Microstructure of Transcallosal Motor Fibers Reflects Type of Cortical (Re-)Organization in Congenital Hemiparesis

Juenger, Hendrik; Koerte, Inga K.; Muehlmann, Marc; Mayinger, Michael; Krägeloh-Mann, I.; Shenton, M.E.; Berweck, S.; Mall, Volker; Staudt, Martin; Heinen, Florian

doi:10.1055/s-0034-1390511

Cited by 3 publications

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“…One hypothesis suggests alterations in the maturation of transcallosal pathways that inhibit ipsilateral movements . Magnetic resonance imaging (MRI) of participants with persistent mirror movements supports this theory . We have recently shown that such interhemispheric interactions are altered in children with perinatal stroke .…”

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confidence: 97%

Mirror movements in children with unilateral cerebral palsy due to perinatal stroke: clinical correlates of plasticity reorganization

Riddell

Kuo

Zewdie

et al. 2019

Develop Med Child Neuro

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Aim We aimed to determine if the mirror movements that often result in children with unilateral cerebral palsy (CP) after perinatal stroke represent a clinical biomarker of developmental plasticity. Method This was a prospective, controlled cohort study. Mirror movements in children with unilateral CP from a population‐based cohort were compared to those of typically developing controls. The population with stroke was assessed further via electromyography (EMG), motor function, and corticospinal organization investigations. Mirror movements were quantified (0–5) bidirectionally. EMG mirror movements were quantified during voluntary contraction. Motor function was quantified by validated measures including the Assisting Hand Assessment (AHA). Corticospinal organization was categorized as ipsilateral or contralateral using transcranial magnetic stimulation (TMS). The relationships between mirror movements, function, and corticospinal organization were assessed (t‐tests, Pearson rank correlation coefficients). Results Ninety‐two participants were scored (55 males, 37 females, mean [SD] 12y [5y 6mo], range 4–17y), 63 with complete motor outcomes and 39 with TMS data. EMG ratios correlated with clinical mirror movements (r=0.562, p=0.008). Mild mirror activity in controls declined with age (r=−0.459, p<0.001). Mirroring was stronger with tasks performed by the affected hand (p<0.001). Mirror movements correlated with AHA scores (r=−0.255, p=0.04) and poor motor outcome (p<0.001). Unaffected hand mirror activity was higher in children with ipsilateral corticospinal tract arrangements (p<0.001). Interpretation Clinical mirror movements correlate with disability and corticospinal organization in children with unilateral CP with perinatal stroke. This simple bedside biomarker could facilitate patient selection for personalized rehabilitation. What this paper adds Mirror movements are a clinical indicator of corticospinal organization in children with unilateral cerebral palsy with perinatal stroke. Mirroring is strongest in children with ipsilateral corticospinal tract reorganization. The concept of a ‘directionality factor’ to mirror movements highlights additional, clinically relevant functional correlations.

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confidence: 97%

Mirror movements in children with unilateral cerebral palsy due to perinatal stroke: clinical correlates of plasticity reorganization

Riddell

Kuo

Zewdie

et al. 2019

Develop Med Child Neuro

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“…Models for understanding developmental neuroplasticity of the motor system after early unilateral lesions suggest interactions between the ipsilesional and contralesional motor cortex as the key to clinical function, but the structural connection between the motor cortices (i.e. the corpus callosum) remains an understudied element of such models.…”

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confidence: 99%

Association of transcallosal motor fibres with function of both hands after unilateral neonatal arterial ischemic stroke

Groeschel¹,

Hertz‐Pannier

Delion

et al. 2017

Develop Med Child Neuro

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Compared to typically developing children, children after NAIS exhibited a smaller motor part of their corpus callosum associated with reduced contralesional but also ipsilesional manual dexterity. These results indicate that the affection of transcallosal motor fibres in unilateral NAIS might be of functional relevance and an important part of the involved structural network that should be elucidated in further studies.

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“…This is a novel finding, as previous studies had shown that bimanual coordination is rather influenced by the involvement of other brain structures, in particular the corpus callosum. 43,44 Although never explored in children with CP, anatomic and functional data support the cerebellum as a key structure in coordination of complex bimanual movements, potentially making tests assessing bimanual skills more sensitive to CPC disruption. 41 It is of note that the AHA assesses impaired hand function in bimanual tasks, thus being substantially influenced by unimanual abilities and coordination skills, supporting our finding of a low statistical correlation.…”

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confidence: 99%

Corticopontocerebellar Connectivity Disruption in Congenital Hemiplegia

Fiori

Pannek

Pasquariello

et al. 2015

Neurorehabil Neural Repair

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Microstructure of Transcallosal Motor Fibers Reflects Type of Cortical (Re-)Organization in Congenital Hemiparesis

Cited by 3 publications

References 0 publications

Mirror movements in children with unilateral cerebral palsy due to perinatal stroke: clinical correlates of plasticity reorganization

Mirror movements in children with unilateral cerebral palsy due to perinatal stroke: clinical correlates of plasticity reorganization

Association of transcallosal motor fibres with function of both hands after unilateral neonatal arterial ischemic stroke

Corticopontocerebellar Connectivity Disruption in Congenital Hemiplegia

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