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Task‐related fMRI in hemiplegic cerebral palsy—A systematic review
Author(s) -
Gaberova Katerina,
Pacheva Iliyana,
Ivanov Ivan
Publication year - 2018
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12929
Subject(s) - functional magnetic resonance imaging , cerebral palsy , psychology , hemiparesis , physical medicine and rehabilitation , supplementary motor area , sensory system , neuroscience , somatosensory system , cognitive psychology , medicine , lesion , psychiatry
Abstract Rationale Functional magnetic resonance imaging (fMRI) is used widely to study reorganization after early brain injuries. Unilateral cerebral palsy (UCP) is an appealing model for studying brain plasticity by fMRI. Aim To summarize the results of task‐related fMRI studies in UCP in order to get better understanding of the mechanism of neuroplasticity of the developing brain and its reorganization potential and better translation of this knowledge to clinical practice. Methods A systematic search was conducted on the PubMed database by keywords: “cerebral palsy”, “congenital hemiparesis”, “unilateral”, “Magnetic resonance imaging” , “fMRI”, “reorganization”, and “plasticity” The exclusion criteria were as follows: case reports; reviews; studies exploring non‐UCP patients; and studies with results of rehabilitation. Results We found 7 articles investigated sensory tasks; 9 studies—motor tasks; 12 studies—speech tasks. Ipsilesional reorganization is dominant in sensory tasks (in 74/77 patients), contralesional—in only 3/77. In motor tasks, bilateral activation is found in 64/83, only contralesional—in 11/83, and only ipsilesional—8/83. Speech perception is bilateral in 35/51, only or dominantly ipsilesional (left‐sided) in 8/51, and dominantly contralesional (right‐sided) in 8/51. Speech production is only or dominantly contralesional (right‐sided) in 88/130, bilateral—26/130, and only or dominantly ipsilesional (left‐sided)—in 16/130. Discussion The sensory system is the most “rigid” to reorganization probably due to absence of ipsilateral (contralesional) primary somatosensory representation. The motor system is more “flexible” due to ipsilateral (contralesional) motor pathways. The speech perception and production show greater flexibility resulting in more bilateral or contralateral activation. Conclusions The models of reorganization are variable, depending on the development and function of each neural system and the extent and timing of the damage. The plasticity patterns may guide therapeutic intervention and prognostics, thus proving the fruitiness of the translational approach in neurosciences.