The aim of the present study was to assess the role of action observation treatment (AOT) in the rehabilitation of upper limb motor functions in children with cerebral palsy. We carried out a two-group, parallel randomized controlled trial. Eighteen children (aged 5–11 yr) entered the study: 11 were treated children, and 7 served as controls. Outcome measures were scores on two functional scales: Melbourne Assessment of Unilateral Upper Limb Function Scale (MUUL) and the Assisting Hand Assessment (AHA). We collected functional scores before treatment (T1), at the end of treatment (T2), and at two months of follow-up (T3). As compared to controls, treated children improved significantly in both scales at T2 and this improvement persisted at T3. AOT has therefore the potential to become a routine rehabilitation practice in children with CP. Twelve out of 18 enrolled children also underwent a functional magnetic resonance study at T1 and T2. As compared to controls, at T2, treated children showed stronger activation in a parieto-premotor circuit for hand-object interactions. These findings support the notion that AOT contributes to reorganize brain circuits subserving the impaired function rather than activating supplementary or vicariating ones.

BACKGROUND AND PURPOSE:A potential role of perfusion CT (PCT) in selecting patients with stroke for reperfusion therapies has been recently advocated. The purpose of the study was to assess the reliability of PCT in predicting clinical outcome of patients with acute ischemic stroke treated with intra-arterial thrombolysis (IAT).

A n important issue for language rehabilitation after stroke is the relationship between the effects of therapeutic interventions and the functional changes observed in brain language-related areas. Most studies focused on the spontaneous recovery of language, [1][2][3][4][5][6][7] but only a few, often single case descriptions, focused on patients submitted to language rehabilitation. [8][9][10][11][12][13] All of these were conducted on chronic patients. The rate of complete spontaneous (ie, without language therapy) aphasia recovery poststroke has been estimated at ≈33% in the first month, 43% after 4 months, and 50% 12 months later.14 However, the concept of spontaneous recovery of language may not be appropriate (as human beings are extensively exposed to language). The term language therapy commonly relates to formal interventions provided by speech therapists aimed at improving different language abilities with specific exercises.Evidence supports the use of language rehabilitation in stroke, particularly if intensively administered for short courses in chronic aphasics. 15,16 In a pilot study, Godecke et al 17 found that daily aphasia therapy in early stroke, that is, mean 3 days poststroke (dps), resulted in improved communication outcomes in moderate to severe aphasia. Brain plasticity induced by language training has not been extensively investigated to date. Several studies, conducted in chronic patients, suggested that functional correlates of aphasia recovery could be either the activation of predominantly left hemisphere (LH) language-related areas [18][19][20][21][22] or of the homologous right hemisphere (RH) areas, 2,23-25 but often the authors do not clarify whether patients were formally treated and to what extent, or not. Saur et al 4 suggest that in the postacute stages of recovery (2 weeks poststroke), the LH areas would be reduced in activation, whereas after months Background and Purpose-Early poststroke aphasia rehabilitation effects and their functional MRI (fMRI) correlates were investigated in a pilot, controlled longitudinal study. Methods-Twelve patients with mild/moderate aphasia (8 Broca, 3 anomic, and 1 Wernicke) were randomly assigned to daily language rehabilitation for 2 weeks (starting 2.2 [mean] days poststroke) or no rehabilitation. The Aachen Aphasia Test and fMRI recorded during an auditory comprehension task were performed at 3 time intervals: mean 2.2 (T1), 16.2 (T2), and 190 (T3) days poststroke. Results-Groups did not differ in terms of age, education, aphasia severity, lesions volume, baseline fMRI activations, and in task performance during fMRI across examinations. Rehabilitated patients significantly improved in naming and written language tasks (P<0.05) compared with no rehabilitation group both at T2 and T3. Functional activity at T1 was reduced in language-related cortical areas (right and left inferior frontal gyrus and middle temporal gyrus, right inferior parietal lobule and superior temporal gyrus) in patients compared with controls. T2 and T3 follow-ups r...

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