Impaired Visual Integration in Children with Traumatic Brain Injury: An Observational StudyReportar como inadecuado




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Background

Axonal injury after traumatic brain injury TBI may cause impaired sensory integration. We aim to determine the effects of childhood TBI on visual integration in relation to general neurocognitive functioning.

Methods

We compared children aged 6–13 diagnosed with TBI n = 103; M = 1.7 years post-injury to children with traumatic control TC injury n = 44. Three TBI severity groups were distinguished: mild TBI without risk factors for complicated TBI mildRF- TBI, n = 22, mild TBI with ≥1 risk factor mildRF+ TBI, n = 46 or moderate-severe TBI n = 35. An experimental paradigm measured speed and accuracy of goal-directed behavior depending on: 1 visual identification; 2 visual localization; or 3 both, measuring visual integration. Group-differences on reaction time RT or accuracy were tracked down to task strategy, visual processing efficiency and extra-decisional processes e.g. response execution using diffusion model analysis. General neurocognitive functioning was measured by a Wechsler Intelligence Scale short form.

Results

The TBI group had poorer accuracy of visual identification and visual integration than the TC group Ps ≤ .03; ds ≤ -0.40. Analyses differentiating TBI severity revealed that visual identification accuracy was impaired in the moderate-severe TBI group P = .05, d = -0.50 and that visual integration accuracy was impaired in the mildRF+ TBI group and moderate-severe TBI group Ps < .02, ds ≤ -0.56. Diffusion model analyses tracked impaired visual integration accuracy down to lower visual integration efficiency in the mildRF+ TBI group and moderate-severe TBI group Ps < .001, ds ≤ -0.73. Importantly, intelligence impairments observed in the TBI group P = .009, d = -0.48 were statistically explained by visual integration efficiency P = .002.

Conclusions

Children with mildRF+ TBI or moderate-severe TBI have impaired visual integration efficiency, which may contribute to poorer general neurocognitive functioning.



Autor: Marsh Königs , Wouter D. Weeda , L. W. Ernest van Heurn , R. Jeroen Vermeulen , J. Carel Goslings , Jan S. K. Luitse , Bwee Tien

Fuente: http://plos.srce.hr/



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