PROJECT 3: CONSEQUENCES OF FOCAL BRAIN LESIONS ACQUIRED DURING DEVELOPMENTLesion method studies of individuals who have sustained childhood-onset focal brain damage are animportant means of gathering more precise descriptions of brain-behavior relationships in developmentaldisorders. Conditions causing focal brain damage in childhood are not common, but we have developedeffective mechanisms of enrolling a sufficient number of patients for systemic studies. During the currentfunding period we have established a registry of patients with early-onset focal brain damage, and havecollected comprehensive neuropsychological data characterizing their cognition, emotion, and psychosocialfunctioning. Here we propose to conduct a series of hypothesis-driven studies designed to further delineatethe neuropsychological and neuroanatomical factors that contribute to the chronic impairments of cognition,emotion, and social behavior that characterize some patients with childhood-onset brain damage. We willcontinue the longitudinal study of the patients in the registry, as well as newly enrolled patients, using: (1)precise description of brain lesions using MRI and 3-D reconstruction, (2) comprehensive characterization ofcognition and behavior with standardized, age-appropriate neuropsychological measures, (3) standardizedindices of functional outcome (academic achievement, employment, social adjustment), (4) experimentalmeasures of cognition and behavior, with a focus on emotion and social competence, and (5) analysis ofgray and white matter structure in brain regions functionally associated with the damaged area. Delineationof relationships between damage to specific neural systems early in life and the short- and long-termconsequences for cognition, emotion, and behavior is providing fundamental information of relevance to theunderstanding of human development and of importance for better evaluation and treatment ofneurobehavioral disorders with onset in childhood.Public health relevance: Developmental disorders of cognition, emotion, and social behavior present a majorpublic health burden, but their underlying brain mechanisms remain poorly understood. This researchprovides a unique and important source of information regarding the neural bases of cognition, emotion, andtheir interaction during development.
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