Assessment of cortical activity, functional connectivity, and neuroplasticity in cerebral palsy using functional...

To map and critically appraise the literature on the feasibility and current use of functional near-infrared spectroscopy (fNIRS) to assess cortical activity, functional connectivity, and neuroplasticity in individuals with cerebral palsy (CP).

A scoping review methodology was prospectively registered and reported following Preferred Reporting Items for Systematic review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was conducted in four databases. Empirical studies using fNIRS to assess neural activity, functional connectivity, or neuroplasticity in individuals with CP aged 3 years or older were included.

Sixteen studies met the inclusion criteria. Individuals with CP (age range = 3-43 years; 70% unilateral CP) underwent fNIRS-based assessment for task-evoked activity (studies [n] = 15) and/or resting-state functional connectivity (n = 3). Preliminary observations suggest greater magnitude, extent, and ipsilateral hemispheric lateralization of sensorimotor cortex activity in CP, while magnitude and patterns of prefrontal cortex activity in CP appear dependent on task demands. Normalization of fNIRS-based activity metrics observed postintervention (n = 3) paralleled improvements in functional outcomes, highlighting their potential as promising biomarkers for functional gains in CP.

This review details the use of fNIRS in CP, highlights research gaps and technical limitations, and offers recommendations to support fNIRS implementation for ecologically valid functional neuroimaging in individuals with CP.