Brain lateralization in children with upper-limb reduction deficiency

Jorge M Zuniga; James E Pierce; Christopher Copeland; Claudia Cortes-Reyes; David Salazar; YingYing Wang; K M Arun; Theodore Huppert

doi:10.1186/s12984-020-00803-1

Brain lateralization in children with upper-limb reduction deficiency

J Neuroeng Rehabil. 2021 Feb 3;18(1):24. doi: 10.1186/s12984-020-00803-1.

Authors

Jorge M Zuniga¹, James E Pierce², Christopher Copeland², Claudia Cortes-Reyes², David Salazar², YingYing Wang³, K M Arun⁴, Theodore Huppert⁵

Affiliations

¹ Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, 68182, USA. jmzuniga@unomaha.edu.
² Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, 68182, USA.
³ Department of Special Education and Communication Disorders (SECD), University of Nebraska-Lincoln, Lincoln, NE, 68182, USA.
⁴ Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, India.
⁵ Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, 16148, USA.

Abstract

Background: The purpose of the current study was to determine the influence of upper-limb prostheses on brain activity and gross dexterity in children with congenital unilateral upper-limb reduction deficiencies (ULD) compared to typically developing children (TD).

Methods: Five children with ULD (3 boys, 2 girls, 8.76 ± 3.37 years of age) and five age- and sex-matched TD children (3 boys, 2 girls, 8.96 ± 3.23 years of age) performed a gross manual dexterity task (Box and Block Test) while measuring brain activity (functional near-infrared spectroscopy; fNIRS).

Results: There were no significant differences (p = 0.948) in gross dexterity performance between the ULD group with prosthesis (7.23 ± 3.37 blocks per minute) and TD group with the prosthetic simulator (7.63 ± 5.61 blocks per minute). However, there was a significant (p = 0.001) difference in Laterality Index (LI) between the ULD group with prosthesis (LI = - 0.2888 ± 0.0205) and TD group with simulator (LI = 0.0504 ± 0.0296) showing in a significant ipsilateral control for the ULD group. Thus, the major finding of the present investigation was that children with ULD, unlike the control group, showed significant activation in the ipsilateral motor cortex on the non-preferred side using a prosthesis during a gross manual dexterity task.

Conclusions: This ipsilateral response may be a compensation strategy in which the existing cortical representations of the non-affected (preferred) side are been used by the affected (non-preferred) side to operate the prosthesis. This study is the first to report altered lateralization in children with ULD while using a prosthesis. Trial registration The clinical trial (ClinicalTrial.gov ID: NCT04110730 and unique protocol ID: IRB # 614-16-FB) was registered on October 1, 2019 ( https://clinicaltrials.gov/ct2/show/NCT04110730 ) and posted on October 1, 2019. The study start date was January 10, 2020. The first participant was enrolled on January 14, 2020, and the trial is scheduled to be completed by August 23, 2023. The trial was updated January 18, 2020 and is currently recruiting.

Keywords: Brain activation; Pediatric; Prosthesis; Upper-limb deficiency; fNIRS.

Publication types

Clinical Study
Research Support, N.I.H., Extramural

MeSH terms

Artificial Limbs*
Child
Female
Functional Laterality / physiology*
Humans
Male
Motor Cortex / physiology*
Motor Cortex / physiopathology*
Motor Skills / physiology*
Upper Extremity Deformities, Congenital / physiopathology*

Associated data

ClinicalTrials.gov/NCT04110730

Abstract

Publication types

MeSH terms

Associated data

Grants and funding