An exploratory study of functional brain activity associated with gross motor function improvement in children with unilateral cerebral palsy

Abstract

ABSTRACT Purpose Identify relations of gross motor function and primary motor cortex (M1) functional activity pre and post gross motor interventions for children with unilateral cerebral palsy (UCP). Methods Thirteen children with UCP completed a gross motor intervention. Pre/post-intervention functional MRI outcomes included the laterality index (LI), activation volume, and spatial overlap of M1 activation during active ankle dorsiflexion. Advanced gross motor function (Challenge) was assessed pre/post-intervention, and 2–6 months later. Bivariate correlations and linear regression assessed relations between neuroimaging and motor function. Results Mean pre-intervention M1 activity was contralateral during dominant (LI = +0.85, SD 0.21) but variable during the affected (LI = +0.43, SD 0.57) ankle dorsiflexion. Changes in motor function and neuroimaging outcomes were not significantly associated. However, smaller affected ankle activation and less spatial overlap between ankle activations pre-intervention predicted Challenge improvements post-intervention (adjusted R2 = 0.74, p = .001.) Conclusions This exploratory study identified pre-intervention neuroimaging predictors of post-intervention improvements in advanced gross motor function.