Somatosensory‐evoked cortical activity in spastic diplegic cerebral palsy

Abstract

Somatosensory deficits have been identified in cerebral palsy (CP), but associated cortical brain activity in CP remains poorly understood. Functional MRI was used to measure blood oxygenation level-dependent (BOLD) responses during three tactile tasks in 10 participants with spastic diplegia (mean age 18.70y, SD 7.99y; 5 females) and 10 age-matched controls (mean age 18.60y, SD 3.86y; 5 females). Tactile stimulation involved servo-controlled translation of smooth or embossed surfaces across the right index finger pad; the discrimination tasks with embossed surfaces involved judging whether 1) paired shapes were similar or different, and 2) a rougher set of horizontal gratings preceded or followed a smoother one. Velocity and duration of surface translation was identical across all trials. Additionally, an event-related design revealed response dynamics per trial in both groups. Compared to controls, individuals with spastic diplegia had significantly reduced spatial extents in activated cortical areas and smaller BOLD response magnitudes in cortical areas for somatosensation, motor, and goal-directed/attention behaviors. These results provide mechanisms for the widespread somatosensory deficits in CP. The reduced activation noted across multiple cortical areas might contribute to motor deficits in CP.

Relationship between functional connectivity and sensory impairment: Red flag or red herring?

“…Accordingly, the patients with the MCA infarction also tend to have less somatosensory functional connectivity than those with PL; however, the difference was not statistically significant. This is in line with a recent fMRI study [Wingert et al, 2010] where mildly affected spastic diplegia individuals showed smaller spatial extent of brain activation especially in S1 and S2. Guzzetta et al [2007] also found a significant correlation between severity of sensory impairment and extent of cortical activation following sensory stimulation on fMRI.…”

Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis

“…The children with GMFCS II of this study did not need aids to walk on ramp. Exclusion criteria for the DG included: visual changes and/or moderate to severe intellectual disability, other CP motor disorders such as ataxia, athetosis and dystonia, orthopedic disorders such as lower limb (LL) discrepancy, shortening and deformity or other situations that could prevent independent gait (11) and symmetry, application of botulinum toxin in the LL within the previous six months (12) and phenol within a time period of less than 36 months and/or surgery in the LL or trunk within a time period of less than one year (12 -14).…”

The Case for Musical Instrument Training in Cerebral Palsy for Neurorehabilitation

“…However, structural alterations are not restricted to central motor tracts [21, 38, 40, 44, 47] but have also been shown to affect also sensorimotor pathways [23, 30, 31, 41, 42], with reorganization of the latter being dissociated from the reorganization in corticospinal tracts [22, 30]. Structural changes in sensorimotor pathways in CP are accompanied by altered somatosensory processing of tactile stimulation, with patients showing less extended cortical activation during tactile stimulation and lower magnitude of activation during tactile discrimination tasks [31].…”