Saman Hazany1,2, Daljit Mann3, Neelesh Bagrodia4, Anthony J Krafnick3,5, Remy Chu6, Susan Shaw6,7, Kristi Clark3. 1. Department of Neuroradiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, Second Floor Imaging, Los Angeles, CA, 90033, USA. shazany@usc.edu. 2. Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Highway, Downey, CA, 90242, USA. shazany@usc.edu. 3. USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, 2025 Zonal Ave., CA, 90033, Los Angeles, USA. 4. Keck School of Medicine, University of Southern California, 1540 Alcazar Street, Suite 215, Los Angeles, CA, 90089, USA. 5. Psychology Department, Dominican University, 7900 W Division Street, River Forest, IL, 60305, USA. 6. Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Highway, Downey, CA, 90242, USA. 7. Department of Neurology, Keck School of Medicine, University of Southern California, 1540 Alcazar Street, Suite 215, Los Angeles, CA, 90089, USA.
Abstract
INTRODUCTION: Partial preservation of sensory and motor functions in the contralateral extremities after hemispherectomy is likely secondary to cortical reorganization of the remaining hemisphere and can be improved by rehabilitation. This study aims to investigate behavioral and structural cerebral cortical changes that may occur after a 2-week novel robotic rehabilitation program in children with prior anatomic hemispherectomy. METHODS: Five patients with prior anatomic hemispherectomy (average age 10.8 years; all female) participated in a 2-week novel robotic rehabilitation program. Pre- and post-treatment (2 time points) high-resolution structural 3D FSPGR (fast spoiled gradient echo) magnetic resonance images were analyzed to measure cortical thickness and gray matter volume using a locally designed image processing pipeline. RESULTS: Four of the five patients showed improvement in the Fugl-Meyer score (average increase 2.5 + 2.1 SD. Individual analyses identified small increases in gray matter volume near the hand knob area of the primary cortex in three of the five patients. Group analyses identified an increase in cortical thickness near the hand knob area of the primary motor cortex, in addition to other sensorimotor regions. CONCLUSION: This small pilot study demonstrates that potentially rehabilitation-associated cortical changes can be identified with MRI in hemispherectomy patients.
INTRODUCTION: Partial preservation of sensory and motor functions in the contralateral extremities after hemispherectomy is likely secondary to cortical reorganization of the remaining hemisphere and can be improved by rehabilitation. This study aims to investigate behavioral and structural cerebral cortical changes that may occur after a 2-week novel robotic rehabilitation program in children with prior anatomic hemispherectomy. METHODS: Five patients with prior anatomic hemispherectomy (average age 10.8 years; all female) participated in a 2-week novel robotic rehabilitation program. Pre- and post-treatment (2 time points) high-resolution structural 3D FSPGR (fast spoiled gradient echo) magnetic resonance images were analyzed to measure cortical thickness and gray matter volume using a locally designed image processing pipeline. RESULTS: Four of the five patients showed improvement in the Fugl-Meyer score (average increase 2.5 + 2.1 SD. Individual analyses identified small increases in gray matter volume near the hand knob area of the primary cortex in three of the five patients. Group analyses identified an increase in cortical thickness near the hand knob area of the primary motor cortex, in addition to other sensorimotor regions. CONCLUSION: This small pilot study demonstrates that potentially rehabilitation-associated cortical changes can be identified with MRI in hemispherectomy patients.
Authors: Christoph J Griessenauer; Smeer Salam; Philipp Hendrix; Daxa M Patel; R Shane Tubbs; Jeffrey P Blount; Peter A Winkler Journal: J Neurosurg Pediatr Date: 2015-01 Impact factor: 2.375