Somatosensory deficits and neural correlates in cerebral palsy: a scoping review

Abstract

Aim To synthetize studies assessing somatosensory deficits and alterations in cerebral responses evoked by somatosensory stimulation in individuals with cerebral palsy (CP) compared to typically developing individuals. Method A scoping review of the literature was performed in the MEDLINE, Embase, PsycInfo, CINAHL, Evidence‐Based Medicine Reviews, and Web of Science databases (last search carried out on 6th and 7th August 2020) with a combination of keywords related to CP and somatosensory functions. Somatosensory deficits were measured with clinical tests and alterations in cerebral responses were measured with functional magnetic resonance imaging, electroencephalography, and magnetoencephalography. Results Forty‐eight articles were included. Overall, 1463 participants with CP (mean [SD] age 13y 1mo [4y 11mo], range 1–55y; 416 males, 319 females, sex not identified for the remaining participants) and 1478 controls (mean [SD] age 13y 1mo [5y 8mo], range 1–42y; 362 males, 334 females, sex not identified for the remaining participants) were included in the scoping review. For tactile function, most studies reported registration (8 out of 13) or perception (21 out of 21) deficits in participants with CP. For proprioception, most studies also reported registration (6 out of 8) or perception (10 out of 15) deficits. Pain function has not been studied as much, but most studies reported registration (2 out of 3) or perception (3 out of 3) alterations. Neuroimaging findings (18 studies) showed alterations in the somatotopy, morphology, latency, or amplitude of cortical responses evoked by somatosensory stimuli. Interpretation Despite the heterogeneity in the methods employed, most studies reported somatosensory deficits. The focus has been mainly on tactile and proprioceptive function, whereas pain has received little attention. Future research should rigorously define the methods employed and include a sample that is more representative of the population with CP. Most of the papers reviewed found tactile registration and perception deficits in the upper limbs. Proprioceptive deficits were generally observed in cerebral palsy but results were heterogeneous. Pain has received little attention compared to tactile and proprioceptive functions. Neuroimaging studies supported behavioral observations. Alterations were observed for both the most and least affected limb.

Principais Transtornos De Processamento Sensorial Em Crianças Com Paralisia Cerebral: Uma Revisão Integrativa De Literatura

“…Os déficits de percepção tátil são caracterizados principalmente por déficits na estereognosia, grafestesia e discriminação de dois pontos. Estudos avaliaram as respostas corticais durante a percepção tátil (testes de discriminação de forma e grade) e mostraram uma ativação diminuída nos córtices frontal e parietal em participantes com PC em comparação com grupo de controle (BRUN et al, 2021).…”

A case series assessing relationship between active motions and stereognosis in cerebral palsy

“…It is not until the last decade that studies have assessed sensory disorders for persons diagnosed with cerebral palsy for a renewed focus on the concept that cerebral palsy is a sensory and motor disorder. In their 2021 review of the literature Brun et al reported all 20 studies consistently demonstrated a decrease in spatial tactile perception for CP populations [9]. Specifically, deficits in stereognosis, graphesthesia and two-point discrimination.…”

“…Specifically, deficits in stereognosis, graphesthesia and two-point discrimination. Additionally, impairments in tactile perception were almost systematic, while impairments of proprioception and pain were more heterogenous across CP populations [9]. Russo et al used structural equation model to assess the relationships between self-care and upper extremity impairments (spasticity, sensory function, and manual abilities) for children with hemiplegia [1].…”

Neuro-imaging characteristics of sensory impairment in cerebral palsy; a systematic review

“…Somatosensory impairment is a broad term used for tactile deficits as well as for impairments in the processing of sensory information such as vibration, stereognosis, and two-point discrimination. In addition, proprioception can be considered one of the subsystems within the somatosensory system (12,13). Proprioception consists of kinesthesia and joint position sense.…”