Corpus Callosum Integrity Relates to Improvement of Upper-Extremity Function Following Intensive Rehabilitation in Children With Unilateral Spastic Cerebral Palsy
| Autor: | Marina de Brito Brandão, Kathleen M. Friel, Andrew M. Gordon, Jennifer Gutterman, Maxime T Robert, Karen Chin, Claudio L Ferre |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment hemiplegia Brain damage Corpus callosum Corpus Callosum diffusion MRI Upper Extremity Physical medicine and rehabilitation Original Research Articles Outcome Assessment Health Care medicine Humans Child interventions Retrospective Studies Rehabilitation business.industry Cerebral Palsy Neurological Rehabilitation General Medicine brain damage Unilateral spastic cerebral palsy Diffusion Tensor Imaging Female medicine.symptom business interhemispheric connections Psychomotor Performance Diffusion MRI |
| Zdroj: | Neurorehabilitation and Neural Repair |
| ISSN: | 1552-6844 1545-9683 |
| Popis: | Background The corpus callosum (CC) plays an important role in upper extremity (UE) function. The impact on UE function in children with unilateral spastic cerebral palsy (USCP) and improvements following intensive interventions remain unknown. Objectives To examine the (1) relationship between UE function and CC integrity and (2) relationship between CC integrity and changes in UE function following intensive interventions. Methods We retrospectively analyzed clinical and neuroimaging data from a sample of convenience of 44 participants (age 9.40 ± 3.10 years) from 2 larger trials. Participants received 90 hours of Hand-Arm Bimanual Intensive Therapy (HABIT) or Constraint-Induced Movement Therapy (CIMT). Unimanual dexterity (Jebsen-Taylor Test of Hand Function [JTTHF]) and bimanual performance (Assisting Hand Assessment [AHA]) were assessed preintervention and postintervention. CC tractography was reconstructed with diffusion tensor imaging (DTI) and segmented into 3 regions (genu, midbody, splenium). Pearson correlations and regression were used to assess the relationship between outcomes and DTI parameters (ie, fractional anisotropy [FA], number of streamlines, and mean, radial, and axial diffusivity). Results Both groups improved in bimanual performance ( P < .01). The CIMT group improved in unimanual dexterity ( P < .01). Baseline unimanual dexterity and bimanual performance correlated with FA and number of streamlines for most CC regions ( P < .05). Following CIMT, pre-post changes in JTTHF were negatively correlated with axial and radial diffusivity of the CC, and AHA with splenium and number of streamlines for the CC, midbody, and splenium (all P < .05). Following HABIT, midbody FA was positively correlated with pre-post AHA changes ( r = 0.417; P = .042). Conclusions CC integrity is important for UE function in children with USCP. |
| Databáze: | OpenAIRE |
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