title: Proxy-reported quality of life in adolescents and adults with dyskinetic cerebral palsy is associated with executive functions and cortical thickness.
abstract: Quality of life (QOL) is a key outcome for people with cerebral palsy (CP), and executive functioning is an important predictor of QOL in other health-related conditions. Little is known about this association in CP or about its neural substrate. We aim to analyze the influence of executive functioning (including cognitive flexibility) as well as that of other psychological, motor, communication and socioeconomic variables on QOL and to identify neuroanatomical areas related to QOL in adolescents and adults with CP.
  
  
  
  Fifty subjects diagnosed with dyskinetic CP (mean age 25.96 years) were recruited. Their caregivers completed the primary caregiver proxy report version of the CP QOL-Teen questionnaire. Motor status, communication, IQ, four executive function domains, anxiety/depression and socioeconomic status were evaluated. Correlations and multiple linear regression models were used to relate CP QOL domains and total score to these variables. Thirty-six participants underwent an MRI assessment. Correlations were examined between cortical thickness and CP QOL total score and between cortical thickness and variables that might predict the CP QOL total score.
  
  
  
  Executive functions predict scores in four domains of CP QOL (General well-being and participation, Communication and physical health, Family health and Feelings about functioning) in the regression model. Among the cognitive domains that comprise executive function, only cognitive flexibility measured in terms of performance on the Wisconsin card sorting test (WCST) predicts the CP QOL total score. Monthly income, fine motor functioning and communication ability predict scores on the domains Access to services and Family Health, Feelings about functioning and School well-being, respectively. The clusters resulting from the correlation between cortical thickness and both CP QOL total score and WCST performance overlapped in the posterior cingulate and precuneus cortices.
  
  
  
  Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Barcelona, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.|Institute of Neurosciences, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.
authors.forename: O
authors.identifier: 0000-0001-8415-2076
authors.initials: O
authors.lastname: Laporta-Hoyos
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Barcelona, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.|Institute of Neurosciences, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ballester-Plané
authors.affiliation: Neuropaediatric Service, Hospital Universitario Sant Joan de Déu, Santa Rosa St., Esplugues de Llobregat, 08950, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Póo
authors.affiliation: Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Macaya
authors.affiliation: Traumatology and Rehabilitation Service, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Meléndez-Plumed
authors.affiliation: Pediatric Radiology Service, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Vázquez
authors.affiliation: Pediatric Radiology Service, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Delgado
authors.affiliation: Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Unibertsitateen Etorbidea 24, 48007, Bilbo-Bizkaia, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Zubiaurre-Elorza
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Medical Technology Research Center, Faculty of Medicine, Norwegian University of Science and Technology, P.O. Box 8905, 7491, Trondheim, Norway.
authors.forename: V L
authors.initials: VL
authors.lastname: Botellero
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Barcelona, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Narberhaus
authors.affiliation: Traumatology and Rehabilitation Service, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Toro-Tamargo
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Barcelona, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.|Institute of Neurosciences, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Segarra
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Barcelona, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain. rpueyo@ub.edu.|Institute of Neurosciences, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain. rpueyo@ub.edu.
authors.forename: R
authors.identifier: 0000-0002-8230-8409
authors.initials: R
authors.lastname: Pueyo
mesh_terms: D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000523:psychology*; D002648:Child; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cerebral palsy; Cortical thickness; Executive functions; Magnetic resonance imaging; Quality of life