Neuropsychological profiles of children with vestibular loss.

Objective: While previous research has shown that children with vestibular loss (VL) experience delayed motor development, it is not yet clear if vestibular loss also leads to delayed cognitive development. The impact of vestibular function on cognition is described in experimental animal and human studies, and adult patient studies with VL. These studies show links between uni and/or bilateral VL, and cognition impairments in working memory mental rotation and visual scanning. However, few studies have been conducted on children with VL. In this study, we will try to determine which cognitive abilities are impacted by VL in order to understand the impact of a vestibular loss on cognition from a developmental perspective. Methods: A sample of 13 children with VL that consulted our department for vertigo/dizziness/clumsiness disorders (diagnosed with bithermal caloric irrigation, Video Head Impulse Test and Vestibular-Evoked Myogenic Potentials), and a group of 60 average-age matched controls performed neuropsychological assessment consisting of visuospatial working memory, selective visual attention, mental rotation and space orientation tasks. Results: The results showed significant differences between the two groups for the cognitive measures of visuospatial working memory (both forward and backward span), mental rotation, and additional travelled distance in one of the space orientation tasks (mazes). However, we found no differences on selective visual attention and the other space orientation task (Rey Complex Figure). Conclusion: We discuss whether tasks characteristics could explain the child VL cognitive neuropsychological profile. We propose that visuospatial working memory, mental rotation and one of the space orientation tasks involves dynamic cognitive processes requiring high attentional load, causing impaired task performance in VL children. This is in contrast to static cognitive processes in selective visual attention and in the other space orientation task, requiring less attentional load, and no difference in performance relative to control participants