Volume 16 - Special Issue on Cognitive Sciences- In Press
BCN 2025, 16 - Special Issue on Cognitive Sciences- In Press: 309-322 |
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Moradi Birgani P, Ashtiyani M, Jameie S B, Shahrokhi A, Rahimian E, Deevband M R et al . Brain Functional Activity and Walking Capacity Enhancement in Children With Cerebral Palsy: A Pilot fMRI Study. BCN 2025; 16 (S1) :309-322
URL: http://bcn.iums.ac.ir/article-1-2548-en.html
URL: http://bcn.iums.ac.ir/article-1-2548-en.html
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, Tehran, Iran.
2- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3- Neuroscience Research Centre (NRC), Iran University of Medical Sciences, Tehran, Iran.
4- Department of Basic Science, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
5- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran.
2- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3- Neuroscience Research Centre (NRC), Iran University of Medical Sciences, Tehran, Iran.
4- Department of Basic Science, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
5- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran.
Abstract:
Introduction: Gait impairment is one of the consequences of cerebral palsy (CP) as a permanent neurological disorder. The therapy-induced neuroplasticity should be accompanied by functional improvement to have a persistent treatment effect. 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).
Methods: 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 system) training. AlterG training and OT were provided for 45 minutes, and rTMS was applied for 20 minutes per session, 3 times per week for 8 weeks. Brain functional activity while executing passive tasks involving knee flexion/extension and ankle plantarflexion/dorsiflexion over the range of motion 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.
Results: Our results indicate that intensive OT, rTMS, and AlterG training enhance brain functional activity and walking capacity in pediatrics with CP. Also, our results reveal a robust correlation between the corpus callosum (CC) 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 an increase in brain functional activity in callosal neurons, which may reveal an increase in interhemispheric coupling.
Methods: 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 system) training. AlterG training and OT were provided for 45 minutes, and rTMS was applied for 20 minutes per session, 3 times per week for 8 weeks. Brain functional activity while executing passive tasks involving knee flexion/extension and ankle plantarflexion/dorsiflexion over the range of motion 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.
Results: Our results indicate that intensive OT, rTMS, and AlterG training enhance brain functional activity and walking capacity in pediatrics with CP. Also, our results reveal a robust correlation between the corpus callosum (CC) 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 an increase in brain functional activity in callosal neurons, which may reveal an 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: 2022/09/8 | Accepted: 2022/12/28 | Published: 2025/03/18
Received: 2022/09/8 | Accepted: 2022/12/28 | Published: 2025/03/18
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