Giovanni Baranello1, Davide Rossi Sebastiano2, Emanuela Pagliano3, Elisa Visani4, Claudia Ciano5, Adriana Fumarola6, Maria Teresa Arnoldi7, Alice Corlatti8, Maria Foscan9, Alessia Marchi10, Alessandra Erbetta11, Daria Riva12. 1. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: giovanni.baranello@istituto-besta.it. 2. Department of Neurophysiology-Epilepsy Centre, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: rossi.d@istituto-besta.it. 3. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: epagliano@istituto-besta.it. 4. Department of Neurophysiology-Epilepsy Centre, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: visani.e@istituto-besta.it. 5. Department of Neurophysiology-Epilepsy Centre, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: claudia.ciano@istituto-besta.it. 6. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: tnpeends@istituto-besta.it. 7. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: mariateresa.arnoldi@gmail.com. 8. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: alice.corlatti@alice.it. 9. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: maria.foscan@live.it. 10. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: alessia_marchi@yahoo.it. 11. Neuroradiology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: alessandra.erbetta@istituto-besta.it. 12. Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Via Celoria 11, 20133 Milan, Italy. Electronic address: driva@istituto-besta.it.
Abstract
AIM: The purpose of the present study was to correlate early hand function assessment during the first years of life with neuroimaging findings and the different patterns of cortico-motor reorganization in children with unilateral cerebral palsy (UCP). METHODS: We conducted a long prospective observational study, in which 17 children with UCP (8 left-sided hemiplegia; Manual Ability Classification System level 1-3) were first assessed at a mean age of 24 months (range 18-28), and followed up by means of the Besta Scale, a new standardized protocol assessing both unimanual and bimanual hand function. They also underwent Melbourne Assessment of Unilateral Upper Limb Function (MUUL) and single-pulse Transcranial Magnetic Stimulation (TMS) at a mean age of 10 years 5 months (range 9 y 1 m-12 y 8 m). Brain MRIs of all the 17 children were independently assessed and scored by two blinded observers, according to a defined protocol. Possible correlations between hand function at first assessment, neuroimaging and TMS data were analyzed. RESULTS: Early hand function impairment significantly correlated with the extension of brain damage (ρ = -0.531, p = 0.028), number of involved areas (ρ = -0.608, p = 0.010), presence of radiological signs of cortico-spinal degeneration (ρ = -0.628, p = 0.007), and basal ganglia involvement (ρ = -0.485, p = 0.049). Additionally, higher hand function scores (i.e. better hand function) at first assessment significantly correlated with contralateral cortico-spinal projections, while lower scores significantly correlated with either mixed or ipsilateral cortico-spinal projections to the affected hand (χ(2)(2) = 11.418, p = 0.003; post-hoc tests: contralateral TMS group versus ipsilateral: Z = -2.943, p = 0.002 and contralateral TMS group versus mixed: Z = -2.775, p = 0.006). CONCLUSIONS: To our knowledge, this is the first study correlating hand function assessment in the first years of life, and its evolution over time, with neuroimaging and cortico-spinal projection patterns in children with UCP. These findings could contribute to an improved prediction of prognosis and a better delineation of therapeutic interventions in young children with UCP.
AIM: The purpose of the present study was to correlate early hand function assessment during the first years of life with neuroimaging findings and the different patterns of cortico-motor reorganization in children with unilateral cerebral palsy (UCP). METHODS: We conducted a long prospective observational study, in which 17 children with UCP (8 left-sided hemiplegia; Manual Ability Classification System level 1-3) were first assessed at a mean age of 24 months (range 18-28), and followed up by means of the Besta Scale, a new standardized protocol assessing both unimanual and bimanual hand function. They also underwent Melbourne Assessment of Unilateral Upper Limb Function (MUUL) and single-pulse Transcranial Magnetic Stimulation (TMS) at a mean age of 10 years 5 months (range 9 y 1 m-12 y 8 m). Brain MRIs of all the 17 children were independently assessed and scored by two blinded observers, according to a defined protocol. Possible correlations between hand function at first assessment, neuroimaging and TMS data were analyzed. RESULTS: Early hand function impairment significantly correlated with the extension of brain damage (ρ = -0.531, p = 0.028), number of involved areas (ρ = -0.608, p = 0.010), presence of radiological signs of cortico-spinal degeneration (ρ = -0.628, p = 0.007), and basal ganglia involvement (ρ = -0.485, p = 0.049). Additionally, higher hand function scores (i.e. better hand function) at first assessment significantly correlated with contralateral cortico-spinal projections, while lower scores significantly correlated with either mixed or ipsilateral cortico-spinal projections to the affected hand (χ(2)(2) = 11.418, p = 0.003; post-hoc tests: contralateral TMS group versus ipsilateral: Z = -2.943, p = 0.002 and contralateral TMS group versus mixed: Z = -2.775, p = 0.006). CONCLUSIONS: To our knowledge, this is the first study correlating hand function assessment in the first years of life, and its evolution over time, with neuroimaging and cortico-spinal projection patterns in children with UCP. These findings could contribute to an improved prediction of prognosis and a better delineation of therapeutic interventions in young children with UCP.
Authors: Neda Sadeghi; Mohammad Taghi Joghataei; Ali Shahbazi; Seyed Hassan Tonekaboni; Hale Akrami; Mohammad Ali Nazari Journal: Exp Brain Res Date: 2022-07-25 Impact factor: 2.064
Authors: Lisa Mailleux; Cristina Simon-Martinez; Katrijn Klingels; Ellen Jaspers; Kaat Desloovere; Philippe Demaerel; Simona Fiori; Andrea Guzzetta; Els Ortibus; Hilde Feys Journal: Front Hum Neurosci Date: 2017-12-12 Impact factor: 3.169
Authors: Jesse L Kowalski; Samuel T Nemanich; Tanjila Nawshin; Mo Chen; Colleen Peyton; Elizabeth Zorn; Marie Hickey; Raghavendra Rao; Michael Georgieff; Kyle Rudser; Bernadette T Gillick Journal: J Clin Med Date: 2019-08-13 Impact factor: 4.241
Authors: Bernadette T Gillick; Andrew M Gordon; Tim Feyma; Linda E Krach; Jason Carmel; Tonya L Rich; Yannick Bleyenheuft; Kathleen Friel Journal: Front Pediatr Date: 2018-03-16 Impact factor: 3.418