Topographical orientation as a model of plasticity in children with perinatal stroke

Abstract

Background: Children with perinatal stroke go on to develop most cognitive skills (e.g. language) due to brain plasticity; however, their performance is usually poor when compared to age-matched controls, indicating a reduced potential compared to uninjured children. To date, how plasticity after early injury affects the development of complex cognitive skills remains uncertain. Here, we use topographical orientation, which relies on integration of several cognitive processes underlain by widespread neural networks, as a model to test plasticity in complex behaviour. Methods: Children with perinatal stroke and age-matched controls were tested with a neuropsychological battery and a novel navigation task. In addition, for each patient, we obtained the most recent MRI scan to assess the effects of lesion characteristics on performance at the navigational task. Results: Children with history of injury performed worse than controls, and their scores were not different based on lesion’s laterality, location or functional region affected. In particular, involvement of regions known to contribute to spatial orientation did not result in significantly decreased performance. Conclusions: As seen in other skills, orientation was preserved, but decreased when compared to age-matched controls. Given its cognitive and neural complexity, topographical orientation may be used as a model for network plasticity after early injury.