Neuroplastic Sensorimotor Resting State Network Reorganization in Children With Hemiplegic Cerebral Palsy Treated With Constraint-Induced Movement Therapy

J Child Neurol. 2016 Feb;31(2):220-6. doi: 10.1177/0883073815588995. Epub 2015 Jun 15.

Abstract

Using resting state functional magnetic resonance imaging (MRI), we aim to understand the neurologic basis of improved function in children with hemiplegic cerebral palsy treated with constraint-induced movement therapy. Eleven children including 4 untreated comparison subjects diagnosed with hemiplegic cerebral palsy were recruited from 3 clinical centers. MRI and clinical data were gathered at baseline and 1 month for both groups, and 6 months later for the case group only. After constraint therapy, the sensorimotor resting state network became more bilateral, with balanced contributions from each hemisphere, which was sustained 6 months later. Sensorimotor resting state network reorganization after therapy was correlated with a change in the Quality of Upper Extremity Skills Test score at 1 month (r = 0.79, P = .06), and Canadian Occupational Performance Measure scores at 6 months (r = 0.82, P = .05). This clinically correlated resting state network reorganization provides further evidence of the neuroplastic mechanisms underlying constraint-induced movement therapy.

Keywords: cerebral palsy; constraint-induced movement therapy; neuroplasticity; resting state network.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Arm / physiopathology
  • Brain / physiopathology*
  • Cerebral Palsy / complications
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / therapy*
  • Child
  • Cohort Studies
  • Exercise Therapy / methods*
  • Female
  • Functional Laterality
  • Hemiplegia / complications
  • Hemiplegia / physiopathology
  • Hemiplegia / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Motor Activity / physiology
  • Neural Pathways / physiopathology
  • Neuronal Plasticity / physiology*
  • Rest
  • Restraint, Physical / methods*
  • Severity of Illness Index
  • Treatment Outcome