Cognition and bimanual performance in children with unilateral cerebral palsy: protocol for a multicentre, cross-sectional study

Hoare, Brian; Ditchfield, Michael; Thorley, Megan; Wallen, Margaret; Bracken, Jenny; Harvey, Adrienne; Elliott, Catherine; Novak, Iona; Crichton, Ali

doi:10.1186/s12883-018-1070-z

Cited by 22 publications

(14 citation statements)

References 111 publications

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“…However, the limitations of their upper limb are more variable and may still adversely affect their independence in life (Klingels et al 2012). Moreover, upper limb function is not solely determined by structural and functional limitations, but also by practice, preference and strategy (Hoare et al 2018). Hence, understanding the clinical variability of the upper limb and its best treatment options within this population is a major clinical concern.…”

Section: Introductionmentioning

confidence: 99%

White matter characteristics of motor, sensory and interhemispheric tracts underlying impaired upper limb function in children with unilateral cerebral palsy

et al. 2020

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This study explored the role of lesion timing (periventricular white matter versus cortical and deep grey matter lesions) and type of corticospinal tract (CST) wiring pattern (contralateral, bilateral, ipsilateral) on white matter characteristics of the CST, medial lemniscus, superior thalamic radiation and sensorimotor transcallosal fibers in children with unilateral cerebral palsy (CP), and to determine the association with upper limb function. Thirty-four children (mean age 10y7m ± 2y3m) with unilateral CP underwent a comprehensive upper limb evaluation and diffusion weighted imaging (75 directions, b-value 2800).Streamline count, fractional anisotropy and mean diffusivity were extracted from the targeted tracts and asymmetry indices were additionally calculated. Transcranial magnetic stimulation was applied to assess the CST wiring pattern. Results showed a more damaged CST in children with cortical and deep grey matter lesions (N=10) and ipsilateral CST projections (N=11) compared to children with periventricular white matter lesions (N=24; p<0.02) and contralateral CST projections (N=9; p<0.025), respectively. Moderate to high correlations were found between diffusion metrics of the targeted tracts and upper limb function (r=0.45-0.72; p<0.01). Asymmetry indices of the CST and sensory tracts could best explain bimanual performance (74%, p<0.0001) and unimanual capacity (50%, p=0.004). Adding lesion timing and CST wiring pattern did not further improve the model of bimanual performance, while for unimanual capacity lesion timing was additionally retained (58%, p =0.0002). These results contribute to a better understanding of the underlying neuropathology of upper limb function in children with unilateral CP and point towards a clinical potential of tractography.

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Section: Introductionmentioning

confidence: 99%

White matter characteristics of motor, sensory and interhemispheric tracts underlying impaired upper limb function in children with unilateral cerebral palsy

et al. 2020

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“…Children enhance their manual abilities by using fine motor skills, and these manual abilities are connected with many cognitive skills (Ritter & Haschke,2015). Hoare, et al (2018) conducted a study to see how cognition affects bimanual performance (fine motor skills) of children with cerebral palsy. Their study indicate after undergoing targeted treatment and intervention children with cerebral palsy improved their motor movement (of upper limbs) and cognition.…”

Section: Discussionmentioning

confidence: 99%

Development of Fine Motor Skills to Enhance the Functional Abilities of Children With Cerebral Palsy

Ashraf

Nisar

2019

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Cerebral palsy is a neurological, non-progressive and commonest cause of severe physical disabilities. It affects body movement and muscle coordination permanently and usually appears in early childhood. Children with cerebral palsy have severe problems of fine motor skills. The research was conducted to achieve the following objectives 1) to identify the current level of fine motor skills of students with cerebral palsy studying in the schools, 2)Design an intervention strategic plan to enhance the fine motor skills of children with cerebral palsy,3)implement the prescribed intervention plan to enhance the fine motor skills of children with cerebral palsy.4)improve the fine motor skills of children with cerebral palsy by implementing the intervention strategies. It was an experimental research conducted by applying single subject research design (ABA).The researchers used two different checklists to assess the functional abilities of the children with CP before and after intervention. The reliability of all the instruments was checked by using cronbach alpha (.87 and .78) whereas the content validity of the instruments was estimated by taking expert opinions. On the basis of pretest an intervention plan was implemented to enhance the functional abilities of the students. A self-developed test was used after implementing the intervention strategies to see the improvement in the functional abilities of children with cerebral palsy.

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“…The study was implemented across five Australian treatment centres (Monash Children's Hospital, Victoria; Royal Children's Hospital, Victoria; Cerebral Palsy Alliance, New South Wales; Lady Cilento Children's Hospital, Queensland; and Perth Children's Hospital, Western Australia), as previously described. 21…”

Section: Methods Study Designmentioning

confidence: 99%

Brain magnetic resonance imaging is a predictor of bimanual performance and executive function in children with unilateral cerebral palsy

Crichton

Ditchfield

Gwini

et al. 2020

Develop Med Child Neuro

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Aim To examine the association between brain magnetic resonance imaging (MRI) characteristics and executive function and bimanual performance in children with unilateral cerebral palsy (CP). Method Clinical MRI brain scans were classified as: (1) predominant pathological pattern (normal, white matter injury [WMI]; grey matter injury; focal vascular insults [FVI]; malformations; or miscellaneous); and (2) focal lesions (frontal, basal ganglia, and/or thalamus). Assessments included: (1) bimanual performance; (2) unimanual dexterity; and (3) executive function tasks (information processing, attention control, cognitive flexibility, and goal setting) and behavioural ratings (parent). Results From 131 recruited children, 60 were ineligible for analysis, leaving 71 children (47 males, 24 females) in the final sample (mean age 9y [SD 2y], 6y–12y 8mo). Brain MRIs were WMI (69%) and FVI (31%); and frontal (59%), thalamic (45%), basal ganglia (37%), and basal ganglia plus thalamic (21%). Bimanual performance was lower in FVI versus WMI (p<0.003), and with frontal (p=0.36), basal ganglia (p=0.032), and thalamic/basal ganglia lesions (p=0.013). Other than information processing, executive function tasks were not associated with predominant pattern. Frontal lesions predicted attention control (p=0.049) and cognitive flexibility (p=0.009) but not goal setting, information processing, or behavioural ratings. Interpretation Clinical brain MRI predicts cognitive and motor outcomes when focal lesions and predominate lesion patterns are considered. What this paper adds Early brain magnetic resonance imaging (MRI) predicts bimanual performance and cognitive outcomes. Brain MRI may identify children requiring targeted interventions. Basal ganglia with/without thalamic lesions predicted bimanual performance. Frontal lesions were associated with attention control and cognitive flexibility. Brain MRI predominant patterns predicted motor, not cognitive outcomes, other than information processing.

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Cognition and bimanual performance in children with unilateral cerebral palsy: protocol for a multicentre, cross-sectional study

Cited by 22 publications

References 111 publications

White matter characteristics of motor, sensory and interhemispheric tracts underlying impaired upper limb function in children with unilateral cerebral palsy

White matter characteristics of motor, sensory and interhemispheric tracts underlying impaired upper limb function in children with unilateral cerebral palsy

Development of Fine Motor Skills to Enhance the Functional Abilities of Children With Cerebral Palsy

Brain magnetic resonance imaging is a predictor of bimanual performance and executive function in children with unilateral cerebral palsy

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