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, 36 (10), 870-7

An fNIRS Exploratory Investigation of the Cortical Activity During Gait in Children With Spastic Diplegic Cerebral Palsy

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An fNIRS Exploratory Investigation of the Cortical Activity During Gait in Children With Spastic Diplegic Cerebral Palsy

Max J Kurz et al. Brain Dev.

Abstract

Objective: The primary aim of this exploratory investigation was to determine if there are differences in cortical activation of children with spastic diplegic cerebral palsy (CP) and typically developing children during gait.

Methods: Functional near-infrared spectroscopy was used to measure the concentration of oxygenated hemoglobin that was present in the supplementary motor area, pre-central gyrus, post-central gyrus and superior parietal lobule as the children walked on a treadmill. A sagittal plane video was concurrently collected and later digitized to quantify the temporal gait variations.

Results: (1) The children with CP had an increased amount of activation in the sensorimotor cortices and superior parietal lobule during gait, (2) the children with CP had a greater amount of variability or error in their stride time intervals, and (3) an increased amount of error in the temporal gait kinematics was associated with an increased amount of activity across the cortical network.

Conclusion: Our results suggest that the perinatal damage and subsequent neural reorganization that occurs with spastic diplegic CP may impact the functional cortical activity for controlling gait. Furthermore, our results imply the increased cortical activity of the somatosensory cortices and superior parietal cortices may underlie the greater amount of error in the temporal gait kinematics.

Keywords: Mobile brain imaging; Motor control; Variability; Walking.

Figures

Figure 1
Figure 1
Representative time series of the oxyHb concentrations for all channels in children with CP (black lines) and TD children (red lines). The grayed area represents the active walking period, while the white areas represent the baseline period where the child is standing still. The approximate correspondence between channels and cortical areas was as follows: channels 1–3 and 5–6 were over the supplementary motor area, channels 8–10 and 12–13 were above the precentral gyrus, channels 12–13 and 15–17 were near the postcentral gyrus, and channels 19–20 and 22–24 were over the superior parietal lobule; see the Methods section for further information. As can be clearly discerned, the concentration of oxyHb was greater in children with CP across most channels. Units on the ordinate are Mmol × mm and seconds on the abscissa.
Figure 2
Figure 2
Average maximum oxyHb concentration in the respective cortical areas for children with CP (white) and TD children (gray). SMA is the supplementary motor area, and SPL is the superior parietal lobule. Error bars reflect the standard error of the mean. * p < 0.05.
Figure 3
Figure 3
A) Mean stance time intervals for children with CP and TD children, B) coefficient of variation for the stance time intervals, C) coefficient of variation for the stride time intervals. Error bars reflect the standard error of the mean. * p < 0.05.

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