PHYSICAL, COGNITIVE AND MULTI-MODAL INTERVENTIONS HAVE AN IMPACT ON COGNITION IN CHILDREN WITH CEREBRAL PALSY

A systematic review published in the journal Neuropsychology Review provided a greater understanding of those interventions with an impact on cognitive functions in cerebral palsy.

CEREBRAL PALSY AND COGNITION

Cerebral palsy is the leading cause of childhood disability with an overall prevalence of 1.6 per 1000 live births. The motor impairments are often accompanied by disturbances of cognition, affecting the quality of life of people with cerebral palsy. Given the fact that cerebral palsy is a long-life disorder, interest has grown to discover interventions to improve cognitive functions. This study aimed at investigating those interventions that impact on cognitive functioning in children and adults with cerebral palsy.

INTERVENTIONS WITH AN IMPACT ON COGNITION IN CEREBRAL PALSY

This study is the first systematic review focused on interventions with an impact on cognitive functions in cerebral palsy. Papers published between 2010 and 2021 were reviewed. Results of the best available evidence revealed that general cognitive functioning, visual perception, working memory and inhibitory control improve after an intervention. Specifically, the most remarkable findings were:

• General cognitive functioning was improved by multi-modal (cognitive and physical tasks) and physical interventions.
• Computerized multi-modal and cognitive interventions had beneficial effects on visual perception.
• Cognitive interventions seem to be the most effective to improve different executive function domains.

FUTURE RESEARCH

This systematic review allowed to identify the potential gaps in the literature to drive future research. In this way, the results revealed that the effects of interventions on specific domains, such as language and memory, have been insufficiently studied. Moreover, the long-term effects of interventions have not been studied properly. Future research should focus on performing randomized controlled trials covering these gaps as well as considering aspects such as age, sex differences and clinical heterogeneity.

This is a publication that precedes results of a randomized controlled trial of a home-based computerized executive function intervention for children with cerebral palsy. The project is carried out by the team “Neuropsychology: Cerebral Palsy and Neuroimaging” of the Institut de Neurociències UB (UBNeuro), with the collaboration of the Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Vall d’Hebron and Fundació ASPACE Catalunya. The Queensland Cerebral Palsy and Rehabilitation Research Centre of The University of Queensland, and the Australian e-Health Research Centre (CSIRO) are also collaborators. Preliminary results have showed improvements in different cognitive functions (including executive functions, visual perception and memory) after the intervention. Moreover, it seems that beneficial effects are maintained in executive functions over 9 months.    
The study was funded by the Ministerio de Economía y Competitividad (PSI2016-75979-R AEI/FEDER, EU) and by Agència de Gestió d’Ajuts Universitaris i de Recerca from Generalitat de Catalunya (2017SGR0748).

Article reference:

Blasco, M., García-Galant, M., Berenguer-González, A., Caldú, X., Arqué, M., Laporta-Hoyos, O., … & Pueyo, R. (2022). Interventions with an Impact on Cognitive Functions in Cerebral Palsy: a Systematic Review. Neuropsychology Review, 1- 27. https://doi.org/10.1007/s11065-022-09550-7