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volume 4, issue 2, 2025
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COGNITIVE DISORDERS IN CHILDREN WHO HAVE SUFFERED PERINATAL
DAMAGE TO THE NERVOUS SYSTEM
M.Sh.Хojimatova.
ANDIJAN STATE MEDICAL INSTITUTE
Annotation:
Perinatal damage to the nervous system (PDNS) is a major contributor to
developmental delays in children, with cognitive impairments as a common outcome. This study
evaluates the impact of PDNS on cognitive function using clinical data from 200 children aged
3-7 years. Statistical analysis highlights the role of neuroimaging, cognitive assessments, and
tailored therapeutic interventions. Early detection and intervention are shown to significantly
reduce long-term disabilities.
Keywords:
Perinatal brain injury,Cognitive impairment,Developmental delay,Early
intervention,Neurorehabilitation
Introduction
Perinatal brain injuries (PBIs) occur during late pregnancy, labor, or shortly after birth, posing
risks for long-term neurological sequelae. Common causes include:
1.
Hypoxia-Ischemia
: Oxygen deprivation during delivery.
2.
Infections
: Such as intrauterine viral or bacterial infections.
3.
Trauma
: Mechanical injury during labor.
According to the
World Health Organization (WHO)
, PBIs affect approximately 5-10 out of
every 1,000 live births globally, with higher rates in low- and middle-income countries due to
limited access to prenatal care. Cognitive impairments in these children range from mild
attention deficits to severe intellectual disabilities.
Materials and Methods
Study Design
This study employed a
longitudinal cohort design
, tracking neurodevelopmental outcomes over
a 2-year period.
Participants
Group A (PDNS group)
: 100 children diagnosed with PDNS.
Group B (control group)
: 100 age-matched typically developing children.
Assessments
1.
Cognitive Testing
:
o
WISC-IV: General IQ assessment.
o
BRIEF-P: Behavioral Rating Inventory of Executive Function for Pre-schoolers.
o
Peadiv Picture Vocabulary Test: Evaluates receptive language skills.
2.
Neuroimaging
:
o
MRI scans to detect structural abnormalities (e.g., periventricular leukomalacia,
cortical atrophy).
3.
Parental Questionnaires
:
o
Ages and Stages Questionnaire (ASQ): Measures developmental milestones.
o
Family Adaptation Scale: Evaluates caregiver stress and involvement in
rehabilitation.
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Results
Neuroimaging Findings
70% of children in Group A showed significant white matter damage, with
periventricular leukomalacia being the most common abnormality.
Cortical atrophy was noted in 20% of cases.
No structural abnormalities were identified in Group B.
Cognitive Outcomes
Mean IQ Scores
:
o
Group A: 78 ± 10
o
Group B: 98 ± 8 (p < 0.001)
Executive Function
:
o
Group A had a 65% delay in executive functions compared to Group B.
Language Development
:
o
55% of children in Group A had delayed expressive language, compared to 5% in
Group B.
Therapeutic Efficacy
Children in Group A who underwent intensive therapy demonstrated:
50% improvement in attention span over 12 months.
40% reduction in language delays after 18 months of speech therapy.
60% enhancement in problem-solving abilities following cognitive training.
Statistical Insights
Early diagnosis (before 12 months) led to a 30% better outcome in cognitive metrics than
late diagnosis (after 18 months).
Parental involvement in therapy correlated with a 20% increase in rehabilitation success.
Discussion
Impact of PDNS on Cognitive Development
PDNS significantly alters neurodevelopment, particularly in areas associated with memory,
attention, and problem-solving. White matter damage, commonly detected in neuroimaging,
disrupts neural pathways essential for cognitive processing.
Importance of Early Intervention
Children diagnosed before 12 months and treated with structured programs exhibited better
cognitive and behavioral outcomes. Key interventions include:
1.
Cognitive Training
: Focused activities like puzzles and memory games.
2.
Speech and Language Therapy
: Techniques to enhance verbal communication.
3.
Family-Centered Care
: Educating caregivers to support therapy at home.
Limitations
While the study provides compelling evidence, limitations include a relatively small sample size
and the need for longer follow-up periods to assess academic outcomes.
Conclusion
Cognitive impairments resulting from PDNS are prevalent and significantly affect quality of life.
Early detection through neuroimaging and cognitive assessments, combined with tailored
rehabilitation, offers the best outcomes. Public health initiatives should prioritize prenatal care,
early screening, and affordable therapy programs to mitigate the impact of PDNS globally.
Additional Recommendations
1.
Policy Changes
: Advocate for mandatory prenatal screening programs.
2.
Training Programs
: Increase the availability of trained pediatric neurologists and
therapists in low-resource areas.
3.
Parental Support Groups
: Provide resources for families to navigate challenges
associated with PDNS.
References
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volume 4, issue 2, 2025
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1.
Johnson A., et al.
Long-term Cognitive Effects of Perinatal Brain Injury
. Pediatric
Neurology, 2023.
2.
WHO.
Perinatal Brain Injuries: A Global Perspective
. WHO Annual Report, 2022.
3.
Brown T., Smith J.
Role of Neuroimaging in Early Diagnosis of PDNS
.
Neurodevelopment Journal, 2021.
4.
Lee P., et al.
Rehabilitation Strategies for Children with Cognitive Disorders
.
Developmental Medicine & Child Neurology, 2020.
