Functional connectivity and quality of life in young adults with cerebral palsy: a feasibility study

Abstract

Background Cerebral Palsy (CP) is a group of disorders that affect the development of movement and posture. CP results from injuries to the immature brain during the prenatal, perinatal, or postnatal stage of development. Neuroimaging research in CP has focused on the structural changes of the brain during early development, but little is known about brain’s structural and functional changes during late adolescence and early adulthood, a period in time when individuals experience major changes as they transition into adulthood. The work reported here served as a feasibility study within a larger program of research (MyStory Study). We aimed to determine whether it would be feasible to scan and obtain good quality data without the use of sedation during a resting state condition for functional connectivity (FC) analyses in young adults with CP. Second, we aimed to identify the FC pattern(s) that are associated with depressive mood ratings, indices of pain and fatigue, and quality of life in this group. Methods Resting state functional images were collected from 9 young people with CP (18–29 years). We applied a stringent head motion correction and quality control methods following preprocessing. Results We were able to scan and obtain good quality data without the use of sedation from this group of young individuals with CP who demonstrated a range of gross motor ability. The functional connectivity networks of interest were identified in the data using standard seed regions. Our analyses further revealed that higher well-being scores were associated with higher levels of FC between the Medial Pre-Frontal Cortex and the right Lateral Parietal regions, which are implicated in prosocial and emotion regulations skills. The implications of this association are discussed. Conclusion The findings of the present study demonstrate that it is feasible to conduct resting state functional connectivity in young adults with CP with different gross motor abilities without the use of sedation. Our results also highlight a neural circuitry that is associated with the self-report of quality of life and emotion regulation. These findings identify these regions/circuitries as important seeds for further investigations into mental health and wellbeing in CP.

Psychological and functional problems of children and adolescents with cerebral palsy from the neurodevelopmental perspective

“…This period is characterized by changes in a maturing brain under the influences of physical, psychosocial, and cognitive factors. One study showed functional differences during that time in patients with CP in comparison to a healthy control group [43]. Adolescents with CP usually engage in more passive, solitary activities, which as a result affects structural and functional brain development, in particular self-concept and emotional functioning.…”

Addressing disparities among children with cerebral palsy: Optimizing enablement, functioning, and participation

“…In the US, where there is increasing recognition of living a life with CP (Cerebral Palsy Foundation: https:// www.yourCPF.org), we can go beyond fixing what we do not fully understand and systematically count, audit and improve population outcomes. Our focus can be on precisely optimizing trajectories of functioning, participation, and caregiver well-being [21,22]. That is our task as we aspire to integrated, enabled and equitable systems of population health for all children and adults with CP after the COVID-19 pandemic.…”

Emotion Regulation Is Associated with Anxiety, Depression and Stress in Adults with Cerebral Palsy

“…Moreover, brain pathology for people with CP occurs in early development [ 17 ], likely impacting plasticity and experiential learning pathways. A recent study examining neural circuitry in adults with CP demonstrated associations between level of functional connectivity in brain regions associated with ER and social skills, and participant well-being scores [ 18 ]. As regions of the brain known to control ER have been associated with CP, it is reasonable to hypothesise that adults with CP may experience an increased incidence of ER difficulties than expected in the general population.…”