title: Do mirror movements relate to hand function and timing of the brain lesion in children with unilateral cerebral palsy?
abstract: This study aimed to systematically map the severity of mirror movements in both hands in a prospective cohort of children with unilateral cerebral palsy, and to explore the relationship with hand function and brain lesion type.
  
  
  
  Seventy-eight children were included (41 males, 37 females; age 9y 4mo, SD 3y 1mo, range 5-15y). Mirror movements were scored during three repetitive tasks following Woods and Teuber criteria. Strength, tone, Melbourne Assessment, Jebsen-Taylor test, and Assisting Hand Assessment were evaluated. Lesions were classified into malformations (n=5), periventricular (n=43), cortico-subcortical (n=22), and postnatally acquired lesions (n=8).
  
  
  
  Significantly more mirror movements were observed in the non-paretic versus the paretic hand (p≤0.003). Higher mirror movement scores in the non-paretic hand significantly correlated with lower distal strength and lower scores on unimanual and bimanual assessments (r=0.29-0.41). In the paretic hand, significant differences were found between lesion types (p=0.03).
  
  
  
  The occurrence of mirror movements in the non-paretic hand seems related to hand function while mirror movements in the paretic hand seem more related to the lesion timing, whereby children with earlier lesions present with more mirror movements.
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.|Rehabilitation Research Center (REVAL), Biomed, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
authors.forename: Katrijn
authors.initials: K
authors.lastname: Klingels
authors.affiliation: Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
authors.forename: Ellen
authors.initials: E
authors.lastname: Jaspers
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany.|Epilepsy Center for Children and Adolescents, Clinic for Neuropediatrics and Neurorehabilitation, Schoen Klinik Vogtareuth, Vogtareuth, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Staudt
authors.affiliation: Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Guzzetta
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.
authors.forename: Lisa
authors.initials: L
authors.lastname: Mailleux
authors.affiliation: Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Ortibus
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D002547:Cerebral Palsy / Q000150:complications* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D011596:Psychomotor Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D018709:Statistics, Nonparametric