Explicit Motor Imagery for Grasping Actions in Children With Spastic Unilateral Cerebral Palsy

Abstract

Background: Motor Imagery (MI) refers to mental simulation of a motor action without producing any overt movement. Previous studies showed that children with Unilateral Cerebral Palsy (UCP) are impaired in implicit MI, as demonstrated by the performance of Hand Laterality Judgment tasks. The aim of this study was to examine the specificity of explicit MI deficits in UCP children. Methods: A group of UCP children ( n = 10; aged 9–14) performed a mental chronometry task consisting in grasping an object and placing it into a container, or in imagining to perform the same action. As control, a group of typically developing (TD) children, matched by age, performed the same task. Movement durations for executed and imagined trials were recorded. A subgroup of 7 UCP children and 10 TD children also underwent a session of functional MRI to examine the activation of parieto-frontal areas typically associated to MI processes, during the imagination of reaching-grasping actions performed with the paretic hand. Results: Behavioral results revealed the existence of a correlation between executed and imagined movement durations both in TD and UCP groups. Moreover, the regression analysis in TD children showed that higher scores in mental chronometry tasks were positively correlated to increased bilateral activation of the intraparietal sulcus (IPS), superior parietal lobule (SPL), and dorsal premotor (PMd) cortex. A similar analysis revealed in the UCP group a positive correlation between a higher score in the mental chronometry task and bilateral activations of IPS, and to activation of contralesional, right PMd, and putamen during imagination of grasping movements. Conclusions: These results provide new insights on the relationship between MI capacity and motor deficits in UCP children, suggesting the possibility of the use of explicit MI training to improve patient's upper limb motor functions.

Effect of Motor Imagery Training on Motor Learning in Children and Adolescents: A Systematic Review and Meta-Analysis

“…The development of MI ability has been extensively studied in children without impairments [ 42 , 50 ]. More recently, a few studies on MI ability in children with motor deficits such as development coordination disorder (DCD) [ 51 , 52 , 53 ] or cerebral palsy (CP) have been conducted [ 54 ]. DCD is a neurodevelopmental condition that is characterized by the inability to acquire and execute well-coordinated movements at an age-appropriate level [ 55 ], reflected by slow, effortful, inaccurate and ill-coordinated movements [ 56 , 57 ].…”

“…Consequently, their capability to retrieve motor representations should equally be preserved. Furthermore, they suggested that the application of explicit MI training could support the development of upper limb manipulation function in the cerebral palsy rehabilitation of children [ 54 ].…”

Reorganization of Resting-State EEG Functional Connectivity Patterns in Children with Cerebral Palsy Following a Motor Imagery Virtual-Reality Intervention

“…Studies addressing how to overcome such issues have suggested that MI training for children with CP should be performed with explicit (rather than implicit) MI [14]. Notwithstanding, even explicit MI capability can be affected by brain lesions [15] and, hence, the patients' neuropathophysiology must be considered for MI-based neurorehabilitation [15].…”

BCI-activated electrical stimulation in children with perinatal stroke and hemiparesis: A pilot study

“…Most children with perinatal stroke manifest major differences in the developmental organization of their motor system, often engaging major components of the motor system in the non-lesioned hemisphere (Alawieh et al, 2017;Craig et al, 2018Craig et al, , 2019. How this disrupted developmental plasticity impacts motor imagery systems is poorly understood though abnormalities in more generic CP populations are described (Errante et al, 2019). Source localization analysis would be one approach that might enhance understanding of mechanisms underlying motor imagery in individual children.…”