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Parmida Moradi Birgani1 
, Meghdad Ashtiyani2 , Seyed Behnamedin Jameie3 , Amin Shahrokhi4 , Elham Rahimian5 , Mohammad Reza Deevband2 , M. Mehdi Mirbagheri * 1
, Meghdad Ashtiyani2 , Seyed Behnamedin Jameie3 , Amin Shahrokhi4 , Elham Rahimian5 , Mohammad Reza Deevband2 , M. Mehdi Mirbagheri * 1
1- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences
2- Biomedical Engineering and Medical Physics Department, School of Medicine, Shahid Beheshti University of Medical Sciences
3- Neuroscience Research Centre (NRC), Iran University of Medical Sciences
4- University of Social Welfare and Rehabilitation Sciences
5- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital
2- Biomedical Engineering and Medical Physics Department, School of Medicine, Shahid Beheshti University of Medical Sciences
3- Neuroscience Research Centre (NRC), Iran University of Medical Sciences
4- University of Social Welfare and Rehabilitation Sciences
5- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital
Abstract:
Introduction: Gait impairment is one of the consequences of cerebral palsy (CP) as a permanent neurological disorder. In order to have persistent treatment effect, the therapy-induced neuroplasticity should have accompanied by functional improvement. In this regard, we aimed to determine the correlation between brain functional activity changes and walking capacity improvement following treatments in children with hemiplegic CP (HCP).
Method: Twenty-one spastic HCP children (7-12 years old) were randomly divided into 3 groups. Occupational therapy (OT) was performed for the first group. The second group received repetitive transcranial magnetic stimulation (rTMS) treatment and the third group underwent anti-gravity treadmill (AlterG) training. OT and AlterG training was provided for 45min, and rTMS was applied for 20min per sessions, 3 times per week for 8 weeks.
Brain functional activity while execution of passive tasks involving knee flexion/extension and ankle plantarflexion/dorsiflexion over the range of motion (ROM) was quantified using functional magnetic resonance imaging (fMRI). Walking capacity was indexed by clinical measures. Clinical and fMRI evaluations were performed pre- and post-training.
Result: Our results indicate that intensive OT, rTMS and AlterG training enhanced brain functional activity as well as walking capacity in pediatrics with CP. Also our results revealed a robust correlation between the corpus callosum functional activity changes and walking capacity improvement.
Conclusion: Regardless of the type of treatment, the improvement in gait function in children with CP may reflect as an increase in brain functional activity in callosal neurons which in turn may reveal the increase in interhemispheric coupling.
Method: Twenty-one spastic HCP children (7-12 years old) were randomly divided into 3 groups. Occupational therapy (OT) was performed for the first group. The second group received repetitive transcranial magnetic stimulation (rTMS) treatment and the third group underwent anti-gravity treadmill (AlterG) training. OT and AlterG training was provided for 45min, and rTMS was applied for 20min per sessions, 3 times per week for 8 weeks.
Brain functional activity while execution of passive tasks involving knee flexion/extension and ankle plantarflexion/dorsiflexion over the range of motion (ROM) was quantified using functional magnetic resonance imaging (fMRI). Walking capacity was indexed by clinical measures. Clinical and fMRI evaluations were performed pre- and post-training.
Result: Our results indicate that intensive OT, rTMS and AlterG training enhanced brain functional activity as well as walking capacity in pediatrics with CP. Also our results revealed a robust correlation between the corpus callosum functional activity changes and walking capacity improvement.
Conclusion: Regardless of the type of treatment, the improvement in gait function in children with CP may reflect as an increase in brain functional activity in callosal neurons which in turn may reveal the increase in interhemispheric coupling.
Keywords: Functional magnetic resonance imaging (fMRI), Cerebral palsy (CP), Correlation, Corpus callosum (CC), Gait
Type of Study: Original |
Subject:
Cognitive Neuroscience
Received: 2022/09/18 | Accepted: 2022/12/18
Received: 2022/09/18 | Accepted: 2022/12/18
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