Comparison of executive function skills between patients with cerebral palsy and typically developing populations: A systematic review and meta-analysis

Nóra Zimonyi*, Tamás Kói, Viktor Dombrádi, Marcell Imrei, Rita Nagy, Márk Ágoston Pulay, Zsolt Lang, Péter Hegyi, Zsofia K. Takacs, Ibolya Túri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: Children with CP show deficits in executive function compared to their typically developing peers, based on the majority of the available evidence. However, the magnitude of these deficits, as well as the proportions of the shortfalls in the three main components, have not yet been examined. This is the first meta-analysis to synthesize evidence on the magnitude of differences between patients with cerebral palsy (CP) and typically developing populations in different components of executive function skills (working memory, inhibitory control and cognitive flexibility), and thus makes recommendations on which areas of executive functioning are in greatest need of intervention. Methods: We conducted a systematic literature search of four databases for studies that measured executive functions in these two groups until 31 August 2023. We calculated the standardized mean difference (Hedges’ g), an average effect size overall, and for the three components of executive function skills separately, we used several moderator analyses, including methodological differences between the primary studies. Results: Fifteen articles were included in the meta-analysis. The average mean difference in executive functioning overall was large (g+ = −0.82). Furthermore, large significant differences were found in working memory (g+ = −0.92) and inhibitory control (g+ = −0.82) and a moderate difference was identified in cognitive flexibility (g+ = −0.57). In addition, results of moderator analyses reveal the importance of a rigorous matching of control group participants and CP patients. Conclusions: The results demonstrate a severe impairment in all executive functions among CP patients compared to typically developing peers, which do not decrease over time.
Original languageEnglish
Article number1867
Pages (from-to)1-16
Number of pages16
JournalJournal of Clinical Medicine
Volume13
Issue number7
DOIs
Publication statusPublished - 24 Mar 2024

Keywords / Materials (for Non-textual outputs)

  • cerebral palsy
  • executive functions
  • working memory
  • inhibitory control
  • cognitive flexibility

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