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23. Linking corticospinal tract activation and upper‐limb motor control in adults with cerebral palsy.

Author

Dukkipati, Saihari S., Walker, Sarah J., Trevarrow, Michael P., Busboom, Morgan T., Schlieker, Katie L., and Kurz, Max J.

Subjects
PYRAMIDAL tract, CEREBRAL palsy, ADULTS, EVOKED potentials (Electrophysiology), CERVICAL cord
Abstract

Aim: To quantify the cervicomedullary motor evoked potentials (CMEPs) at the cervical spinal level in adults with cerebral palsy (CP) and determine if altered CMEPs are linked with upper‐extremity motor function in this population. Method: This cross‐sectional study consisted of a cohort of adults with CP (n = 15; mean age = 33 years 5 months [SD = 11 years 8 months]); Manual Ability Classification System levels I–IV) and neurotypical controls (n = 18; mean age = 30 years 10 months [SD = 10 years 4 months]), who were recruited to participate at an academic medical center. Adults with CP and typical adults (controls) were stimulated at the cervicomedullary junction to assess CMEPs at the cervical spinal cord level. Upper‐extremity motor function was quantified using the Box and Blocks and Purdue Pegboard tests, self‐reported upper‐extremity function (UEF), and assessments of selective motor control. Results: At higher stimulation levels, the contralateral CMEP responses of adults with CP were different from typical adults (p = 0.032). Reduced CMEP was correlated with reduced upper‐limb function, including worse performance on the Box and Blocks (rho = 0.625, p = 0.025) and Purdue Pegboard tests (rho = 0.701, p = 0.010), lower self‐reported UEF (rho = 0.761, p = 0.009), and overall selective motor control (rho = 0.731, p = 0.007). Interpretation: Changes in the activation of spinal motoneurons through corticospinal pathways may have an important role in the altered upper‐extremity motor function of individuals with CP. [ABSTRACT FROM AUTHOR]

Published
2024
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37. Aberrant age-related alterations in spontaneous cortical activity in participants with cerebral palsy.

Author

Bergwell, Hannah, Trevarrow, Michael P., Heinrichs-Graham, Elizabeth, Reelfs, Anna, Ott, Lauren R., Penhale, Samantha H., Wilson, Tony W., and Kurz, Max J.

Subjects
CEREBRAL palsy, AGE groups, SENSORIMOTOR cortex, BRAIN imaging, ADULTS
Abstract

Introduction: Cerebral Palsy (CP) is the most common neurodevelopmental motor disability, resulting in life-long sensory, perception and motor impairments. Moreover, these impairments appear to drastically worsen as the population with CP transitions from adolescents to adulthood, although the underlying neurophysiological mechanisms remain poorly understood. Methods: We began to address this knowledge gap by utilizing magnetoencephalographic (MEG) brain imaging to study how the amplitude of spontaneous cortical activity (i.e., resting state) is altered during this transition period in a cohort of 38 individuals with spastic diplegic CP (Age range = 9.80-47.50 years, 20 females) and 67 neurotypical controls (NT) (Age range = 9.08-49.40 years, Females = 27). MEG data from a five-minute eyes closed resting-state paradigm were source imaged, and the power within the delta (2-4 Hz), theta (5-7 Hz), alpha (8-12 Hz), beta (15-29 Hz), and gamma (30-59 Hz) frequency bands were computed. Results: For both groups, the delta and theta spontaneous power decreased in the bilateral temporoparietal and superior parietal regions with age, while alpha, beta, and gamma band spontaneous power increased in temporoparietal, frontoparietal and premotor regions with age. We also found a significant group x age interaction, such that participants with CP demonstrated significantly less age-related increases in the spontaneous beta activity in the bilateral sensorimotor cortices compared to NT controls. Discussion: Overall, these results demonstrate that the spontaneous neural activity in individuals with CP has an altered trajectory when transitioning from adolescents to adulthood. We suggest that these differences in spontaneous cortical activity may play a critical role in the aberrant motor actions seen in this patient group, and may provide a neurophysiological marker for assessing the effectiveness of current treatment strategies that are directed at improving the mobility and sensorimotor impairments seen in individuals with CP. [ABSTRACT FROM AUTHOR]

Published
2023
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