Differences in somatosensory processing due to dominant hemispheric motor impairment in cerebral palsy

Abstract

BackgroundAlthough cerebral palsy (CP) is usually defined as a group of permanent motor disorders due to non-progressive disturbances in the developing fetal or infant brain, recent research has shown that CP individuals are also characterized by altered somatosensory perception, increased pain and abnormal activation of cortical somatosensory areas. The present study was aimed to examine hemispheric differences on somatosensory brain processing in individuals with bilateral CP and lateralized motor impairments compared with healthy controls. Nine CP individuals with left-dominant motor impairments (LMI) (age range 5–28 yrs), nine CP individuals with right-dominant motor impairments (RMI) (age range 7–29 yrs), and 12 healthy controls (age range 5–30 yrs) participated in the study. Proprioception, touch and pain thresholds, as well as somatosensory evoked potentials (SEP) elicited by tactile stimulation of right and left lips and thumbs were compared.ResultsPain sensitivity was higher, and lip stimulation elicited greater beta power and more symmetrical SEP amplitudes in individuals with CP than in healthy controls. In addition, although there was no significant differences between individuals with RMI and LMI on pain or touch sensitivity, lip and thumb stimulation elicited smaller beta power and more symmetrical SEP amplitudes in individuals with LMI than with RMI.ConclusionsOur data revealed that brain processing of somatosensory stimulation was abnormal in CP individuals. Moreover, this processing was different depending if they presented right- or left-dominant motor impairments, suggesting that different mechanisms of sensorimotor reorganization should be involved in CP depending on dominant side of motor impairment.

Somatosensory Evoked Potentials and Central Motor Conduction Times in children with dystonia and their correlation with outcomes from Deep Brain Stimulation of the Globus pallidus internus

“…The majority of abnormal cortical SEPs occurred in children with acquired dystonia, which is not surprising. Abnormal SEPs have been reported in children with ‘spastic’( Tomita et al, 2006 , Riquelme et al, 2014 ) and athetoid CP ( Tomita et al, 2006 ), but not specifically in dystonic CP or other forms of acquired dystonia. Indeed there is a paucity of published neurophysiological data in children with dystonia or dyskinetic cerebral palsy ( McClelland, 2017 ).…”

“…Whilst it is not possible to conclude from these data that the sensory abnormalities are causal, it is likely that disruption of sensory pathways contributes to the disordered motor control in these children. Several studies have demonstrated anomalous sensory processing in children with “spastic” CP ( Riquelme and Montoya, 2010 , Kurz et al, 2014 , Kurz et al, 2015a , Riquelme et al, 2014 ) and these abnormalities do appear to have functional importance ( Kurz et al, 2015b ). There is clear evidence that primary dystonia is a network disorder involving multiple brain regions, including the cerebellum and sensorimotor cortex ( Neychev et al, 2011 , Neumann et al, 2015 ) and is a disorder of sensorimotor integration ( Hallett, 1995 , Tinazzi et al, 2000 , Abbruzzese et al, 2001 , Frasson et al, 2001 , Abbruzzese and Berardelli, 2003 ; Tinazzi et al, 2003 ).…”

Kinesthetic deficits after perinatal stroke: robotic measurement in hemiparetic children

“…In hemiparetic CP, reduced and altered patterns of spontaneous movement may be due to abnormal sensory feedback, altered cortical reorganization of sensorimotor function and/or abnormal sensory-motor integration. These can all lead to asymmetric somatosensory processing deficits [ 58 ]. Several studies in healthy and stroke groups have discussed the lateralization of sensorimotor function in the hemispheres, where the left hemisphere is associated with visual feedback [ 52 ] and initial trajectory features (i.e.…”

“…Animal studies have shown better outcomes in younger primates following unilateral lesions in the motor cortex [ 61 ]. Previous neuroimaging studies have reported significant alterations in white matter pathways connecting to the somatosensory cortex, suggesting that CP disrupts sensory and motor pathways [ 58 , 62 , 63 ]. One study of children with unilateral CP found that proprioception, pain and touch sensitivity did not differ between children with left versus right motor impairments, but lip and thumb stimulation in the left motor impaired group elicited smaller beta power and more symmetrical somatosensory evoked potential amplitude, suggesting different mechanisms of sensorimotor reorganization [ 58 ].…”

Changes in Tactile Function During Intensive Bimanual Training in Children With Unilateral Spastic Cerebral Palsy

“…6 Moreover, the integrity of sensory information has been demonstrated to be necessary for satisfactory performance of precision grip tasks, [7][8][9] and up to 90% of children with USCP may have some degree of sensory impairment. 4 In addition to the deficits of tactile perception, children with CP also present an abnormal brain processing of somatosensory stimulation, 10 as well as an atypical response of the somatosensory cortices to external stimuli with a negative correlation found between the amount of errors in a motor task performance and the efficacy of the somatosensory cortices synchronization. 11 Considerable attention has been paid in the literature to improving upper-extremity motor abilities.…”