Resting State and Diffusion Neuroimaging Predictors of Clinical Improvements Following Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy

J Child Neurol. 2015 Oct;30(11):1507-14. doi: 10.1177/0883073815572686. Epub 2015 Mar 11.

Abstract

The aim was to identify neuroimaging predictors of clinical improvements following constraint-induced movement therapy. Resting state functional magnetic resonance and diffusion tensor imaging data was acquired in 7 children with hemiplegic cerebral palsy. Clinical and magnetic resonance imaging (MRI) data were acquired at baseline and 1 month later following a 3-week constraint therapy regimen. A more negative baseline laterality index characterizing an atypical unilateral sensorimotor resting state network significantly correlated with an improvement in the Canadian Occupational Performance Measure score (r = -0.81, P = .03). A more unilateral network with decreased activity in the affected hemisphere was associated with greater improvements in clinical scores. Higher mean diffusivity in the posterior limb of the internal capsule of the affect tract correlated significantly with improvements in the Jebsen-Taylor score (r = -0.83, P = .02). Children with more compromised networks and tracts improved the most following constraint therapy.

Keywords: cerebral palsy; constraint-induced movement therapy; functional magnetic resonance imaging; resting state.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Brain / pathology*
  • Brain / physiopathology*
  • Cerebral Palsy / diagnosis*
  • Cerebral Palsy / pathology
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / therapy*
  • Child
  • Diffusion Tensor Imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Physical Therapy Modalities*
  • Prognosis
  • Rest
  • Restraint, Physical / methods
  • Treatment Outcome