Visuo-perceptual Abilities in Children With Perinatal Arterial Ischemic Stroke and Associated White Matter Microstructure

Visuoperceptual skills are crucial for childhood development yet remain poorly understood in children with perinatal arterial ischemic stroke (PAIS). This study examined visuoperceptual performance and structural connectivity of visual pathways in children with perinatal arterial ischemic stroke and typically developing controls. Participants completed the Motor-Free Visual Perceptual Test (MVPT), Apples Test, Jerry John's Basic Reading Inventory (BRI), and diffusion-weighted magnetic resonance imaging (MRI) with tractography of optic pathways. Visuoperceptual and reading scores were compared by group and lesion laterality. Twenty-six perinatal arterial ischemic stroke and 27 typically developing controls were recruited. Perinatal arterial ischemic stroke children scored significantly lower on the Motor-Free Visual Perceptual Test and Jerry John’s Basic Reading Inventory and took longer on the Apples Test. Right hemisphere lesions were associated with greater deficits in visuoperceptual and reading than left-sided lesions. No correlations were found between white matter microstructure and visuoperceptual scores. Findings highlight the need for early visuoperceptual screening in perinatal arterial ischemic stroke, regardless of motor status, and further investigation by lesion laterality.