Two types of exercise‐induced neuroplasticity in congenital hemiparesis: a transcranial magnetic stimulation, functional <scp>MRI</scp>, and magnetoencephalography study

Juenger, Hendrik; Kuhnke, N.; Braun, Christoph; Ummenhofer, Frank; Wilke, Marko; Walther, Michael; Koerte, Inga K.; Delvendahl, Igor; Jung, Nikolai H.; Berweck, Steffen; Staudt, Martin; Mall, Volker

doi:10.1111/dmcn.12209

Cited by 95 publications

(124 citation statements)

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“…In addition, changes in motor-evoked potentials of the affected hand were quantified by transcranial magnetic stimulation as an alternative treatment response metric. 20 In recent years, fNIRS has been increasingly shown as a viable alternative neuroimaging modality to fMRI for monitoring brain activation. 21,22 FNIRS detects changes in near-infrared light absorption caused by changes in the concentration of oxyhemoglobin (ΔHbO) and deoxyhemoglobin (ΔHb) resulting from neuronal activity, known as neurovascular coupling.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy

et al. 2015

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Abstract. Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2 AE 2.1 years old) with hemiplegic cerebral palsy was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger-tapping task and the resting-state functional connectivity were quantified before, immediately after, and 6 months after CIMT. These fNIRS-based metrics were used to help explain changes in clinical scores of manual performance obtained concurrently with imaging time points. Five age-matched healthy children (9.8 AE 1.3 years old) were also imaged to provide comparative activation metrics for normal controls. Interestingly, the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted 6 months later. In contrast to this improved localized activation response, the laterality index and resting-state connectivity metrics that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed 6 months later. In addition, for the subjects measured in this work, there was either a trade-off between improving unimanual versus bimanual performance when sensorimotor activation patterns normalized after CIMT, or an improvement occurred in both unimanual and bimanual performance but at the cost of very abnormal plastic changes in sensorimotor activity. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Section: Introductionmentioning

confidence: 99%

Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy

et al. 2015

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“…Children's mastery motivation is a force that energizes, directs, and sustains goal-directed behavior 2 and is a predictor of later functioning. 3 For children with developmental disabilities, mastery motivation is also a predictor of later performance of daily activities and academic achievement. 4 The book 'From Neurons to Neighborhoods' identifies mastery motivation as a key developmental concept, which should be assessed as part of a child's evaluation.…”

mentioning

confidence: 99%

“…4 The book 'From Neurons to Neighborhoods' identifies mastery motivation as a key developmental concept, which should be assessed as part of a child's evaluation. 3 The article by Miller et al 1 demonstrates that inadequate parenting relates cross-sectionally to lower mastery motivation for school-aged children with congenital hemiplegia, using the parental report Dimensions of Mastery Questionnaire (DMQ). With cross-sectional studies it is less possible to know whether maternal behavior has an effect on children's motivation than with a longitudinal study design.…”

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confidence: 99%

Is constraint‐induced movement therapy harmful in unilateral spastic cerebral palsy with ipsilateral cortico‐spinal projections?

Staudt

Berweck

2013

Develop Med Child Neuro

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Constraint-induced movement therapy (CIMT) has become a well-established treatment for patients with hemiplegia, not only after stroke, but also in unilateral spastic cerebral palsy (USCP). In fact, most centers treating children and adolescents with this disorder offer CIMT. Numerous studies showed a good effect of CIMT in various cohorts of patients with USCP, but with considerable variability. Therefore, one would wish to be able to predict the response to CIMT in individual patients, especially since other treatment modalities like intensive bimanual training programs are available and have been demonstrated to be similarly effective. 1Five years ago, we published our observation that, on a behavioral level, patients with ipsilateral cortico-spinal projections responded differently to CIMT when compared with patients with preserved contralateral projections 2 : while both groups improved in the quality of movements with the paretic hand, only the contralateral group became faster, while the ipsilateral group became slower. Recently, we reported that this difference was not only present on a behavioral level, but that these two groups of patients also showed diverging changes of cortical excitability and taskrelated activation of the motor cortex controlling the paretic hand: 3 in patients with contralateral projections, transcranial magnetic stimulation of the motor cortex controlling the paretic hand elicited motor evoked potentials with a higher amplitude than before CIMT, while in patients with ipsilateral projections, the motor evoked potential amplitudes decreased. Likewise, after CIMT, functional magnetic resonance imaging (MRI) during active movements of the paretic hand demonstrated a stronger activation in the (contralateral) sensorimotor cortex of patients with contralateral projections, but a weaker activation in the (ipsilateral) motor cortex of patients with ipsilateral projections. Therefore, we are now more confident of our finding that these two groups of patients indeed respond differently to CIMT, not only on a behavioral level, but also with different mechanisms of cortical neuromodulation induced by therapy.Islam et al. 4 challenge the findings of our study. 2 In contrast to us, they did not study prototypical samples of patients with distinct types of cerebral lesions and corticospinal organization, but investigated a typical clinical sample of 16 children and adolescents chosen by their eligibility for CIMT according to clinical characteristics; both transcranial magnetic stimulation and MRI data were available for 11 participants. This sample included patients with contralateral, ipsilateral, and 'mixed type' cortico-spinal projections; underlying lesions comprised maldevelopments, white matter lesions and ischemic cortico-subcortical infarcts. Not surprisingly, in this heterogeneous sample, they could not identify any factors influencing the outcome of CIMT in individual participants. Most of them ameliorated in at least one of the hand function tests used in the study (Jebson-Taylor...

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“…101 In the third study, an associated analysis showed bilateral activation of S1-M1 in adolescents with corticospinal projections ipsilateral to the impaired hand; the balance of this activation shifted towards the impaired hemisphere after training. 69 In the same study, CIMT increased TMS-evoked MEPs in the primary descending corticospinal connection to the impaired hand, but not to the unimpaired (constrained) hand, in children with UCP, regardless of whether the impaired hand was controlled by the contralateral or ipsilateral motor cortex. MEG data that was acquired at the same time also found that somatosensory-evoked magnetic fields increased marginally in both groups after mCIMT.…”

Section: Multimodal Studies and Cimtmentioning

confidence: 86%

“…Three related studies of children with UCP have used a multimodal approach to investigate brain changes that occur in response to mCIMT. 68,69,101 These reports, which used data from two studies with overlapping participants, used fMRI to assess how brain activation changed when a ball-squeezing task was performed with the impaired hand. After exclusion of scans that were influenced by confounding factors, the first of these studies found no activation changes in two participants, and increased bilateral activation of the hand knob of the sensorimotor cortices in one individual aged 16 years with UCP.…”

Section: Multimodal Studies and Cimtmentioning

confidence: 99%

Measuring motor-training induced neuroplasticity using diffusion and functional MRI: a sensitive, pathology-robust approach

Reid¹

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Brain injury constitutes a significant health burden worldwide, and outcomes are generally poor. To improve treatment, we must better understand how injury affects brain function, how the brain responds to learning pressures (neuroplasticity), and the interaction between the two. This is difficult, however, because of current technological shortcomings.This thesis focusses on the measurement of neuroplasticity in response to motor training in situations such as rehabilitation following brain injury. Although the principles and methods discussed generalise to many forms of brain pathology, discussion is generally focussed on unilateral cerebral palsy (UCP) because altered brain-development in UCP makes analyses particularly difficult. This begins with a literature review (Chapter 2) that outlines UCP, rehabilitative approaches, and the relationship between atypical brain organisation and early-life brain injury. Also discussed is how novel rehabilitation strategies may stem from studying brain changes induced by rehabilitation, and why the most informative findings are likely to come from studies utilising multiple imaging modalities.Blood Oxygen-Level Dependent Functional Magnetic Resonance Imaging (fMRI) measures brain activity indirectly and has been used to study neuroplasticity in both healthy participants and those with brain pathology. Although fMRI confounds are well understood, no published work has explored their cumulative effect when brain injury is present. Resultantly, confounds have largely been ignored, leading to heterogeneous findings that have provided little toward understanding brain changes, biologically speaking. Chapter 3 examines the cumulative effect of fMRI confounds, assumptions, and other issues, when attempting to measure neuroplasticity in participants with brain injury. This work concludes that, although fMRI can be expected to locate approximate regions of brain activation in an individual scan, numerous confounding factors make its interpretation, in terms of neuroplasticity, difficult without additional information acquired through alternative means.Diffusion MRI (dMRI) is an imaging modality that is typically used to identify the brain's white-matter pathways and calculate metrics that are influenced by factors such as myelination or axonal density. Standard dMRI analyses are ill suited to studying brain injury due to their reliance on brain 'atlases' which indicate relationships between brain regions and brain functions. Brain pathology can prevent reliable atlas registration, and alter relationships between structure and function. Chapter 4 details a novel dMRI analysis designed to measure neuroplasticity, addressing the need for a sensitive and reliable alternative to standalone-fMRI. This method utilises surface-based fMRI analyses, rather than brain atlases, to locate regions involved in motor execution. Corticospinal (CST) and thalamocortical tracts emanating from these regions are delineated using dMRI tractography and iii machine learning. This method was app...

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Two types of exercise‐induced neuroplasticity in congenital hemiparesis: a transcranial magnetic stimulation, functional MRI, and magnetoencephalography study

Cited by 95 publications

References 41 publications

Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy

Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy

Is constraint‐induced movement therapy harmful in unilateral spastic cerebral palsy with ipsilateral cortico‐spinal projections?

Measuring motor-training induced neuroplasticity using diffusion and functional MRI: a sensitive, pathology-robust approach

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