Cognitive Event-Related Potentials in Young Adults With Cerebral Palsy: A Proof-of-Concept Study

Cerebral palsy (CP) is a movement and posture disorder often accompanied by cognitive difficulties which can be assessed using event-related potentials (ERPs), an often-overlooked tool in this population. Here we describe our assessment protocol, examine its feasibility, and validate the use of single-subject ERP analyses in adolescents and young adults with CP, an analysis approach which recognizes the heterogeneity of the clinical population. This study involved a final sample of 9 adolescents/young adults with CP participating in the "MyStory" study (age range 16-29 years, M_age = 25.0 years; 6 female; Gross Motor Function Classification System level I [n = 4], II [n = 2], III [n = 1], IV [n = 1], and V [n = 1]). ERP components were elicited over medial prefrontal and central cortex (error- and correct-related negativities [ERN/CRN], error-positivity [Pe], N100, P200, N200, P300), as well as those generated over occipital cortex (P100, N170). Group and single-subject ERP statistics were computed for ERPs recorded over both areas. Using recently developed data analysis methods (independent components analysis and robust bootstrapped single-subject statistics), we measured the number of participants demonstrating significant condition differences at the timing of each ERP component of interest. We demonstrate good validity for ERPs recorded during 2 of our 3 tasks eliciting frontal activation (eg, 4 of 6 participants with usable data showed a significant single-subject medial frontal negativity condition difference in a context-switching task) and good validity for ERPs derived from a task engaging occipital regions (eg, 8 of 9 participants each showed a significant N170 face-object condition effect).