Executive function following pediatric stroke. A systematic review

Objective: Pediatric strokes are rare events that can lead to neuropsychological impairment or disability. While motor deficits are relatively easy to identify and investigate, cognitive outcomes after stroke are more complex to define. Many studies have focused on global cognitive outcomes, while only a few recent studies have focused on specific cognitive processes. The aims of the present review were to provide an overview of the effects of pediatric strokes on executive function and to investigate the relations between executive functioning and clinical factors. Method: Studies concerning executive functioning after pediatric stroke were identified using PsycInfo, PsycArticles and PubMed. A total of 142 studies were identified, and 22 met the inclusion criteria. Results: The review of the 22 studies included clearly indicates that childhood and perinatal strokes can affect executive function, and in particular inhibition. In contrast, the results concerning clinical factors related to EF outcomes are inconsistent. Discussion: Our results highlight the importance to assess EF following pediatric stroke. Early identification of difficulties in EF is crucial to provide adequate training to the children and to prevent the development of other correlated difficulties, such as behavioral problems or learning difficulties. Methodological issues regarding the heterogeneity of samples and measurement difficulties limit the conclusions that can be made about the clinical predictors of the outcomes. Studies are needed to better understand this aspect and to develop adequate EF interventions for children following stroke.