[Significance of executive functioning in children with severe traumatic brain injury at different stages of consciousness recovery. Neuropsychological approach].
Severe traumatic brain injury leads to a sharp increase in the number of children with severe disabilities. Early identification of higher mental functions disorders allows to develop rehabilitation programs and to increase effectiveness of intervention. The aim of this study was to investigate the executive function in children with severe traumatic brain injury at different stages of consciousness recovery and to develop the protocol of early neuropsychological assessment and intervention.



62 children in age from 4 to 17 years with sTBI (Glasgow Coma Scale (GCS) < or = 8) were studied. 11 of them were studied in a vegetative state and minimal consciousness state with functional magnetic resonance imaging (fMRI) and with neurobehavioral scales. 51 children were evaluated with Paediatric Luria Neuropsychological Battery test which was adapted for early stage of recovery.



The MRI data analysis has shown structural brain damage: bilateral cortical contusions of the frontal lobes and diffuse axonal injuries were the most frequent lesions. Assessment of neuropsychological outcomes has shown that the most destroyed functions at the early recovery period were executive functions, processing speed (neurodynamics of metal activity) and memory functions (modal-nonspecific memory). Early identification of higher mental functions disorders with analysis of patient's behavior by neurobehavioral scales allowed to develop a protocol of monitoring and rehabilitation methods for early stage of recovery.
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Fufaeva
D000293:Adolescent; D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003243:Consciousness; D056344:Executive Function; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000503:physiopathology*