Martinie Ophélie, Karan Philippe, Simoneau Martin, Descoteaux Maxime, Mercier Catherine, Robert Maxime T
Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada.
School of Rehabilitation Sciences, Laval University, Quebec City, QC, Canada.
Front Neurol. 2025 Mar 7;16:1515432. doi: 10.3389/fneur.2025.1515432. eCollection 2025.
Precise upper limb movements required for daily activities rely on feedback and feedforward control mechanisms. In children with cerebral palsy (CP), damage to white matter tracts impairs motor execution and sensorimotor control. Most studies in CP have focused on motor execution deficits, whereas the relationship between feedforward control alterations and white matter microstructure features has received less attention.
This study compared feedforward control during a grasp and lift task in 9 children with CP (diagnosis of hemiplegic CP with mild to moderate upper limb deficits) to 40 typically developing (TD) children aged 8 to 17 years. A secondary objective was to examine associations between feedforward control and the microstructural measures of corticocerebellar and other motor-planning related tracts. All participants completed 13 trials of the grasp and lift task. The CP group also underwent diffusion magnetic resonance imaging (MRI) using a 3-Tesla system to acquire anatomical and diffusion MRI.
Results showed feedforward control deficits in the non-dominant hand of children with CP, reflected by reduced peak force rates before sensory feedback was available and a lack of adaptation across trials. Strong correlations were observed between feedforward control and microstructural measures of the corticospinal tract and superior longitudinal fasciculus, but not with the corticocerebellar tracts.
These findings suggest that broader sensorimotor processes, beyond feedforward control alone, contribute to force control deficits observed in children with CP.
日常活动所需的精确上肢运动依赖于反馈和前馈控制机制。在脑瘫（CP）儿童中，白质束受损会损害运动执行和感觉运动控制。大多数关于CP的研究都集中在运动执行缺陷上，而前馈控制改变与白质微观结构特征之间的关系则较少受到关注。
本研究将9名CP儿童（诊断为偏瘫型CP，伴有轻度至中度上肢缺陷）在抓握和提起任务中的前馈控制与40名8至17岁的正常发育（TD）儿童进行了比较。第二个目标是检查前馈控制与皮质小脑和其他运动规划相关束的微观结构测量之间的关联。所有参与者都完成了13次抓握和提起任务的试验。CP组还使用3特斯拉系统进行了扩散磁共振成像（MRI），以获取解剖学和扩散MRI。
结果显示CP儿童非优势手存在前馈控制缺陷，表现为在感觉反馈可用之前峰值力率降低，并且在各试验中缺乏适应性。在前馈控制与皮质脊髓束和上纵束的微观结构测量之间观察到强相关性，但与皮质小脑束无关。
这些发现表明，除了前馈控制之外，更广泛的感觉运动过程也导致了CP儿童中观察到的力控制缺陷。
