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Aim: To disentangle the respective impacts of manual dexterity and cerebral palsy (CP) in cognitive functioning after neonatal arterial ischaemic stroke., Method: The population included 60 children (21 females, 39 males) with neonatal arterial ischaemic stroke but not epilepsy. The presence of CP was assessed clinically at the age of 7 years and 2 months (range 6y 11mo-7y 8mo) using the definition of the Surveillance of CP in Europe network. Standardized tests (Nine-Hole Peg Test and Box and Blocks Test) were used to quantify manual (finger and hand respectively) dexterity. General cognitive functioning was evaluated with the Wechsler Intelligence Scale for Children, Fourth Edition. Simple and multiple linear regression models were performed while controlling for socio-economic status, lesion side, and sex., Results: Fifteen children were diagnosed with CP. In simple regression models, both manual dexterity and CP were associated with cognitive functioning (β=0.41 [p=0.002] and β=0.31 [p=0.019] respectively). However, in multiple regression models, manual dexterity was the only associated variable of cognitive functioning, whether or not a child had CP (β=0.35; p=0.007). This result was reproduced in models with other covariables (β=0.31; p=0.017)., Interpretation: As observed in typically developing children, manual dexterity is related to cognitive functioning in children having suffered a focal brain insult during the neonatal period., What This Paper Adds: Manual dexterity predicts cognitive functioning after neonatal arterial ischaemic stroke. Correlations between manual dexterity and cognitive functioning occur irrespective of sex, lesion side, presence of cerebral palsy, and socio-economic status. Residual motor ability may support cognitive functioning., (© 2018 Mac Keith Press.)

Background: Motor imagery is considered as a promising therapeutic tool for rehabilitation of motor planning problems in patients with cerebral palsy. However motor planning problems may lead to poor motor imagery ability., Aim: The aim of this functional magnetic resonance imaging study was to examine and compare brain activation following motor imagery tasks in patients with hemiplegic cerebral palsy with left or right early brain lesions. We tested also the influence of the side of imagined hand movement., Method: Twenty patients with clinical hemiplegic cerebral palsy (sixteen males, mean age 12 years and 10 months, aged 6 years 10 months to 20 years 10 months) participated in this study. Using block design, brain activations following motor imagery of a simple opening-closing hand movement performed by either the paretic or nonparetic hand was examined., Results: During motor imagery tasks, patients with early right brain damages activated bilateral fronto-parietal network that comprise most of the nodes of the network well described in healthy subjects. Inversely, in patients with left early brain lesion brain activation following motor imagery tasks was reduced, compared to patients with right brain lesions. We found also a weak influence of the side of imagined hand movement., Conclusion: Decreased activations following motor imagery in patients with right unilateral cerebral palsy highlight the dominance of the left hemisphere during motor imagery tasks. This study gives neuronal substrate to propose motor imagery tasks in unilateral cerebral palsy rehabilitation at least for patients with right brain lesions.

Objective: To examine the "clinical utility" of a new virtual rehabilitation tool in order to treat upper-limb motor deficit in cerebral palsy (CP) patient., Methods: Single-case experimental designs. Virtual reality intervention was performed in two left unilateral spastic CP adolescent patients. The virtual reality intervention was given for 60 minutes per session, two sessions a day, and 5 days a week over 2 weeks., Results: For each patient and for both hands, the number of blocks transported within one minute (box and block test scores) is increased. The nonoverlap of all pairs indices for the paretic hand were calculated as 0.95 for subject 1 and 0.93 for subject 2, and the nonoverlap of all pairs indices for the nonparetic hand were calculated, respectively, as 0.92 and 1., Conclusion: We provide empirical evidence in support of a new simple Virtual Rehabilitation system in CP patient to improve upper-limb motor function.

In this paper, we explored how arm movement pattern as well as the related strategy of children with cerebral palsy (CP) and healthy children can be changed in the virtual catching task on a previously proposed rehabilitation system. We recruited 50 healthy children from elementary school, and 3 children with CP as subjects to classify their arm movement pattern/strategy. As a result of the classification, we identified three arm movement stages: Initial position, reaching path, and waving form, as well as the movement pattern strategy under each movement stage. Based on the classified pattern, we compared the differences in the time series changes of movement strategy between healthy children and the children with CP. The results show there is a significant difference in the strategy of arm movements in the initial position between healthy and CP children. [ABSTRACT FROM AUTHOR]

Objective To assess the potential use of indium-111 diethylenetriamine pentaacetic acid ( 111 In-DTPA) scintigraphy coupled with computed tomography (CT) for the investigation of intrathecal baclofen (ITB) device malfunction. Design Retrospective study of a case series of patients. Setting Neurosurgical and physical and rehabilitation medicine departments. Participants Patients (N=7) with reduced ITB effectiveness in whom prior conventional radiographs were inconclusive. Intervention Nine 111 In-DTPA scintigraphic studies and 8 CT scans. Planar acquisitions were followed by tomoscintigraphy combined with CT. Main Outcome Measure Progression of the radiotracer in the pump, catheters, and in the subarachnoid space. Results In 7 cases, scintigraphy coupled with CT showed leakage behind the pump, lack of activity outside the pump reservoir, abrupt interruption of activity in the catheter, or abnormal distribution of the radiotracer, thus demonstrating that the drug did not reach its target. Surgical revision confirmed these findings in 5 cases. In 1 case, combined imagery ruled out device dysfunction. In the remaining case, only planar acquisitions were performed, showing correct diffusion of the radiotracer. Conclusions The combination of scintigraphy and CT provides simultaneous functional and anatomic imagery of the device. The slow infusion of the radioisotope mimics the diffusion of baclofen, and this could be a useful method to explore intrathecal device malfunction. Further studies are required to compare scintigraphy coupled with CT, to radiopaque injection followed by fluoroscopy or CT. [ABSTRACT FROM AUTHOR]

Objective The neurophysiologic mu rhythm reflect the sensorimotor cortex activity. Cerebral palsy (CP) is a sensorimotor network defect. As an easily accessible biomarker of its cortical part, mu rhythm could help to better understand cerebral palsy physiopathology and neural basis of rehabilitation. We aimed to characterised mu rhythm in CP through a systematic review and an experimental study. Methods All English-written original articles in Pubmed and Medline studying neurophysiology of the sensorimotor cortex in children with CP and published between 1980 and 2016 were reviewed. A systematic analysis was proceed because meta-analysis was not possible. A pediatric exploratory study of mu rhythm in unilateral CP was performed. Mu rhythm at rest and during motor-execution and action-observation was recorded and compared between the lesed-hemisphere and the healthy-one. Results Ten articles were included. In all of them, mu rhythm was found in both the lesed and the healthy hemisphere. At rest, mu rhythm amplitude was sometimes lower in the lesed-one. Mu rhythm reactivity was regularly altered in the lesed-hemisphere, compared with the healthy-one or with control. Alterations were found on type and amplitude of the mu rhythm reactivity. Four children with unilateral CP were included in the exploratory study with similar results. No shared pattern of reactivity during action-observation could be determined. Conclusion Mu rhythm was found in both the lesed- and the healthy-hemisphere, but altered in the lesed-one, in children with CP. Theses results could be support by different characteristics of the CP sensorimotor network: a weaker electrical generator; altered interactions between the sensory and the motor cortices; a primary sensory impairment and a motor planning impairment. A better quantification of mu rhythm, especially during action-observation, could rise to a better comprehension of the CP physiopathology and on an innovant, custom-made neuro-rehabilitation. [ABSTRACT FROM AUTHOR]