在有时间限制的机器人辅助够物任务中，脑瘫儿童的准确性缺陷与前额叶皮质活动改变有关。

Accuracy deficits during robotic time-constrained reaching are related to altered prefrontal cortex activity in children with cerebral palsy.

作者信息

Khan Owais A, Singh Tarkeshwar, Barany Deborah A, Modlesky Christopher M

机构信息

Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA, 30602, USA.

Department of Kinesiology & Penn State Neuroscience Institute, The Pennsylvania State University, University Park, PA, 16802, USA.

出版信息

J Neuroeng Rehabil. 2024 Dec 19;21(1):216. doi: 10.1186/s12984-024-01502-x.

DOI:10.1186/s12984-024-01502-x

PMID:39702205

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11661058/

Abstract

BACKGROUND

The prefrontal cortex (PFC) is an important node for action planning in the frontoparietal reaching network but its role in reaching in children with cerebral palsy (CP) is unexplored. This case-control study combines a robotic task with functional near-infrared spectroscopy (fNIRS) to concurrently assess reaching accuracy and PFC activity during time-constrained, goal-directed reaching in children with CP. We hypothesized that reaching accuracy in children with CP would be lower than in typically developing children and would be related to PFC activity.

METHODS

Fourteen children with spastic CP (5-11 y; Manual Ability Classification System level I-II) and 14 age-, sex- and arm dominance-matched typically developing controls performed seated uniplanar reaches with a robotic arm (KINARM End-Point Lab) to hit visual targets projected onto a screen. Four blocks of 10 reaching trials each were performed for each arm. Time constraint (high, low) was varied across blocks by changing the time participants had to hit the target.

RESULTS

Children with CP displayed lower reaching accuracy compared to controls, with greater deficits observed in the non-preferred arm (d = 1.916, p < 0.001) than the preferred arm (d = 1.033, p = 0.011). Inter-limb differences in accuracy were observed only in children with CP (d = 0.839, p < 0.001). PFC activity differed across groups during preferred arm reaching, with PFC deactivation observed in children with CP under high time constraints compared to PFC activation in controls (d = 1.086, p = 0.006). Children with CP also exhibited lower PFC activity under high time constraint compared to low time constraint in the preferred arm (d = 0.702, p = 0.001). PFC activity was positively related to reaching accuracy across time constraints in both arms in children with CP, but not in controls.

CONCLUSIONS

Contrasting patterns of PFC activity observed in children with CP compared to age- and sex-matched controls during a robotic reaching task lends support for the concurrent use of fNIRS and robotics to assess goal-directed reaching in CP.

TRIAL REGISTRATION

Data collected as part of a larger randomized controlled trial; https://clinicaltrials.gov/ct2/show/NCT03484078.

摘要

背景

前额叶皮质（PFC）是额顶叶够物网络中动作规划的重要节点，但其在脑瘫（CP）患儿够物过程中的作用尚未得到探索。本病例对照研究将机器人任务与功能近红外光谱技术（fNIRS）相结合，以同时评估CP患儿在有时间限制的目标导向够物过程中的够物准确性和PFC活动。我们假设CP患儿的够物准确性低于正常发育儿童，且与PFC活动有关。

方法

14名痉挛型CP患儿（5 - 11岁；手动能力分类系统I-II级）和14名年龄、性别及手臂优势匹配的正常发育对照儿童，使用机器人手臂（KINARM端点实验室）进行坐位单平面够物，以击中投射在屏幕上的视觉目标。每只手臂进行4组，每组10次够物试验。通过改变参与者击中目标所需的时间，在不同组间改变时间限制（高、低）。

结果

与对照组相比，CP患儿的够物准确性较低，非优势手臂的缺陷（d = 1.916，p < 0.001）比优势手臂（d = 1.033，p = 0.011）更明显。仅在CP患儿中观察到肢体间准确性差异（d = 0.839，p < 0.001）。在优势手臂够物过程中，不同组间PFC活动存在差异，与对照组PFC激活相比，CP患儿在高时间限制下观察到PFC失活（d = 1.086，p = 0.006）。与低时间限制相比，CP患儿在高时间限制下优势手臂的PFC活动也较低（d = 0.702，p = 0.001）。在CP患儿中，PFC活动在两个手臂的不同时间限制下均与够物准确性呈正相关，但在对照组中并非如此。