Kurz Max J, Taylor Brittany K, Heinrichs-Graham Elizabeth, Spooner Rachel K, Baker Sarah E, Wilson Tony W
Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA.
Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE 68010, USA.
Brain Commun. 2024 Sep 26;6(5):fcae332. doi: 10.1093/braincomms/fcae332. eCollection 2024.
The altered sensorimotor cortical dynamics seen in youth with cerebral palsy appear to be tightly coupled with their motor performance errors and uncharacteristic mobility. Very few investigations have used these cortical dynamics as potential biomarkers to predict the extent of the motor performance changes that might be seen after physical therapy or in the design of new therapeutic interventions that target a youth's specific neurophysiological deficits. This cohort investigation was directed at evaluating the practice dependent changes in the sensorimotor cortical oscillations exhibited by youth with cerebral palsy as a step towards addressing this gap. We used magnetoencephalography to image the changes in the cortical oscillations before and after youth with cerebral palsy ( = 25; age = 15.2 ± 4.5 years; Gross Motor Function Classification Score Levels I-III) and neurotypical controls ( = 18; age = 14.6 ± 3.1 years) practiced a knee extension isometric target-matching task. Subsequently, structural equation modelling was used to assess the multivariate relationship between changes in beta (16-22 Hz) and gamma (66-82 Hz) oscillations and the motor performance after practice. The structural equation modelling results suggested youth with cerebral palsy who had a faster reaction time after practice tended to also have a stronger peri-movement beta oscillation in the sensorimotor cortices following practicing. The stronger beta oscillations were inferred to reflect greater certainty in the selected motor plan. The models also indicated that youth with cerebral palsy who overshot the targets less and matched the targets sooner tended to have a stronger execution-related gamma response in the sensorimotor cortices after practice. This stronger gamma response may represent improve activation of the sensorimotor neural generators and/or alterations in the GABAergic interneuron inhibitory-excitatory dynamics. These novel neurophysiological results provide a window on the potential neurological changes governing the practice-related outcomes in the context of the physical therapy.
在患有脑瘫的青少年中观察到的感觉运动皮层动力学改变，似乎与他们的运动表现误差和异常的运动能力紧密相关。很少有研究将这些皮层动力学作为潜在的生物标志物，来预测物理治疗后可能出现的运动表现变化程度，或者用于设计针对青少年特定神经生理缺陷的新治疗干预措施。这项队列研究旨在评估患有脑瘫的青少年所表现出的与练习相关的感觉运动皮层振荡变化，以此作为填补这一空白的第一步。我们使用脑磁图来成像患有脑瘫的青少年（n = 25；年龄 = 15.2 ± 4.5岁；粗大运动功能分类评分I - III级）和神经典型对照组（n = 18；年龄 = 14.6 ± 3.1岁）在练习膝关节伸展等长目标匹配任务前后的皮层振荡变化。随后，使用结构方程模型来评估β（16 - 22Hz）和γ（66 - 82Hz）振荡变化与练习后的运动表现之间的多变量关系。结构方程模型结果表明，练习后反应时间较快的患有脑瘫的青少年，在练习后感觉运动皮层中运动周围的β振荡也往往更强。较强的β振荡被推断反映了所选运动计划中更大的确定性。模型还表明，练习后目标超调较少且更快匹配目标的患有脑瘫的青少年，在感觉运动皮层中与执行相关的γ反应往往更强。这种较强的γ反应可能代表感觉运动神经发生器的激活改善和/或GABA能中间神经元抑制 - 兴奋动力学的改变。这些新的神经生理学结果为物理治疗背景下控制与练习相关结果的潜在神经学变化提供了一个窗口。
