An exploratory study of functional brain activity associated with gross motor function improvement in children with
A J Hilderley1, D Fehlings1,2,3, M J Taylor4,5
1Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Insights
This study explored brain activity in children with unilateral cerebral palsy (UCP) undergoing motor therapy. Pre-intervention brain imaging predicted improvements in gross motor function after therapy.
Area of Science:
- Neuroscience
- Pediatrics
- Rehabilitation Medicine
Background:
- Unilateral cerebral palsy (UCP) affects motor function in children.
- Understanding the relationship between brain activity and motor recovery is crucial for effective interventions.
Purpose of the Study:
- To investigate the relationship between primary motor cortex (M1) functional activity and gross motor function in children with UCP before and after intervention.
- To identify neuroimaging predictors of motor improvement.
Main Methods:
- Thirteen children with UCP participated in a gross motor intervention.
- Functional MRI (fMRI) assessed M1 activity (laterality index, activation volume, spatial overlap) during ankle dorsiflexion pre/post-intervention.
- Advanced gross motor function (Challenge) was evaluated pre/post-intervention and at follow-up.
Main Results:
- Pre-intervention M1 activity showed variability in the affected limb.
- No significant association was found between changes in motor function and neuroimaging outcomes.
- Reduced M1 activation and spatial overlap in the affected ankle pre-intervention predicted greater improvements in gross motor function post-intervention.
Conclusions:
- This study identified pre-intervention neuroimaging markers that predict improvements in advanced gross motor function in children with UCP.
- These findings highlight the potential of fMRI to predict therapeutic outcomes in pediatric neurorehabilitation.
Purpose:
Identify relations of gross motor function and primary motor cortex (M1) functional activity pre and post gross motor interventions for children with unilateral cerebral palsy (UCP).
Methods:
Thirteen children with UCP completed a gross motor intervention. Pre/post-intervention functional MRI outcomes included the laterality index (LI), activation volume, and spatial overlap of M1 activation during active ankle dorsiflexion. Advanced gross motor function (Challenge) was assessed pre/post-intervention, and 2-6 months later. Bivariate correlations and linear regression assessed relations between neuroimaging and motor function.
Results:
Mean pre-intervention M1 activity was contralateral during dominant (LI = +0.85, SD 0.21) but variable during the affected (LI = +0.43, SD 0.57) ankle dorsiflexion. Changes in motor function and neuroimaging outcomes were not significantly associated. However, smaller affected ankle activation and less spatial overlap between ankle activations pre-intervention predicted Challenge improvements post-intervention (adjusted R2 = 0.74, p = .001.).
Conclusions:
This exploratory study identified pre-intervention neuroimaging predictors of post-intervention improvements in advanced gross motor function.
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