Early bifrontal lesions were acquired at 14 months of age by a patient who was then studied over 20 years. MRI showed increased connectivity of residual frontal areas with posterior brain regions. Neuropsychological testing revealed preserved early development but later cognitive and behavioral dysfunctions. Unlike similar adult lesions, the effects in this case were less severe, likely due to higher plasticity and maturation of prefrontal networks during development. This case study provides insight into plasticity and the influence of the prefrontal cortex on cognitive and behavioral development.
Early bifrontal lesions were acquired at 14 months of age by a patient who was then studied over 20 years. MRI showed increased connectivity of residual frontal areas with posterior brain regions. Neuropsychological testing revealed preserved early development but later cognitive and behavioral dysfunctions. Unlike similar adult lesions, the effects in this case were less severe, likely due to higher plasticity and maturation of prefrontal networks during development. This case study provides insight into plasticity and the influence of the prefrontal cortex on cognitive and behavioral development.
Early bifrontal lesions were acquired at 14 months of age by a patient who was then studied over 20 years. MRI showed increased connectivity of residual frontal areas with posterior brain regions. Neuropsychological testing revealed preserved early development but later cognitive and behavioral dysfunctions. Unlike similar adult lesions, the effects in this case were less severe, likely due to higher plasticity and maturation of prefrontal networks during development. This case study provides insight into plasticity and the influence of the prefrontal cortex on cognitive and behavioral development.
Early bifrontal lesions were acquired at 14 months of age by a patient who was then studied over 20 years. MRI showed increased connectivity of residual frontal areas with posterior brain regions. Neuropsychological testing revealed preserved early development but later cognitive and behavioral dysfunctions. Unlike similar adult lesions, the effects in this case were less severe, likely due to higher plasticity and maturation of prefrontal networks during development. This case study provides insight into plasticity and the influence of the prefrontal cortex on cognitive and behavioral development.
C103 - Early bifrontal lesions in the developping human brain: clinical
and structural plasticity issues in a case study.
Valeria Vianello Dri 1 1 APSS Trento, Mental Health Deparment UOC1 Child and Adolescent Neuropsychiatry, Trento, Italy Valeria Vianello Dri 2 2 Agalma Foundation, Clinical Neuroscience, Geneva, Switzerland Luce Bolomey 3 3 Agalma Foundation, Clinical Neuroscience, Geneva, Switzerland Bogdan Draganski 4 4 CHUV- Lausanne University UNIL, LREN Clinical Neurosciences, Lausanne, Switzerland Franois Ansermet 5 5 Agalma Foundation, Clinical Neuroscience, Geneva, Switzerland Franois Ansermet 6 6 Geneva University Hospital- Geneva University, SPEA- Child and Adolescent Psychiatry, Geneva, Switzerland Introduction Frontal Lobe Syndrome (FLS) is a post lesional syndrome characterized by different emotional/behavioural patterns combined with specific neuropsychological features. In 1848, John Harlow first described FLS; later it was investigated in adults (Bechara, Damasio & Damasio, 2000), rarely in young children. Aims and Methods Our aim is to investigate the impact of early aquired prefrontal lesions on development, seldom recognized in children (Andersen, Damasio et al, 2000). We describe a paradigmatic patient with massive bilateral prefrontal lesions acquired at 14 months of age; perspective evolution up to age 22 years. Protocol from age 2ys to 22ys includes: 1) every 6 months: neuropsychiatric assessments and video recording. 2) Periodic specific neuropsychological assessment with testing adapted to age. 3) EEG and Brain MRI (including Tractography in DTI) Results MRI: maximized connectivity of the residual frontal areas with the posterior brain.
EEG: abnormalities observed from age 18 years with clinical manifestation.
Clinics: Early development preserved, later neuropsychological dysfunctions, cognitive and behavioral alterations. None of the effects of this bilateral frontal damage is comparable to the severe clinical features that the same injury would have induced in adult patients. Discussion A different phenotype emerged from the clinical picture of adults homologues acquired lesions, probably due to higher rates of structural brain plasticity and the maturation of pre-frontal networks/functions. This case adds datas for a better insight on the brain prefrontal cortex influence over human cognitive and behavioural development. It also points out the need for a specific treatment, because neurological, psychic, behavioral and neuropsychological aspects are all present and connected.