Karakteristike jezičkih poremećaja i oporavak jezičkih sposobnosti kod dece sa traumatskom povredom mozga

Abstract

Traumatska povreda je najčešći tip stečene povrede mozga kod dece. Trauma mozga često uzrokuje trajna i kompleksna oštećenja kognitivnih funkcija, uključujući i hronične poremećaje jezika. Traumatskom povredom mozga mogu biti pogođene sve lingvističke oblasti: fonologija, leksika, sintaksa, morfologija i semantika. Pored toga, ovaj tip povrede mozga dovodi i do oštećenja viših nivoa jezičke reprezentacije, kao što su diskurs i razumevanje metaforičkih značenja reči. S obzirom na različita i često široko rasprostranjena oštećenja bele mase hemisfera, neuralni korelati jezičkih poremećaja uglavnom ostaju nejasni. U ovom radu je razmatrano prisustvo hroničnih poremećaja jezika uzrokovanih traumatskom povredom mozga u detinjstvu. Rezultati su pokazali oštećenja formalnih lingvističkih oblasti, kao i oštećenje diskursa. Hronični jezički defciti su evidentirani kod dece koja su pretrpela tešku i umerenu povredu mozga. Utvrđen je komorbiditet između jezičkih defcita i dizartrije, kao i između jezičkih defcita i oštećenja egzekutivnih funkcija. Zaključeno je da prisustvo dizartrije i oštećenje egzekutivnih funkcija kod dece sa jezičkim poremećajima uzrokovanim traumatskom povredom mozga predstavlja povećan rizik za loš oporavak jezičkih sposobnosti.

Research subject: Traumatic brain injuries (TBI) are the most common type of acquired brain injury in children. Sustaining a TBI in childhood has been found to cause persistent and complex cognitive impairments, including chronic language disorders. Language disorders may be manifested in all linguistic domains: phonology, vocabulary, syntax, morphology and semantics. Higher-order language is also impaired in TBI, including discourse skills and understanding of non-literal concepts. Considering the varied and ofen widespread nature of brain white matter damage, the neural correlates of language impairments afer TBI remain elusive. Method: In this work, we discuss the acquired language disorders afer acquired pediatric brain trauma. Te language impairment characteristics across diferent linguistic domain, as well as impairment discourse skills are described. We also discuss language impairment in relation to co-morbidity. Results: Te factors which afect language outcome are presented in this study, as well as the nature of residual language defcits. Te correlation between language impairment and severity of brain injury is pointed out. It is showed that language ability is compromised in the years afer pediatric TBI. Chronic language impairments more frequently appear in children with moderate and severe brain injury in comparison to children with mild injury. Conclusion: Children with language impairment who have dysarthria or defcits in executive functions have a higher risk for poor language outcome compared to the children without this co-morbidity. Children with acquired brain injury need assessment, detection and management of language impairments during the acute phase in order to optimize longer-term functional recovery.