Related Experiment Video
Updated: Aug 15, 2025
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Bradykinesia assessment in children with cerebral palsy and periventricular leukomalacia
Chrysa Outsika1, Kostalas Vangelis2, Papadimitriou Ioanna1
11th Department of Pediatrics, Agia Sofia Children's Hospital, National and Kapodistrian University of Athens, Thivon and Levadias, Athens, 11527, Greece.
Insights
Bradykinesia, a motor impairment, is prevalent in 96% of children with Cerebral Palsy (CP) due to periventricular leukomalacia (PVL). This condition significantly impacts gross and fine motor skills, often co-occurring with dystonia.
Area of Science:
- Neurology
- Pediatrics
- Developmental Pediatrics
Background:
- Cerebral Palsy (CP) is a common neurodevelopmental disorder.
- Periventricular leukomalacia (PVL) is a specific type of brain injury often associated with CP.
- The motor phenotype in children with CP and PVL requires detailed characterization.
Purpose of the Study:
- To analyze the motor phenotype in children with CP and PVL, with a specific focus on bradykinesia.
- To investigate the relationship between bradykinesia, dystonia, spasticity, and functional motor abilities.
Main Methods:
- Analysis of a cohort of 25 children diagnosed with CP and PVL.
- Utilized the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) for functional assessment.
- Assessed spasticity (Modified Ashworth Scale - MAS), dystonia (Burke-Fahn-Marsden Scale - BFMS), and bradykinesia (Unified Parkinson's disease rating scale - UPDRS).
Main Results:
- Bradykinesia was present in 96% of the studied children with CP and PVL.
- Bradykinesia was more pronounced in the legs (moderate-to-severe) than in the arms (mild-to-moderate).
- Bradykinesia showed significant correlations with GMFCS, MACS, and dystonia (BFMS), but not with spasticity (MAS).
Conclusions:
- Confirms the high prevalence of bradykinesia in children with CP and PVL.
- Bradykinesia and dystonia are key interrelated factors affecting gross and fine motor skills in this population.
- Understanding these motor characteristics is crucial for managing functional deficits in children with CP and PVL.
Objective:
To analyse the motor phenotype with a focus on bradykinesia in children with Cerebral Palsy (CP) in the setting of periventricular leukomalacia (PVL).
Methodology:
Analysis of a cohort of 25 children with CP and PVL. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were used to classify the severity of motor function. Spasticity was rated using the Modified Ashworth Scale (MAS), dystonia was rated using the Burke-Fahn-Marsden Scale (BFMS), and bradykinesia was rated using the Unified Parkinson's disease rating scale (UPDRS). All patients were video-recorded following a standard protocol.
Results:
Bradykinesia was observed in 96% of patients. It was noted mainly in the limbs, and it was moderate-to-severe in the legs and mild-to-moderate in the arms. Bradykinesia correlated with functional level, as classified by GMFCS and MACS; also with dystonia, as rated by BFMS but did not correlate with a measure of spasticity (MAS).
Conclusions:
This study confirms the existence of bradykinesia in patients with CP in the setting of PVL. Bradykinesia and dystonia appear to be important interrelated factors influencing the level of gross and fine motor skills in patients with PVL.
