Abstract
Aim: To explore cortical activation during bimanual tasks and functional correlates in unilateral cerebral palsy (CP). Method: This cross-sectional study included eight participants with unilateral CP (six females, two males; mean age [SD] 20y 10mo [5y 10mo], 13y 8mo–31y 6mo) in Manual Ability Classification System levels II to III and nine age-matched participants with typical development (seven females, two males; mean age [SD] 17y 8mo [5y 7mo], 9y 4mo–24y 2mo). They performed bimanual symmetric squeezing (BSS) and bimanual asymmetric squeezing (BAS) tasks at 1Hz, and a pouring task with dominant hand (DPour) and a pouring task with non-dominant hand (NDPour) at 0.67Hz, all while a custom array of functional near-infrared spectroscopy (fNIRS) optodes were placed over their sensorimotor area. Mixed-effects were used to contrast groups, tasks, and hemispheres (corrected p-values [q] reported). Analysis of variance and t-tests compared performance measures across groups and tasks. Results: Participants with unilateral CP showed greater activation in both hemispheres during BAS (non-lesioned: q<0.001; lesioned: q<0.001), and in the lesioned hemisphere during BSS (q<0.001), DPour (q=0.02), and NDPour (q=0.02) than those with typical development. The lesioned hemisphere in unilateral CP showed more activity than the non-lesioned one (BSS: q=0.01; BAS: q=0.009; NDPour: q=0.04). During BAS, higher cortical activity correlated with more synchronous arm activation (r=0.79; p=0.02); activity lateralized towards the non-lesioned hemisphere correlated with better Pediatric Evaluation of Disability Inventory computer adaptive test scores (r=0.81; p=0.03). Interpretation: Results suggest abnormally increased sensorimotor cortical activity in unilateral CP, with implications to be investigated. What this paper adds: Cortical activity in manual tasks is described with functional near-infrared spectroscopy in typical and atypical cohorts. Activation levels in unilateral cerebral palsy appear to escalate with task difficulty. Increased brain activity may be associated with poorer selective manual control. Specific patterns of brain activity may be related to impaired bimanual function.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 625-632 |
| Number of pages | 8 |
| Journal | Developmental Medicine and Child Neurology |
| Volume | 62 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2020 |
Funding
This study was funded by the Intramural Research Program of the NIH Clinical Center (protocol 13-CC-0110). The first author was also supported by the National Council for Scientific and Technological Development (CNPq), Brazil. We are very grateful to our participants and their families, and to Chris Stanley, Andy Gravunder, Laurie Ohlrich, Cristiane Zampieri-Gallagher, and Sara Sadeghi of the Functional and Applied Biomechanics Section for their work on participant recruitment and data collection. The authors have stated that they had no interests that might be perceived as posing a conflict or bias. This study was funded by the Intramural Research Program of the NIH Clinical Center (protocol 13‐CC‐0110). The first author was also supported by the National Council for Scientific and Technological Development (CNPq), Brazil. We are very grateful to our participants and their families, and to Chris Stanley, Andy Gravunder, Laurie Ohlrich, Cristiane Zampieri‐Gallagher, and Sara Sadeghi of the Functional and Applied Biomechanics Section for their work on participant recruitment and data collection. The authors have stated that they had no interests that might be perceived as posing a conflict or bias.
ASJC Scopus subject areas
- Clinical Neurology
- Developmental Neuroscience
- Pediatrics, Perinatology, and Child Health