Identification of Abnormal Motor Cortex Activation Patterns in Children with Cerebral Palsy by Functional Near Infrared Spectroscopy

Khan, Bilal; Tian, Fenghua; Behbehani, Khosrow; Romero-Ortega, Mario I.; Clegg, Nancy J.; Delgado, Mauricio R.; Liu, Hanli; Alexandrakis, George

doi:10.1364/biomed.2010.btud96

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…In unilateral CP, fNIRS has been used to assess brain activation during hand movements ( Tian et al, 2008 ; Tian et al, 2010 ; Khan et al, 2010 ; Decampos et al, 2016 ), and to evaluate pre-frontal cortical activation in bilateral CP during a throwing task ( Chaudhary et al, 2014 ). With respect to the lower extremity, one study evaluated fNIRS activation during gait in four children with bilateral CP compared to eight children with typical development (TD).…”

Section: Introductionmentioning

confidence: 99%

Relationship between sensorimotor cortical activation as assessed by functional near infrared spectroscopy and lower extremity motor coordination in bilateral cerebral palsy

Sukal-Moulton

Campos

Alter

et al. 2018

NeuroImage: Clinical

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BackgroundEvaluation of task-evoked cortical responses during movement has been limited in individuals with bilateral cerebral palsy (CP), despite documented alterations in brain structure/function and deficits in motor control.ObjectiveTo systematically evaluate cortical activity associated with lower extremity tasks, and relate activation parameters to clinical measures in CP.Methods28 ambulatory participants (14 with bilateral CP and 14 with typical development) completed five motor tasks (non-dominant ankle dorsiflexion, hip flexion and leg cycling as well as bilateral dorsiflexion and cycling) in a block design while their sensorimotor cortex was monitored using functional near infrared spectroscopy (fNIRS), in addition to laboratory and clinical measures of performance.ResultsMain effects for group and task were found for extent of fNIRS activation (number of active channels; p < 0.001 and p = 0.010, respectively), magnitude of activation (sum of beta values; p < 0.001 for both), and number of active muscles (p = 0.001 and p < 0.001, respectively), but no group by task interactions. Collectively, subgroups with CP and especially those with greater impairments, showed higher extent and magnitude of cortical sensorimotor activation as well as higher amounts of concurrent activity in muscles not required for task performance. Magnitude of fNIRS activation during non-dominant dorsiflexion correlated with validated measures of selective control (r = −0.60, p = 0.03), as well as mobility and daily activity (r = −0.55, p = 0.04 and r = −0.52, p = 0.05, respectively) and self-reported gait function (r = −0.68, p = 0.01) in those with CP.ConclusionsThe association between higher activity in the sensorimotor cortex and decreased selectivity in cortical organization suggests a potential neural mechanism of motor deficits and target for intervention.

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Section: Introductionmentioning

confidence: 99%

Relationship between sensorimotor cortical activation as assessed by functional near infrared spectroscopy and lower extremity motor coordination in bilateral cerebral palsy

Sukal-Moulton

Campos

Alter

et al. 2018

NeuroImage: Clinical

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“…Near‐infrared spectroscopy (NIRS) is a well‐established method for measuring oxygen saturation and oxidative capacity in skeletal muscle and cerebral tissue (Khan et al . ; Tian et al . ; Ryan et al .…”

Section: Introductionmentioning

confidence: 99%

Age‐related microvascular dysfunction: novel insight from near‐infrared spectroscopy

Rosenberry

Munson

Chung

et al. 2017

Experimental Physiology

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What is the central question of this study? Can near-infrared spectroscopy (NIRS)-derived post-occlusion tissue oxygen saturation recovery kinetics be used to study age-related impairments in microvascular function? What is the main finding and its importance? Using a previously established 5 min cuff occlusion protocol, we found that NIRS-derived indices of microvascular function were markedly reduced in elderly compared with young participants. However, when we controlled for the absolute level of vasodilatory stimulus and matched the tissue desaturation level between groups, we found similar responses in young and elderly participants. Overall, these data highlight the important role NIRS can serve in clinical vascular biology, but also establish the need for assessing tissue ischaemia during cuff occlusion protocols. Near-infrared spectroscopy (NIRS) has emerged as a promising tool to evaluate vascular reactivity in vivo. Whether this approach can be used to assess age-related impairments in microvascular function has not been tested. Tissue oxygen saturation (StO2) post-occlusion recovery kinetics were measured in two distinct age groups (<35 and >65 years of age) using NIRS placed over the flexor digitorum profundus. Key end-points included the following: (i) the desaturation rate during cuff occlusion; (ii) the lowest StO2 value obtained during ischaemia (StO2min); (iii) StO2 reperfusion rate; (iv) the highest StO2 value reached after cuff release (StO2max); and (v) the reactive hyperaemia area under the curve (AUC). At first, using a conventional 5 min cuff occlusion protocol, the elderly participants achieved a much slower rate of oxygen recovery (1.5 ± 0.2 versus 2.5 ± 0.2% s ), lower StO2max (85.2 ± 2.9 versus 92.3 ± 1.5%) and lower reactive hyperaemia AUC (2651.8 ± 307.0 versus 4940.0 ± 375.8% s ). However, owing to a lower skeletal muscle resting metabolic rate, StO2min was also significantly attenuated in the elderly participants compared with the young control subjects (55.7 ± 3.5 versus 41.0 ± 3.4%), resulting in a much lower ischaemic stimulus. To account for this important difference between groups, we then matched the level of tissue ischaemia in a subset of young healthy participants by reducing the cuff occlusion protocol to 3 min. Remarkably, when we controlled for tissue ischaemia, we observed no differences in any of the hyperaemic end-points between the young and elderly participants. These data highlight the important role NIRS can serve in vascular biology, but also establish the need for assessing tissue ischaemia during cuff occlusion protocols.

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“…3 Technological advances have recently enabled the use of functional near-infrared spectroscopy (fNIRS) to study sensorimotor brain activity. [4][5][6] fNIRS non-invasively measures changes in the concentrations of hemoglobin species associated with neuronal activation providing a unique opportunity to study brain activity during functional tasks in populations with movement disorders who may not be able to remain sufficiently still for testing. fNIRS does not require participants to be confined and is relatively robust to movement artifacts.…”

mentioning

confidence: 99%

“…Studies using various imaging techniques have revealed some mechanisms underlying unimanual impairments in unilateral CP and highlighted the neuroplastic potential in children with this condition . Technological advances have recently enabled the use of functional near‐infrared spectroscopy (fNIRS) to study sensorimotor brain activity . fNIRS non‐invasively measures changes in the concentrations of hemoglobin species associated with neuronal activation providing a unique opportunity to study brain activity during functional tasks in populations with movement disorders who may not be able to remain sufficiently still for testing.…”

mentioning

confidence: 99%

Brain activation patterns underlying upper limb bilateral motor coordination in unilateral cerebral palsy: an fNIRS study

Campos

Sukal-Moulton

Huppert

et al. 2020

Develop Med Child Neuro

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Aim To explore cortical activation during bimanual tasks and functional correlates in unilateral cerebral palsy (CP). Method This cross‐sectional study included eight participants with unilateral CP (six females, two males; mean age [SD] 20y 10mo [5y 10mo], 13y 8mo–31y 6mo) in Manual Ability Classification System levels II to III and nine age‐matched participants with typical development (seven females, two males; mean age [SD] 17y 8mo [5y 7mo], 9y 4mo–24y 2mo). They performed bimanual symmetric squeezing (BSS) and bimanual asymmetric squeezing (BAS) tasks at 1Hz, and a pouring task with dominant hand (DPour) and a pouring task with non‐dominant hand (NDPour) at 0.67Hz, all while a custom array of functional near‐infrared spectroscopy (fNIRS) optodes were placed over their sensorimotor area. Mixed‐effects were used to contrast groups, tasks, and hemispheres (corrected p‐values [q] reported). Analysis of variance and t‐tests compared performance measures across groups and tasks. Results Participants with unilateral CP showed greater activation in both hemispheres during BAS (non‐lesioned: q<0.001; lesioned: q<0.001), and in the lesioned hemisphere during BSS (q<0.001), DPour (q=0.02), and NDPour (q=0.02) than those with typical development. The lesioned hemisphere in unilateral CP showed more activity than the non‐lesioned one (BSS: q=0.01; BAS: q=0.009; NDPour: q=0.04). During BAS, higher cortical activity correlated with more synchronous arm activation (r=0.79; p=0.02); activity lateralized towards the non‐lesioned hemisphere correlated with better Pediatric Evaluation of Disability Inventory computer adaptive test scores (r=0.81; p=0.03). Interpretation Results suggest abnormally increased sensorimotor cortical activity in unilateral CP, with implications to be investigated. What this paper adds Cortical activity in manual tasks is described with functional near‐infrared spectroscopy in typical and atypical cohorts. Activation levels in unilateral cerebral palsy appear to escalate with task difficulty. Increased brain activity may be associated with poorer selective manual control. Specific patterns of brain activity may be related to impaired bimanual function.

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Identification of Abnormal Motor Cortex Activation Patterns in Children with Cerebral Palsy by Functional Near Infrared Spectroscopy

Cited by 5 publications

References 26 publications

Relationship between sensorimotor cortical activation as assessed by functional near infrared spectroscopy and lower extremity motor coordination in bilateral cerebral palsy

Relationship between sensorimotor cortical activation as assessed by functional near infrared spectroscopy and lower extremity motor coordination in bilateral cerebral palsy

Age‐related microvascular dysfunction: novel insight from near‐infrared spectroscopy

Brain activation patterns underlying upper limb bilateral motor coordination in unilateral cerebral palsy: an fNIRS study

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