M. (2002). Assessment of adaptive behavior. In Assessment of children (4th ed., pp. 189211). San Diego, CA: Jerome M. Sattler, Publisher, Inc.
Semel, E., Wiig, E.H., & Secord, W.A. (1995). Clinical evaluation of language fundamentals (3rd ed.). San Antonio, TX: The Psychological Corporation.
Sparrow, S.S., Balla, D.A., & Cicchetti, D. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service.
Taylor, H.G., Yeates, K.O., Wade, S.L., Drotar, D., Stancin, T., & Minich, N. (2002). A prospective study of short- and long-term outcomes after traumatic brain injury in children: Behavior and achievement. Neuropsychology, 16, 1527.CrossRefGoogle Scholar
Teasdale, G. & Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet, 2, 8184.Google Scholar
Tranel, D., Bechara, A., & Denburg, N.L. (2002). Asymmetric functional roles of right and left ventromedial prefrontal cortices in social conduct, decision-making, and emotional processing. Cortex, 38, 589612.Google Scholar
Wechsler, D. (1991). Wechsler Intelligence Scale for Children, Third Edition manual. San Antonio, TX: The Psychological Corporation.
Yeates, K.O., Blumenstein, E., Patterson, C.M., Delis, D.C. (1995). Verbal learning and memory following pediatric closed-head injury. Journal of the International Neuropsychological Society, 1, 7887.Google Scholar