title: Resting State and Diffusion Neuroimaging Predictors of Clinical Improvements Following Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy.
abstract: The aim was to identify neuroimaging predictors of clinical improvements following constraint-induced movement therapy. Resting state functional magnetic resonance and diffusion tensor imaging data was acquired in 7 children with hemiplegic cerebral palsy. Clinical and magnetic resonance imaging (MRI) data were acquired at baseline and 1 month later following a 3-week constraint therapy regimen. A more negative baseline laterality index characterizing an atypical unilateral sensorimotor resting state network significantly correlated with an improvement in the Canadian Occupational Performance Measure score (r = -0.81, P = .03). A more unilateral network with decreased activity in the affected hemisphere was associated with greater improvements in clinical scores. Higher mean diffusivity in the posterior limb of the internal capsule of the affect tract correlated significantly with improvements in the Jebsen-Taylor score (r = -0.83, P = .02). Children with more compromised networks and tracts improved the most following constraint therapy.
authors.affiliation: Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada.
authors.forename: Kathryn Y
authors.initials: KY
authors.lastname: Manning
authors.affiliation: Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Darcy
authors.initials: D
authors.lastname: Fehlings
authors.affiliation: CanChild Centre for Childhood Disability Research, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada.
authors.forename: Ronit
authors.initials: R
authors.lastname: Mesterman
authors.affiliation: CanChild Centre for Childhood Disability Research, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada.
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Gorter
authors.affiliation: Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Lauren
authors.initials: L
authors.lastname: Switzer
authors.affiliation: Department of Paediatrics, University of Western Ontario, London, Ontario, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Campbell
authors.affiliation: Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada Centre for Functional and Metabolic Mapping, the University of Western Ontario, London, Ontario, Canada rmenon@robarts.ca.
authors.forename: Ravi S
authors.initials: RS
authors.lastname: Menon
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D026741:Physical Therapy Modalities; D011379:Prognosis; D012146:Rest; D012149:Restraint, Physical / Q000379:methods; D016896:Treatment Outcome
keywords: cerebral palsy; constraint-induced movement therapy; functional magnetic resonance imaging; resting state