Lee Sang Wook, Bulea Thomas C, Kline Julia E, Damiano Diane L
Department of Biomedical Engineering, Catholic University of America, Washington, District of Columbia, USA.
Center for Applied Biomechanics and Rehabilitation Research, MedStar National Rehabilitation Hospital, Washington, District of Columbia, USA.
Brain Connect. 2025 May;15(4):162-174. doi: 10.1089/brain.2024.0096.
Cerebral palsy (CP) often affects function of one or both arms. Resting-state magnetic resonance imaging studies identified abnormal neuronal connectivity related to functional deficits in CP, with few studies on dynamic, task-related changes in connectivity. Here, we compare connectivity in participants with CP and typical development (TD) during an upper limb task and relate these to motor performance. Children with CP ( = 15) and TD ( = 15) performed a button-press task with both arms, while recording 64-channel electroencephalography. Inter- and intrahemispheric connectivity between dominant and nondominant premotor, motor, and sensory regions were examined during rest, movement preparation, and execution using a normalized magnitude squared time-frequency coherence analysis (-band: 8-12 Hz, -band: 13-35 Hz, -band: 36-85 Hz). The only group differences were in intrahemispheric connectivity during nondominant arm trials, with CP having higher frontal to central connectivity than TD in all frequency bands in the dominant hemisphere and higher central to parietal beta connectivity in the nondominant hemisphere. Significant main effects for period showed most differences between rest and movement phases. Group by period interactions were also only found during nondominant arm trials (interhemispheric: CP coherence increased more during execution in frontal, central, and parietal regions; intrahemispheric: CP coherence decreased less during execution in nondominant and dominant frontal to parietal regions). Clinical and movement scores were moderately related to connectivity in CP, with poorer nondominant arm function significantly correlated with higher inter- and intrahemispheric coherence. Group differences emerged mainly during intrahemispheric nondominant arm trials across frequency bands with higher coherence in CP associated with greater functional limitation. Impact Statement In contrast to assessing brain connectivity with MRI in children with CP, the use of EEG enables the investigation of this during a functional task, and the sample is not limited by head movements that preclude the attainment of high-quality MRI data in many with CP. The finding of increased task-specific intrahemispheric brain connectivity in bilateral CP, the magnitude of which was related to the degree of functional limitations, suggests a new target for rehabilitation as well as a sensitive outcome measure for clinical trials aimed at improving brain and motor function in CP.
脑瘫（CP）常常影响一侧或双侧手臂的功能。静息态磁共振成像研究发现，与脑瘫功能缺陷相关的神经元连接异常，而关于连接性动态、任务相关变化的研究较少。在此，我们比较了脑瘫患者和典型发育（TD）参与者在上肢任务期间的连接性，并将其与运动表现相关联。15名脑瘫儿童和15名TD儿童用双臂执行按键任务，同时记录64通道脑电图。在静息、运动准备和执行过程中，使用归一化幅度平方时频相干分析（α波段：8 - 12赫兹，β波段：13 - 35赫兹，γ波段：36 - 85赫兹）检查优势和非优势运动前区、运动区和感觉区之间的半球间和半球内连接性。唯一的组间差异在于非优势手臂试验期间的半球内连接性，在优势半球的所有频段中，脑瘫患者的额叶到中央的连接性高于TD患者，在非优势半球中，脑瘫患者的中央到顶叶的β连接性更高。时期的显著主效应表明，静息期和运动期之间差异最大。组间时期交互作用也仅在非优势手臂试验期间发现（半球间：在额叶、中央和顶叶区域执行任务期间，脑瘫患者的相干性增加更多；半球内：在非优势和优势额叶到顶叶区域执行任务期间，脑瘫患者的相干性下降更少）。临床和运动评分与脑瘫患者的连接性中度相关，非优势手臂功能较差与半球间和半球内较高的相干性显著相关。组间差异主要出现在非优势手臂试验的半球内各频段，脑瘫患者较高的相干性与更大的功能受限相关。影响声明与利用磁共振成像评估脑瘫儿童的脑连接性不同，脑电图的使用能够在功能任务期间对此进行研究，并且样本不受头部运动的限制，而头部运动在许多脑瘫患者中会妨碍获得高质量的磁共振成像数据。在双侧脑瘫中发现特定任务的半球内脑连接性增加，其程度与功能受限程度相关，这为康复提供了一个新靶点，也为旨在改善脑瘫患者脑和运动功能的临床试验提供了一个敏感的结果指标。
