Université Laval, Québec, Canada.
Teachers College, New York, NY, USA.
Neurorehabil Neural Repair. 2021 Jun;35(6):534-544. doi: 10.1177/15459683211011220. Epub 2021 May 6.
The corpus callosum (CC) plays an important role in upper extremity (UE) function. The impact on UE function in children with unilateral spastic cerebral palsy (USCP) and improvements following intensive interventions remain unknown.
To examine the (1) relationship between UE function and CC integrity and (2) relationship between CC integrity and changes in UE function following intensive interventions.
We retrospectively analyzed clinical and neuroimaging data from a sample of convenience of 44 participants (age 9.40 ± 3.10 years) from 2 larger trials. Participants received 90 hours of Hand-Arm Bimanual Intensive Therapy (HABIT) or Constraint-Induced Movement Therapy (CIMT). Unimanual dexterity (Jebsen-Taylor Test of Hand Function [JTTHF]) and bimanual performance (Assisting Hand Assessment [AHA]) were assessed preintervention and postintervention. CC tractography was reconstructed with diffusion tensor imaging (DTI) and segmented into 3 regions (genu, midbody, splenium). Pearson correlations and regression were used to assess the relationship between outcomes and DTI parameters (ie, fractional anisotropy [FA], number of streamlines, and mean, radial, and axial diffusivity).
Both groups improved in bimanual performance ( < .01). The CIMT group improved in unimanual dexterity ( < .01). Baseline unimanual dexterity and bimanual performance correlated with FA and number of streamlines for most CC regions ( < .05). Following CIMT, pre-post changes in JTTHF were negatively correlated with axial and radial diffusivity of the CC, and AHA with splenium and number of streamlines for the CC, midbody, and splenium (all < .05). Following HABIT, midbody FA was positively correlated with pre-post AHA changes ( = 0.417; = .042).
CC integrity is important for UE function in children with USCP.
胼胝体（CC）在上肢（UE）功能中起着重要作用。患有单侧痉挛性脑瘫（USCP）的儿童的 UE 功能受到的影响以及强化干预后的改善情况尚不清楚。
检查（1）UE 功能与 CC 完整性之间的关系，以及（2）强化干预后 CC 完整性与 UE 功能变化之间的关系。
我们回顾性分析了来自 2 个更大的试验的 44 名参与者（年龄 9.40 ± 3.10 岁）的便利样本的临床和神经影像学数据。参与者接受了 90 小时的手-臂双手强化治疗（HABIT）或强制性运动疗法（CIMT）。单手灵巧性（Jebsen-Taylor 手部功能测试 [JTTHF]）和双手表现（辅助手评估 [AHA]）在干预前和干预后进行评估。使用弥散张量成像（DTI）重建 CC 束流，并将其分为 3 个区域（ genu 、 midbody 、 splenium ）。使用 Pearson 相关和回归来评估结果与 DTI 参数（即分数各向异性 [FA]、束流数量以及平均、径向和轴向扩散系数）之间的关系。
两组的双手表现均有所改善（ <.01）。CIMT 组的单手灵巧性也有所改善（ <.01）。基线时的单手灵巧性和双手表现与大多数 CC 区域的 FA 和束流数量相关（ <.05）。在 CIMT 之后，JTTHF 的干预前后变化与 CC 的轴向和径向扩散率以及 AHA 与 CC 的 splenium 和束流数量呈负相关（均 <.05）。在 HABIT 之后，midbody FA 与 AHA 干预前后的变化呈正相关（ = 0.417； =.042）。
CC 完整性对 USCP 儿童的 UE 功能很重要。
