Interventions with an Impact on Cognitive Functions in Cerebral Palsy: a Systematic Review

Blasco, Montse; García-Galant, María; Berenguer-González, Alba; Caldú, Xavier; Arqué, Miquel; Laporta-Hoyos, Olga; Ballester‐Plané, Júlia; Miralbell, Júlia; Jurado, Marı́a Ángeles; Pueyo, Roser

doi:10.1007/s11065-022-09550-7

Cited by 10 publications

(2 citation statements)

References 99 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may suggest that healthy cognitive function could also be recovered in this developmental period. For example, if the appropriate support or intervention was provided in this developmental period between infancy and early school-age, it may be possible to minimise cognitive impairments (Astle et al, 2015; Blasco et al, 2023; Galetto and Sacco, 2017; Prosperini et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Resting-state functional connectivity in children cooled for neonatal encephalopathy

Spencer

Goodfellow

Chakkarapani

et al. 2022

Preprint

View full text Add to dashboard Cite

Therapeutic hypothermia improves outcomes following neonatal hypoxic-ischaemic encephalopathy (HIE), reducing cases of death and severe disability such as cerebral palsy compared to normothermia management. However, when cooled children reach early school-age they have cognitive and motor impairments which are associated with underlying alterations to brain structure and white matter connectivity. It is unknown whether these differences in structural connectivity cause differences in functional connectivity between cooled children and healthy controls. Resting-state fMRI has been used to characterise static and dynamic functional connectivity in children, both with typical development and those with neurodevelopmental disorders. Previous studies of resting-state brain networks in children with HIE have focussed on the neonatal period. In this study, we used resting-state fMRI to investigate static and dynamic functional connectivity in children aged 6-8 years who were cooled for neonatal HIE without cerebral palsy (n = 22, median age [IQR] 7.08 [6.85-7.52] years), and healthy controls matched for age, sex and socioeconomic status (n = 20, median age [IQR] 6.75 [6.48-7.25] years). Using group independent component analysis, we identified 33 intrinsic connectivity networks consistent with those previously reported in children and adults. There were no case-control differences in the spatial maps of these intrinsic connectivity networks. We constructed subject-specific static functional connectivity networks by measuring pairwise Pearson correlations between component time courses, and found no case-control differences in functional connectivity after FDR correction. To study the time-varying organisation of resting-state networks, we used sliding-window correlations and deep clustering to investigate dynamic functional connectivity characteristics. We found k = 4 repetitively occurring functional connectivity states, which exhibited no case-control differences in dwell time, fractional occupancy, or state functional connectivity matrices. These results show that the spatiotemporal characteristics of resting-state brain networks in cooled children without severe disability are comparable to those in healthy controls at early school-age, despite underlying differences in brain structure and white matter connectivity. To our knowledge, this is the first study to investigate resting-state functional connectivity in children with HIE beyond the neonatal period, and the first to investigate dynamic functional connectivity in any children with HIE.

show abstract

Section: Discussionmentioning

confidence: 99%

Resting-state functional connectivity in children cooled for neonatal encephalopathy

Spencer

Goodfellow

Chakkarapani

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…For example, if the appropriate support or intervention was provided in this developmental period between infancy and early school-age, it may be possible to minimize cognitive impairments. 73-76 …”

Section: Discussionmentioning

confidence: 99%

Resting-state functional connectivity in children cooled for neonatal encephalopathy

Spencer,

Goodfellow,

Chakkarapani

et al. 2024

Brain Communications

View full text Add to dashboard Cite

Therapeutic hypothermia improves outcomes following neonatal hypoxic-ischaemic encephalopathy, reducing cases of death and severe disability such as cerebral palsy compared to normothermia management. However, when cooled children reach early school-age they have cognitive and motor impairments which are associated with underlying alterations to brain structure and white matter connectivity. It is unknown whether these differences in structural connectivity are associated with differences in functional connectivity between cooled children and healthy controls. Resting-state functional MRI has been used to characterise static and dynamic functional connectivity in children, both with typical development and those with neurodevelopmental disorders. Previous studies of resting-state brain networks in children with hypoxic-ischaemic (HIE) encephalopathy have focussed on the neonatal period. In this study, we used resting-state fMRI to investigate static and dynamic functional connectivity in children aged 6-8 years who were cooled for neonatal HIE without cerebral palsy (n = 22, median age [interquartile range] 7.08 [6.85-7.52] years), and healthy controls matched for age, sex and socioeconomic status (n = 20, median age [interquartile range] 6.75 [6.48-7.25] years). Using group independent component analysis, we identified 31 intrinsic functional connectivity networks consistent with those previously reported in children and adults. We found no case-control differences in the spatial maps of these intrinsic connectivity networks. We constructed subject-specific static functional connectivity networks by measuring pairwise Pearson correlations between component time courses, and found no case-control differences in functional connectivity after false-discovery rate correction. To study the time-varying organisation of resting-state networks, we used sliding-window correlations and deep clustering to investigate dynamic functional connectivity characteristics. We found k = 4 repetitively occurring functional connectivity states, which exhibited no case-control differences in dwell time, fractional occupancy, or state functional connectivity matrices. In this small cohort, the spatiotemporal characteristics of resting-state brain networks in cooled children without severe disability were too subtle to be differentiated from healthy controls at early school-age, despite underlying differences in brain structure and white matter connectivity, possibly reflecting a level of recovery of healthy resting-state brain function. To our knowledge, this is the first study to investigate resting-state functional connectivity in children with hypoxic-ischaemic encephalopathy beyond the neonatal period, and the first to investigate dynamic functional connectivity in any children with hypoxic-ischaemic encephalopathy.

show abstract

A randomized controlled trial of a home-based computerized executive function intervention for children with cerebral palsy

García-Galant,

Blasco,

Laporta-Hoyos

et al. 2023

Eur J Pediatr

View full text Add to dashboard Cite

Children with cerebral palsy (CP) often show executive function (EF) impairments that are key to quality of life. The aim of this study was to assess whether a home-based computerized intervention program improves executive functions (EFs) compared to usual care. Sixty participants (30 females) with CP (8–12 years old) were paired by age, sex, motor ability, and intelligence quotient score and then randomized to intervention and waitlist control groups. The intervention group received a 12-week home-based computerized EF intervention (5 days/week, 30 min/day, total dose 30 h). Core and higher-order EFs were assessed before, immediately after, and 9 months after completing the intervention. The intervention group performed better than the waitlist control group in the three core EFs (immediately and 9 months after the intervention): inhibitory control (F = 7.58, p = 0.13 and F = 7.85, p = 0.12), working memory (F = 8.34, p = 0.14 and F = 7.55, p = 0.13), and cognitive flexibility (F = 4.87, p = 0.09 and F = 4.19, p = 0.08). No differences were found between the groups in higher-order EFs or EF manifestations in daily life.Conclusions: A home-based computerized EF intervention improved core EFs in children with CP, but further research is needed to identify strategies that allow the transfer of these improvements to everyday life.Trial registration: NCT04025749 retrospectively registered on 19 July 2019. What is Known:• One in two children with cerebral palsy has an intellectual impairment. Visual perception and executive functions are the most reported specific cognitive deficits.• The majority of interventions for cerebral palsy focus on motor impairments, but only a few randomized controlled trials have explored the effect of interventions on executive functions. What is New:• A home-based computerized cognitive intervention can improve the core executive functions of children with cerebral palsy.• Short- and long-term effects on core executive functions have been found.

show abstract

Interventions with an Impact on Cognitive Functions in Cerebral Palsy: a Systematic Review

Cited by 10 publications

References 99 publications

Resting-state functional connectivity in children cooled for neonatal encephalopathy

Resting-state functional connectivity in children cooled for neonatal encephalopathy

Resting-state functional connectivity in children cooled for neonatal encephalopathy

A randomized controlled trial of a home-based computerized executive function intervention for children with cerebral palsy

Contact Info

Product

Resources

About