Abstract
Transcranial magnetic stimulation (TMS) can be used as an assessment or intervention to evaluate or influence brain activity in children with hemiparetic cerebral palsy (CP) commonly caused by perinatal stroke. This communication report analyzed data from two clinical trials using TMS to assess corticospinal excitability in children and young adults with hemiparetic CP. The results of this communication revealed a higher probability of finding a motor evoked potential (MEP) on the non-lesioned hemisphere compared to the lesioned hemisphere (p = 0.005). The resting motor threshold (RMT) was lower on the non-lesioned hemisphere than the lesioned hemisphere (p = 0.013). There was a significantly negative correlation between age and RMT (rs = −0.65, p = 0.003). This communication provides information regarding MEP responses, motor thresholds (MTs) and the association with age during TMS assessment in children with hemiparetic CP. Such findings contribute to the development of future pediatric studies in neuroplasticity and neuromodulation to influence motor function and recovery after perinatal stroke.
Highlights
Perinatal stroke is estimated to occur in as many as 1 in 2300 live births [1], and is the leading cause of cerebral palsy (CP) in children [2]
In the transcranial direct current stimulation (tDCS) study, 20 children or young adults participated in the Transcranial magnetic stimulation (TMS) assessment and motor evoked potential (MEP), determined either by resting motor threshold (RMT) or active motor threshold (AMT), were obtained in the full sample on the non-lesioned hemisphere
The remaining 10 children showed an absent MEP, an AMT, or were not able to tolerate the assessment during the hotspot determination
Summary
Perinatal stroke is estimated to occur in as many as 1 in 2300 live births [1], and is the leading cause of cerebral palsy (CP) in children [2]. Stroke may occur during in-utero development and surrounding birth. Children with hemiparetic CP clinically display greater impairments on the side of body contralateral to stroke. The motor deficits, especially in the upper extremities, are attributed to an interrupted corticospinal pathway and subsequent brain organization [3,4,5]. Movement patterns as a result of hemiparetic CP may include mirroring that affects functional performance [6]. When a child with hemiparetic CP is grasping an object using one hand, the other hand may move in the same manner simultaneously without isolated control
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