title: Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy.
abstract: Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2±2.1 years old) with hemiplegic cerebral palsy was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger-tapping task and the resting-state functional connectivity were quantified before, immediately after, and 6 months after CIMT. These fNIRS-based metrics were used to help explain changes in clinical scores of manual performance obtained concurrently with imaging time points. Five age-matched healthy children (9.8±1.3 years old) were also imaged to provide comparative activation metrics for normal controls. Interestingly, the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted 6 months later. In contrast to this improved localized activation response, the laterality index and resting-state connectivity metrics that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed 6 months later. In addition, for the subjects measured in this work, there was either a trade-off between improving unimanual versus bimanual performance when sensorimotor activation patterns normalized after CIMT, or an improvement occurred in both unimanual and bimanual performance but at the cost of very abnormal plastic changes in sensorimotor activity.
authors.affiliation: University of Texas at Arlington and University of Texas Southwestern Medical Center at Dallas, Joint Graduate Program in Biomedical Engineering, Arlington, Texas 76010, United States.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Cao
authors.affiliation: University of Texas at Arlington and University of Texas Southwestern Medical Center at Dallas, Joint Graduate Program in Biomedical Engineering, Arlington, Texas 76010, United States.
authors.forename: Bilal
authors.initials: B
authors.lastname: Khan
authors.affiliation: University of Texas at Arlington and University of Texas Southwestern Medical Center at Dallas, Joint Graduate Program in Biomedical Engineering, Arlington, Texas 76010, United States.
authors.forename: Nathan
authors.initials: N
authors.lastname: Hervey
authors.affiliation: University of Texas at Arlington and University of Texas Southwestern Medical Center at Dallas, Joint Graduate Program in Biomedical Engineering, Arlington, Texas 76010, United States.
authors.forename: Fenghua
authors.initials: F
authors.lastname: Tian
authors.affiliation: Texas Scottish Rite Hospital for Children, Department of Neurology, Dallas, Texas 75219, United StatesdUniversity of Texas Southwestern Medical Center at Dallas, Department of Neurology, Dallas, Texas 75235, United States.
authors.forename: Mauricio R
authors.initials: MR
authors.lastname: Delgado
authors.affiliation: Texas Scottish Rite Hospital for Children, Department of Neurology, Dallas, Texas 75219, United States.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Clegg
authors.affiliation: Texas Scottish Rite Hospital for Children, Department of Neurology, Dallas, Texas 75219, United States.
authors.forename: Linsley
authors.initials: L
authors.lastname: Smith
authors.affiliation: Texas Scottish Rite Hospital for Children, Department of Neurology, Dallas, Texas 75219, United States.
authors.forename: Heather
authors.initials: H
authors.lastname: Roberts
authors.affiliation: Texas Scottish Rite Hospital for Children, Department of Neurology, Dallas, Texas 75219, United States.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Tulchin-Francis
authors.affiliation: Texas Scottish Rite Hospital for Children, Department of Neurology, Dallas, Texas 75219, United States.
authors.forename: Angela
authors.initials: A
authors.lastname: Shierk
authors.affiliation: University of Texas at Dallas, Department of Electrical Engineering, Richardson, Texas 75080, United States.
authors.forename: Laura
authors.initials: L
authors.lastname: Shagman
authors.affiliation: University of Texas at Dallas, Department of Electrical Engineering, Richardson, Texas 75080, United States.
authors.forename: Duncan
authors.initials: D
authors.lastname: MacFarlane
authors.affiliation: University of Texas at Arlington and University of Texas Southwestern Medical Center at Dallas, Joint Graduate Program in Biomedical Engineering, Arlington, Texas 76010, United States.
authors.forename: Hanli
authors.initials: H
authors.lastname: Liu
authors.affiliation: University of Texas at Arlington and University of Texas Southwestern Medical Center at Dallas, Joint Graduate Program in Biomedical Engineering, Arlington, Texas 76010, United States.
authors.forename: George
authors.initials: G
authors.lastname: Alexandrakis
mesh_terms: D001931:Brain Mapping / Q000379:methods*; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015915:Motion Therapy, Continuous Passive; D009473:Neuronal Plasticity; D010101:Oxygen Consumption; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D066191:Sensorimotor Cortex / Q000503:physiopathology*; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D016896:Treatment Outcome