title: Does somatosensory discrimination activate different brain areas in children with unilateral cerebral palsy compared to typically developing children? An fMRI study.
abstract: Aside from motor impairment, many children with unilateral cerebral palsy (CP) experience altered tactile, proprioceptive, and kinesthetic awareness. Sensory deficits are addressed in rehabilitation programs, which include somatosensory discrimination exercises. In contrast to adult stroke patients, data on brain activation, occurring during somatosensory discrimination exercises, are lacking in CP children. Therefore, this study investigated brain activation with functional magnetic resonance imaging (fMRI) during passively guided somatosensory discrimination exercises in 18 typically developing children (TD) (age, M=14 ± 1.92 years; 11 girls) and 16 CP children (age, M=15 ± 2.54 years; 8 girls). The demographic variables between both groups were not statistically different. An fMRI compatible robot guided the right index finger and performed pairs of unfamiliar geometric shapes in the air, which were judged on their equality. The control condition comprised discrimination of music fragments. Both groups exhibited significant activation (FDR, p<.05) in frontoparietal, temporal, cerebellar areas, and insula, similar to studies in adults. The frontal areas encompassed ventral premotor areas, left postcentral gyrus, and precentral gyrus; additional supplementary motor area (SMA proper) activation in TD; as well as dorsal premotor, and parietal operculum recruitment in CP. On uncorrected level, p<.001, TD children revealed more left frontal lobe, and right cerebellum activation, compared to CP children. Conversely, CP children activated the left dorsal cingulate gyrus to a greater extent than TD children. These data provide incentives to investigate the effect of somatosensory discrimination during rehabilitation in CP, on clinical outcome and brain plasticity.
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium. ann.vandewinckel@faber.kuleuven.be
authors.forename: Ann
authors.initials: A
authors.lastname: Van de Winckel
authors.forename: Geert
authors.initials: G
authors.lastname: Verheyden
authors.forename: Nici
authors.initials: N
authors.lastname: Wenderoth
authors.forename: Ron
authors.initials: R
authors.lastname: Peeters
authors.forename: Stefan
authors.initials: S
authors.lastname: Sunaert
authors.forename: Wim
authors.initials: W
authors.lastname: Van Hecke
authors.forename: Paul
authors.initials: P
authors.lastname: De Cock
authors.forename: Kaat
authors.initials: K
authors.lastname: Desloovere
authors.forename: Maria
authors.initials: M
authors.lastname: Eyssen
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
mesh_terms: D000293:Adolescent; D001132:Arm / Q000502:physiology; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002657:Child Development / Q000502:physiology*; D004192:Discrimination, Psychological / Q000502:physiology*; D025461:Feedback, Physiological / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000502:physiology; D007839:Functional Laterality / Q000502:physiology*; D006429:Hemiplegia / Q000503:physiopathology; D006801:Humans; D007699:Kinesthesis / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010296:Parietal Lobe / Q000502:physiology; D011434:Proprioception / Q000502:physiology; D013003:Somatosensory Cortex / Q000502:physiology*; D013788:Thalamus / Q000502:physiology; D055698:Touch Perception / Q000502:physiology; D055815:Young Adult