serval:BIB_1CB0640932F4
Somatosensory Plasticity in Pediatric Cerebral Palsy following Constraint-Induced Movement Therapy.
10.1155/2018/1891978
000450776000001
30532772
Matusz
P.J.
author
Key
A.P.
author
Gogliotti
S.
author
Pearson
J.
author
Auld
M.L.
author
Murray
M.M.
author
Maitre
N.L.
author
article
2018
Neural plasticity
1687-5443
1687-5443
journal
2018
1891978
Cerebral palsy (CP) is predominantly a disorder of movement, with evidence of sensory-motor dysfunction. CIMT <sup>1</sup> is a widely used treatment for hemiplegic CP. However, effects of CIMT on somatosensory processing remain unclear. To examine potential CIMT-induced changes in cortical tactile processing, we designed a prospective study, during which 10 children with hemiplegic CP (5 to 8 years old) underwent an intensive one-week-long nonremovable hard-constraint CIMT. Before and directly after the treatment, we recorded their cortical event-related potential (ERP) responses to calibrated light touch (versus a control stimulus) at the more and less affected hand. To provide insights into the core neurophysiological deficits in light touch processing in CP as well as into the plasticity of this function following CIMT, we analyzed the ERPs within an electrical neuroimaging framework. After CIMT, brain areas governing the more affected hand responded to touch in configurations similar to those activated by the hemisphere controlling the less affected hand before CIMT. This was in contrast to the affected hand where configurations resembled those of the more affected hand before CIMT. Furthermore, dysfunctional patterns of brain activity, identified using hierarchical ERP cluster analyses, appeared reduced after CIMT in proportion with changes in sensory-motor measures (grip or pinch movements). These novel results suggest recovery of functional sensory activation as one possible mechanism underlying the effectiveness of intensive constraint-based therapy on motor functions in the more affected upper extremity in CP. However, maladaptive effects on the less affected constrained extremity may also have occurred. Our findings also highlight the use of electrical neuroimaging as feasible methodology to measure changes in tactile function after treatment even in young children, as it does not require active participation.
Cerebral Palsy/diagnosis
Cerebral Palsy/physiopathology
Cerebral Palsy/therapy
Child
Child, Preschool
Electroencephalography/methods
Evoked Potentials, Somatosensory/physiology
Female
Humans
Male
Motion Therapy, Continuous Passive/methods
Neuronal Plasticity/physiology
Physical Therapy Modalities
Prospective Studies
Range of Motion, Articular/physiology
Somatosensory Cortex/physiology
eng
60_published
true
peer-reviewed
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: epublish
University of Lausanne
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