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Principal Investigator: Claudio Luis Ferre
Organization: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
Fiscal Year: 2024
Award: $330,000
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
PROJECT SUMMARY
Cerebral palsy is the most common pediatric movement disorder and is caused by
damage to brain areas during development. Children with unilateral cerebral palsy (UCP), the most
common form of cerebral palsy, have unilateral impairments that cause muscle weakness, poor
coordination, and difficulty grasping objects. These upper-extremity (UE) impairments reduce children's ability
to participate in age-appropriate activities. There is an urgent need for effective hand therapies based on
mechanisms of motor recovery. Growing evidence indicates that skill-based training affords the opportunity to
capitalize on residual brain plasticity in children with UCP and improve hand function. Yet, the diversity of brain
injuries, and subsequent brain reorganization in children with UCP, leads to heterogeneous outcomes even for
the most established therapies. Our long-term goal is to optimize the effectiveness of therapies by adapting
them to the individual characteristics of children with UCP. A critical precursor to this goal is characterizing how
motor pathways adapt following perinatal brain injury. However, how best to examine brain networks
underlying control of the affected UE remains unknown. The objective of this project to use a multimodal
approach to identify atypical functional and anatomical patterns of connectivity in children with UCP and relate
these patterns to impairment in unimanual and bimanual function. Characterizing mechanisms of motor
pathway reorganization will serve as a critical precursor to the development of individualized rehabilitation
approaches. We propose to use measurements of functional cortical activity (i.e. functional near-infrared
spectroscopy) and transcranial magnetic stimulation to determine the unique brain areas responsible for
control of the affected upper-extremity in children with UCP. We will examine these patterns in relation to
standardized assessments of dexterity and performance of bimanual skills. We will leverage the information
gained from this study to generate new hypotheses about potential neural targets for functional recovery. Thus,
our work will inform the design of a future large-scale trial testing neurorehabilitation strategies based on
individual motor pathway reorganization.
Terms: <0-11 years old><Acquired brain injury><Affect><Age><Anatomic Sites><Anatomic structures><Anatomy><Area><Artifacts><Bilateral><Brain><Brain Hemisphere><Brain Injuries><Brain Mapping><Brain Nervous System><CNS plasticity><Cerebral Palsy><Cerebral hemisphere><Cerebrum><Characteristics><Child><Child Youth><Childhood><Childhood Injury><Children (0-21)><Clinical><Clinical assessments><Contralateral><Corticospinal Tracts><Development><Dyskinesia Syndromes><Effectiveness><Electrodes><Encephalon><Exhibits><Foundations><Future><Goals><Grips><Hand><Imaging Procedures><Imaging Technics><Imaging Techniques><Impairment><Individual><Injury><Intervention><Intervention Strategies><Ipsilateral><Knowledge><Lead><Lesion><Life><Location><MR Imaging><MR Tomography><MRI><MRIs><Magnetic Resonance Imaging><Manuals><Maps><Measurement><Measures><Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance><Medical Rehabilitation><Membrum superius><Modeling><Morphologic artifacts><Motor><Motor Pathways><Motor disability><Movement><Movement Disorder Syndromes><Movement Disorders><Muscle><Muscle Tissue><Muscle Weakness><Muscular Weakness><NMR Imaging><NMR Tomography><Nervous System Diseases><Nervous System Disorder><Neuranatomies><Neuranatomy><Neuro rehabilitation><Neuroanatomies><Neuroanatomy><Neurologic Disorders><Neurological Disorders><Neuronal Plasticity><Neurorehabilitation><Nuclear Magnetic Resonance Imaging><Outcome><Pattern><Pb element><Performance><Perinatal><Perinatal Brain Injury><Perinatal brain damage><Peripartum><Physiologic pulse><Play><Position><Positioning Attribute><Pulse><Recovery of Function><Rehabilitation><Rehabilitation therapy><Research><Residual><Residual state><Rest><Scalp><Scalp structure><Side><Standardization><Stratification><Surface><Techniques><Testing><Time><Training><Transcranial magnetic stimulation><Treatment outcome><Upper Extremity><Upper Limb><Work><Zeugmatography><ages><body movement><brain damage><brain pathway><brain-injured><central nervous system plasticity><cerebral><cortex mapping><cortical map><cortical mapping><design><designing><developmental><dexterity><early childhood><evidence base><expectation><fNIRS><functional independence><functional near infrared spectroscopy><functional recovery><grasp><hand function rehabilitation><hand function restoration><hand rehab><hand rehabilitation><hand therapy><hands><heavy metal Pb><heavy metal lead><hemodynamics><improve hand function><improved><improvement in hand function><individualized therapeutic><injured child><injured children><injuries><injury in children><interventional strategy><kids><motor control><motor impairment><motor recovery><movement impairment><movement limitation><multi-modality><multimodality><muscular><neural><neural plasticity><neurological disease><neurological rehab><neurological rehabilitation><neurophysiological><neurophysiology><neuroplastic><neuroplasticity><neurorehab><neurorehabilitative><non-invasive optical imaging><noninvasive optical imaging><novel><pediatric><pediatric injury><personalized health intervention><personalized intervention><personalized therapeutic><precision interventions><prevent><preventing><recover hand function><recovery of hand function><rehab therapy><rehabilitative><rehabilitative therapy><response><restore hand function><skills><standard measure><targeted drug therapy><targeted drug treatments><targeted therapeutic><targeted therapeutic agents><targeted therapy><targeted treatment><therapeutic target><tool><youngster>