MOTW
MOTW: Human Experience
Citation:
Verschuren, O., Wiart, L., & Ketelaar, M. (2013). Stages of change in physical activity behavior in children and adolescents with cerebral palsy. Disability and rehabilitation, 35(19), 1630–1635. https://doi.org/10.3109/09638288.2012.748844
Summary:
The purpose of the study was to identify facilitators and barriers frequently experienced by families of children with cerebral palsy (CP) and associated with being at the pre-intention, intention and action stages for physical activity. It was a qualitative study involving in-depth focus group interviews with 33 ambulatory children and adolescents with CP and their parents (n = 33). These interviews were followed by questionnaires to determine stage of behavior change (i.e. pre-intention, intention and action) related to the child’s participation in physical activity. Results showed that families who were classified in the intention stage of behavioral change were more likely to identify environmental barriers related to the social environment and the facility or program than parents at the pre-intention stage. Families who were classified into intention and action stages were more likely to identify facilitators related to parental factors than families at the pre-intention stage. Moreover, at the action stage facilitators were related to the facility/program. The identified facilitators and barriers, organized according to three stages of change (pre-intention, intention and action), provide important theoretical insights into how and why children and adolescents with CP and their parents might change their physical activity behavior.
MOTW: Human Imaging
Citation:
Glass, H. C., Li, Y., Gardner, M., Barkovich, A. J., Novak, I., McCulloch, C. E., & Rogers, E. E. (2021). Early Identification of Cerebral Palsy Using Neonatal MRI and General Movements Assessment in a Cohort of High-Risk Term Neonates. Pediatric neurology, 118, 20–25. https://doi.org/10.1016/j.pediatrneurol.2021.02.003
Summary:
Cerebral palsy (CP) is the most common motor disability of childhood. Early identification of cerebral palsy is an important priority for parents and is critical for access to early intervention resources, which may optimize function. Their study was a prospective cohort of term neonates at high risk for CP was assessed by neonatal magnetic resonance imaging (MRI) to determine myelination of the posterior limb of the internal capsule, General Movements Assessment to assess typical fidgety movements at age three months, and followed to at least age two years to determine diagnosis of CP based on neurological examination. They found that seven of 58 children developed CP (12%), two with moderate/severe CP. Sensitivity and specificity for abnormal myelination of the posterior limb of the internal capsule (PLIC) was 29% and 94%, and for absent fidgety movements, 29% and 98%, respectively. Negative predictive value of both absent myelination of the PLIC and absent fidgety movements was 90% (79% to 96%) for any CP and 98% (90% to 100%) for moderate/severe CP cerebral palsy. None of the children with both normal PLIC and normal fidgety movements had moderate/severe CP. Normal neonatal MRI and General Movements Assessment at age three months are reassuring that a high-risk term-born child is at low risk for moderate/severe CP. These results are important for counseling parents and individualizing therapy resources in the community.
MOTW: Neurology
Citation:
Cheong, J. L., Doyle, L. W., Burnett, A. C., Lee, K. J., Walsh, J. M., Potter, C. R., Treyvaud, K., Thompson, D. K., Olsen, J. E., Anderson, P. J., & Spittle, A. J. (2017). Association Between Moderate and Late Preterm Birth and Neurodevelopment and Social-Emotional Development at Age 2 Years. JAMA pediatrics, 171(4), e164805. https://doi.org/10.1001/jamapediatrics.2016.4805
Summary:
The study compared neurodevelopment and social-emotional development between moderate and late preterm infants and term born infants at age 2. It was a longitudinal cohort study done at a single tertiary hospital. In total, 198 MLPT infants (98.5% of 201 recruited) and 183 term-born controls (91.0% of 201 recruited) were assessed at 2 years' corrected age.They assessed motor development using the Bayley Scales of Infant Development-Third Edition and social-emotional/ behavioral problems assessed by a parent questionnaire (Infant Toddler Social Emotional Assessment). They had a pedictrician assess the infants for blindness, cerebral palsy, and blindness. Linear and logistic regression was used to compare birth groups. The results showed that MLPT children had worse cognitive, language, and motor development at age 2 compared to the control infants. Social-emotional competence was worse in MLPT children compared to the control infants. Overall this study shows that moderate and late preterm infants exhibit developmental delay compared to their term-born peers.
MOTW: Tract Tracing Studies
Citation:
Carneiro, M. I. S., Russo, C., Masson, R., Rossi Sebastiano, D., Baranello, G., Turati, C., & Bolognini, N. (2020). Motor learning in unilateral cerebral palsy and the influence of corticospinal tract reorganization. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society, 27, 49–59. https://doi.org/10.1016/j.ejpn.2020.04.013
Summary:
The study gauged to investigate motor learning abilities in children with unilateral Cerebral Palsy and the different patterns of motor system reorganization. The 3 different patterns are bilateral, ipsilateral, and contralateral. They had children with unilateral cerebral palsy and children of the same age who are typically developing children complete a sequential finger-tapping task. They used a single pulse transcranial magnetic stimulation to assess the pattern of corticospinal tract projections. The results showed the presence of finger dexterity impairments in children with unilateral CP presenting with a bilateral or an ipsilateral control of the affected (trained) hand, as compared to TD children. Conversely, motor sequence learning was impaired in unilateral CP with ipsilateral or contralateral corticospinal reorganization, but not in the case of a bilateral control of the paretic hand.
MOTW: Lesioning
Citation:
Daniel D’Aquino, Moussa, A. A., Ammar, A., Ingale, H., & Vloeberghs, M. (2018). Selective dorsal rhizotomy for the treatment of severe spastic cerebral palsy: Efficacy and therapeutic durability in GMFCS grade IV and V children. Acta Neurochirurgica, 160(4), 811-821. doi:https://doi.org/10.1007/s00701-017-3349-z
Summary:
This study investigates the use of SDR in severe cases of cerebral palsy, GMFCS IV and V, and its long-term effects. Selective dorsal rhizotomy (SDR) is a surgical treatment for spastic diplegia and has been effective. The study included 54 pediatric patients who underwent SDR and specialized physiotherapy. The primary outcome was a reduction in spasticity in upper and lower limb muscle groups, which significantly improved at 2, 8, and 14 months after the surgery. The results showed a significant and sustained improvement in spasticity over a 1-year follow-up period. The urological function also improved in these patients. Overall, the study suggests that SDR, in combination with physiotherapy, is a safe and effective treatment for GMFCS IV and V patients, providing sustained improvements in spasticity and urological function, making it a rational alternative to intrathecal baclofen.
MOTW: Animal Behavior
Citation:
Tao, D., Zhong, T., Pang, W., & li, X. (2021). Saccharomyces boulardii improves the behaviour and emotions of spastic cerebral palsy rats through the gut-brain axis pathway. BMC Neuroscience, 22, 1-16. doi:https://doi.org/10.1186/s12868-021-00679-4
Summary:
This study aimed to investigate the potential of Saccharomyces boulardii (S. boulardii) in improving the behavior and emotional well-being of rats with spastic cerebral palsy (CP), which is a disability affecting movement and often associated with depression-like symptoms. Inflammation is known to play a role in both CP and depression, and there is growing interest in the gut-brain axis as a possible contributing factor. They created a new rat model by surgically damaging the cortex and subcortical white matter in 17-day-old CP rats. These rats were then administered S. boulardii or a control substance via gastric gavage for a period of 9 days. The researchers assessed various behavioral aspects and general health conditions, measured inflammatory markers (IL-6 and TNF-α) to gauge inflammation levels, evaluated the activity of the hypothalamic-pituitary-adrenal (HPA) axis by measuring adrenocorticotropic hormone and corticosterone in the rats' serum, and analyzed changes in the gut microbiome through 16S rRNA sequencing. The results showed that the rats with spastic CP-like symptoms exhibited depression-like behavior, but treatment with S. boulardii significantly improved their behavior and overall well-being. S. boulardii treatment also led to a reduction in inflammation, decreased HPA axis activity, and increased diversity in the gut microbiota. In conclusion, this study successfully established a rat model that mimics hemiplegic spastic cerebral palsy. The findings suggest that S. boulardii has the potential to be a beneficial treatment option for this type of CP, possibly acting through the gut-brain axis pathway.