Cortical reorganization after modified constraint-induced movement therapy in pediatric hemiplegic cerebral palsy

J Child Neurol. 2007 Nov;22(11):1281-7. doi: 10.1177/0883073807307084.

Abstract

Constraint-induced movement therapy improves motor function in the affected hand of children with hemiplegic cerebral palsy and results in cortical changes in adults with stroke. This study measured clinical improvement and cortical reorganization in a child with hemiplegia who underwent modified constraint-induced movement therapy for 3 weeks. Clinical, functional magnetic resonance imaging and magnetoencephalography measurements were done at baseline, after therapy, and 6 months after therapy. Modified constraint-induced movement therapy resulted in clinical improvement as measured by the Pediatric Motor Activity Log. Functional magnetic resonance imaging showed bilateral sensorimotor activation before and after therapy and a shift in the laterality index from ipsilateral to contralateral hemisphere after therapy. Magnetoencephalography showed increased cortical activation in the ipsilateral motor field and contralateral movement evoked field after therapy. Cortical reorganization was maintained at the 6-month follow-up. This is the first study to demonstrate cortical reorganization after any version of constraint-induced movement therapy in a child with hemiplegia.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Mapping
  • Cerebral Cortex / blood supply
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology*
  • Cerebral Palsy / complications
  • Cerebral Palsy / pathology
  • Cerebral Palsy / rehabilitation*
  • Child
  • Exercise Movement Techniques / methods*
  • Functional Laterality
  • Hand / physiopathology
  • Hemiplegia / complications
  • Hemiplegia / pathology
  • Hemiplegia / rehabilitation*
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Magnetoencephalography / methods
  • Male
  • Movement / physiology*
  • Oxygen / blood

Substances

  • Oxygen