Longitudinal Stability of Spatial Inattention in Children with Perinatal Stroke

Abstract: Background Signs of contralateral hemispatial inattention may be witnessed in children following perinatal brain infarcts (lesions), and some evidence shows a pattern that is distinct from that in adults. This study is a longitudinal analysis of children with perinatal infarcts, with the goals of determining the pattern of inattention found in children with both left and right hemisphere lesions, and whether or not this pattern shows signs of change over time. Methods 21 children with LH lesions, 9 children with RH lesions and 80 neurologically healthy control children were given the Infant and Toddler Neglect Task in a longitudinal design at two different time points. At time 1, median age was 1.54 years (IQR = .92-2.29). At time 2, median age was 3.25 years (IQR = 2.23-5.00). A standardized scoring system was developed to compare the children’s preference for the left vs. right side of space. Results Children with LH lesions showed a significantly increased preference for the left side of space (P = .02) and a slightly decreased preference for the right side of space (P = .055) at time 1, and a significantly decreased preference for the right side of space (P = .03) at time 2 compared to controls. Children with RH lesions showed a significantly decreased preference for the left side of space (P = .04) and a significantly increased preference for the right side of space (P = .04) compared to controls at time 1, and a significantly decreased preference for the left side of space (P = .03) and a significantly increased preference for the right side of space (P = .01) compared to controls at time 2. There were no significant within-subjects effects across time. Conclusions These data suggest that mechanisms of hemispatial inattention affect children early in the developmental process, and that evidence of hemispatial inattention in children with both LH and RH lesions perinatal lesions likely persist through at least the early elementary school years.