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The plasticity of the corticospinal tract in children with obstetric brachial plexus palsy after Botulinum Toxin A treatment.
- Source :
-
Journal of the neurological sciences [J Neurol Sci] 2018 Nov 15; Vol. 394, pp. 19-25. Date of Electronic Publication: 2018 Aug 28. - Publication Year :
- 2018
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Abstract
- Botulinum neurotoxin A (BTX-A) intervention has long-term benefits for children with obstetric brachial plexus palsy (OBPP). Although cortical plasticity has been widely studied, plasticity in white matter has not received as much attention. Here, six children with OBPP underwent functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) before and 6 months after BTX-A treatment. Surface electromyography (EMG) was recorded. The aim was to investigate changes in the corticospinal tract (CST) as an example longitudinal observation of white matter plasticity. Deterministic fiber tracking with a Fiber Assignment by Continuous Tracking algorithm was used to reconstruct the CST. Fiber tracts passing through a region of interest (ROI) in the posterior limb of the internal capsule and a target ROI in the upper-limb representation of M1 (defined by task-related fMRI) were selected as the CST. Motor performances were improved while EMG showed no significant difference 6 months after the treatment. We observed a significant increase in mean fractional anisotropy and a significant decrease in fiber number after treatment. We analyzed the correlations between DTI metrics and clinical motor assessments. Although the correlation results were not statistically significant, they support the notion that BTX-A treatment causes white matter plasticity and has a positive long-term outcome. Peripheral deafferentation may lead to altered information flow, resulting in the positive adaptation of white matter. This study provides novel insight into cerebral plasticity following peripheral nerve regeneration and indicates that a combination of relatively non-invasive therapies can accelerate plasticity of sensorimotor circuits and promote functional recovery in OBPP.<br /> (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Subjects :
- Animals
Child
Child, Preschool
Female
Humans
Male
Anisotropy
Brachial Plexus diagnostic imaging
Brachial Plexus drug effects
Brachial Plexus pathology
Brain Mapping
Diffusion Tensor Imaging
Electromyography
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome
Botulinum Toxins, Type A therapeutic use
Neuromuscular Agents therapeutic use
Neuronal Plasticity drug effects
Pyramidal Tracts diagnostic imaging
Pyramidal Tracts drug effects
Neonatal Brachial Plexus Palsy diagnostic imaging
Neonatal Brachial Plexus Palsy drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1878-5883
- Volume :
- 394
- Database :
- MEDLINE
- Journal :
- Journal of the neurological sciences
- Publication Type :
- Academic Journal
- Accession number :
- 30196131
- Full Text :
- https://doi.org/10.1016/j.jns.2018.08.025