[Standardization of the Children's Orientation and Amnesia Test, French version, to evaluate post-traumatic amnesia in children]. / Etalonnage de la version française du Children's Orientation and Amnesia Test (COAT-VF), questionnaire d'évaluation de l'amnésie post-traumatique chez l'enfant.

INTRODUCTION: The duration of post-traumatic amnesia (PTA), the period of altered memory that often follows traumatic brain injury (TBI), is a useful index of severity of TBI and a predictor of outcome after TBI. Yet, evaluating PTA in French-speaking brain-injured children is not standardized. OBJECTIVE: We aimed to translate into the French language and standardize the Children's Orientation and Amnesia Test (COAT), inspired by the Galveston Orientation and Amnesia Test (GOAT), which estimates PTA duration in adults. METHOD: Development of a French version of the COAT (COAT-VF) with 16 items: 7 of general orientation, 5 temporal orientation and 4 memory. Normative data were collected for 137 children aged 4, 6, 8 and 10 years who were attending school. RESULTS: Performance on the COAT-VF was influenced by age and sociocultural factors but not sex. CONCLUSION: The COAT-VF, short and simple to administer, allows for an accurate evaluation of PTA duration in French children.

Spatial and motor neglect in children.

OBJECTIVE: To determine if unilateral spatial neglect can be found in very young children with acquired brain lesions. METHODS: A retrospective study was carried out over a 10-year period in a pediatric rehabilitation department specializing in acquired brain lesions. Twelve cases were selected involving children aged 7 months to 14 years. Neglect was assessed by behavior observation for all children and, depending on age, by drawing, copying, reading, writing, and arithmetic tasks. Seven patients underwent the experimental "Teddy Bear" cancellation task, specially adapted to children. RESULTS: All children exhibited spatial and motor neglect in daily activities. In addition, children who were over 2 years of age made lateralized omissions in paper and pencil tasks as well as in the "Teddy Bear" cancellation task. Nine of the 12 children exhibited left spatial and motor neglect, whereas the other three, all of whom were very young (under 4 years), exhibited right spatial neglect. In three cases, cortical lesions were restricted to one lobe, either the parietal, frontal, or temporal. In eight children, lesions extended over more than one lobe, and one child sustained only subcortical lesions. CONCLUSION: Unilateral spatial and motor neglect occurs even in very young children. Right spatial neglect described in very young children may be related to the development of hemispheric specialization.

Lateralities in normal children ages 3 to 8 and their role in cognitive performances.

The presence and type of correlations between laterality and cognitive skills in normal adults or children remains controversial. This study examines relations between different lateralities, that is, handedness, footedness, eyedness, parental left-handedness, asymmetry of hand skill on a computerized version of the Peg-Moving Task (CPMT) proposed by Annett (1985), and different verbal and non-verbal skills assessed by 13 tasks in 254 normal children, aged 3 to 8 years. Results showed increasing performances with increasing dextrality on the CPMT for 2 tasks involving phonology (Phonological Fluency and Reading Nonwords), 2 tasks involving visual memory and visuospatial skills, and for finger localization. Footedness, eyedness, and parental left-handedness had no significant effect on cognitive performance. The pattern of performance according to the sinistrality-dextrality continuum was highly variable from one cognitive task to the other. The previously mentioned results suggest that relative hand skill is a better correlative of cognitiveperformance than the usual measures of handedness. Further study is needed to specify the pattern of associations.

Reading habits influence aesthetic preference.

The aim of the present study was to determine the extent to which aesthetic preference, previously attributed to cerebral dominance, may be determined by reading habits. One hundred and sixty two normal subjects were presented pairs of images, one being the mirror-image of the other, and were asked for their aesthetic preference. Half of the subjects were left-to-right readers (French subjects) and the other half were right-to-left readers (Israeli subjects). We found a significant effect of reading habits on aesthetic preference, with left-to-right readers showing a preference for stimuli with a rightward directionality while right-to-left readers preferred stimuli with a leftward directionality. These findings raise the question of an interaction between cultural factors and cerebral dominance.

Rehabilitation of brain-injured children.

A care network has been created in the Paris area according to two criteria--the continuity and the specificity of the care, with a single place to manage pediatric neurosurgical emergencies. This network makes possible research about brain-injured children. Until recently, the "Kennard principle", that is, the assumption that recovery after similar lesions is greater in children than in adults has been supposed to be always true. In fact, if the lesions are diffuse, recovery is not greater in children compared with adults, or in younger children compared with older ones: the prognosis depends on the remaining ability to learn new practices. Normal IQ does not mean absence of sequelae. The cognitive deficits are very similar to those found in adults at the acute phase. For instance, visuo-spatial neglect appears as rather frequent when systematically looked for. The final assessment of outcome after childhood traumatic brain-injury should be done only after several years.

Eye dominance in children: a longitudinal study.

In a sample of 807 normal preschool children aged from 3 to 6, examined eye dominance was not associated with the declared eye dominance of their parents. Forty percent of the children showed left-eyedness. Eyedness was associated with handedness and not significantly related to age group or sex. A strong relationship between the answers of the two parents concerning eye preference was observed. Two hundred forty-four children were followed-up for 2 years. The examinations were carried out once every 6 months. Two thirds of the children showed perfect stability in eye dominance. There was some evidence that stability in eye use tends to increase with age and to be lower in left-handed children with left-handed parents. There is, at present, very little evidence of a positive association between eye dominance in parents and that in their children.

Right-left orientation and significance of systematic reversal in children.

Shortly before the acquisition of right and left, which generally occurs around age 6-7 years, a very simple right/left discrimination task makes it possible to distinguish groups of children with strikingly different cognitive abilities. Preschool children aged from 5 to 6.4 years were asked to show their left hand, right eye, left ear and right hand. On a variety of simple cognitive tasks exploring verbal fluency, syntactic comprehension, working memory, visuo-spatial ability and number processing, children who made from 1 to 3 errors (14% of the sample) performed significantly worse than those who showed systematic reversal (30%) and those who made no error. Differential use of logical thinking can partially explain these differences. Neuropsychological implications of these developmental findings are discussed.

Environmental influences in hand preference: an African point of view.

In order to examine further the role of cultural and environmental factors in human manual preference, two surveys were undertaken in students from Ivory Coast and Sudan. In the first study (Abidjan, Ivory Coast) 382 secondary students, ages 12 to 22, answered a 20-item manual preference questionnaire. The observed frequency of left-hand preference was 7.9%, with very low left-hand use among the 18-22 age group (1%) and high among the 12-15 age group (14%). In the second study (Khartoum, Sudan) 759 undergraduates, ages 18 to 33, answered a 25-item questionnaire. The observed frequency of left manual preference was 5%. Subjects were also asked to indicate any pressure to change hand for writing, eating, or other manual activities and, in the second study, any upper limb injury which temporarily rendered the subject unable to use his (her) preferred hand. Report of an upper limb injury in the past was related to mixed (or inconsistent) hand preference. In both studies, the target activity against left-hand use was eating. These results show that cultural and environmental factors could change "natural" hand preference in three ways: (i) by changing the hand used for only one activity (e.g., eating), with no change for other familiar unimanual activities; (ii) by reducing the degree of hand preference; (iii) by changing the overall preferred hand, generally reducing the prevalence of left-handedness. The design of handedness studies should allow these possibilities to be distinguished.

Bisection and perception of horizontal lines in normal children.

Simple line bisection is a complex task in which both perceptual/attentional factors and motor factors are involved. Using a judgment task on prebisected lines it is possible to assess independently the role of perceptual/attentional factors. The judgment-bisection relationship was investigated in 37 preschool children aged 4-5 and 70 school children aged 10-12. At bisection, a clear shift of the right hand with age from right to left bisections was observed, more pronounced in right- than in left-handers, and probably related to learned patterns. At judgment, a slight but significant left side overestimation was observed. In right-handers, judgment was related to left-hand but not to right-hand bisection. It is concluded that motor (manual) factors strongly influence visuo-motor bisection in normal children, and it is suggested that the judgment-bisection relationship has to be systematically investigated when bisection is used as a task informing on space perception or on direction of attention.

Reading habits and line bisection: a developmental approach.

120 normal right-handed subjects, children and adults, with opposite reading habits (60 French, left-to-right readers, 60 Israeli, right-to-left readers) and 60 pre-school children (30 French and 30 Israeli), were submitted to a visuo-motor bisection task. Bisection is found to be dependent upon reading habits with a leftward deviation of the subjective middle for left-to-right readers, and a rightward bias for right-to-left readers. Even before formal reading learning, French and Israeli pre-school children differ significantly in bisecting a line. Results are discussed with respect to hemispheric activation theories and directional hypotheses.

Parental hand preference and manual functional asymmetry in preschool children.

Hand preference and hand skill in 1150 normal children between 3 and 6 years of age and hand preference of their parents were assessed to study the effect of parental hand preference on different dimensions of manual asymmetry in children. Children hand skill was measured with a computerized version of the Peg Moving Task which allowed us to split the overall performance into two components, a "transport time" and a "search time." Paternal and maternal left-handedness was significantly related to child left-handedness. Both components of hand skill asymmetry were reduced with mother's left-handedness. and one component (search time) with father's left-handedness. A significant impact of paternal and preference on child hand skill asymmetry, after controlling for child hand preference, was observed. When this analysis was limited to strong right-handed children, a greater paternal effect on child hand skill emerged. These results show the usefulness of performance tasks in detecting parent-child associations concerning manual functional asymmetry.

Foot and eye preferences in adults: relationship with handedness, sex and age.

Age, sex, and handedness effects in foot and eye preferences were studied by questionnaire in large samples of normal adult populations from five different countries (total sample, n = 5064). Foot and eye preference were significantly associated with handedness category (right or left) in all the 10 sex by country samples for foot, and in 9/10 samples for eye. The overall frequencies of crossed preferences were 5% between hand and foot and 19.5% between hand and eye. In right-handers, a gradual shift toward the "right" with increasing age was systematically observed, both for footedness and eyedness. The proportion of crossed hand-foot preference was higher in men than women (7.4% vs 2.5%), and higher in left-handers than right-handers (16.3% vs 4.1%). Sex differences in the proportion of crossed hand-eye preference were variable from one country to the other.

Low levels of serum type III procollagen aminoterminal propeptide confirmed type III collagen deficiency in patients without typical clinical symptoms of Ehlers-Danlos type IV.

Biochemical analysis of skin samples revealed that the content of type III collagen was greatly reduced in several subjects with joint hypermobility, stretchability and bruisability of skin. When cultured dermal fibroblasts were found to secrete decreased amounts of type III procollagen into medium (about 30-45% the normal amount) and serum type III procollagen aminopropeptide levels were significantly lower than normal values (P less than 0.001). The abnormalities in type III procollagen are in keeping with Ehlers-Danlos type IV although the clinical findings in our patients are not normally associated with this disorder. The results illustrate the clinical heterogeneity of Ehlers-Danlos type IV and the importance of biochemical analysis, such as determination of type III procollagen aminopropeptide levels, to check type III collagen metabolism especially if there is no family history and if correct diagnosis is not reliable by clinical examination alone.

Polyamines in lymphocytes from patients infected by human immunodeficiency virus.

Lymphocytes from patients with antibodies against the AIDS associated human immuno-deficiency virus (HIV-1) have elevated concentrations of polyamines. Spermidine and spermine are similar in amount in patients with Persistent Generalized Lymphadenopathy (PGL) and overt AIDS, while putrescine is much higher in the latter. Spermidine-acetyltransferase activity is also increased in lymphocytes from patients with PGL. Diamine-oxidase activity is decreased in serum of patients with PGL, but not in those with AIDS.

Effect of the triterpenoid fraction of Centella asiatica on macromolecules of the connective matrix in human skin fibroblast cultures.

The mechanism of action of the total triterpenoid fraction extracted from Centella Asiatica (TTFCA) was evaluated using human skin fibroblasts cultures as the experimental system. In particular its influence on the biosynthesis of collagen, fibronectin and proteoglycans was considered. The presence of TTFCA (25 micrograms/ml) does not seem to affect cell proliferation, total protein synthesis or the biosynthesis of proteoglycans in a significant way. A statistically important increase was observed in the percentage of collagen and, as revealed by immunofluorescence measurements, in cell layer fibronectin. This effect on collagen and fibronectin may help to explain the action of TTFCA in promoting wound healing, and suggests an interesting working hypothesis for its action on basal endothelia.