Publication Type Academic Article
Authors Marneweck M, Kuo H, Smorenburg A, Ferre C, Flamand V, Gupta D, Carmel J, Bleyenheuft Y, Gordon A, Friel K
Journal Neurorehabil Neural Repair
Volume 32
Issue 1
Pagination 62-72
Date Published 01/05/2018
ISSN 1552-6844
Keywords Cerebral Palsy, Hand, Hand Strength, Motor Cortex, Movement
Abstract BACKGROUND: In many children with unilateral spastic cerebral palsy (USCP), the corticospinal tract to the affected hand atypically originates in the hemisphere ipsilateral to the affected hand. Such ipsilateral connectivity is on average a predictor of poor hand function. However, there is high variability in hand function in these children, which might be explained by the complexity of motor representations of both hands in the contralesional hemisphere. OBJECTIVE: To measure the link between hand function and the size and excitability of motor representations of both hands, and their overlap, in the contralesional hemisphere of children with USCP. METHODS: We used single-pulse transcranial magnetic stimulation to measure the size and excitability of motor representations of both hands, and their overlap, in the contralesional hemisphere of 50 children with USCP. We correlated these measures with manual dexterity of the affected hand, bimanual performance, and mirror movement strength. RESULTS: The main and novel findings were (1) the large overlap in contralesional motor representations of the 2 hands and (2) the moderate positive associations of the size and excitability of such shared-site representations with hand function. Such functional associations were not present for overall size and excitability of representations of the affected hand. CONCLUSIONS: Greater relative overlap of the affected hand representation with the less-affected hand representation within the contralesional hemisphere was associated with better hand function. This association suggests that overlapping representations might be adaptively "yoked," such that cortical control of the child's less-affected hand supports that of the affected hand.
DOI 10.1177/1545968317745991
PubMed ID 29303031
PubMed Central ID PMC5943063
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