The prevalence of cerebral palsy (CP) varies globally, with higher rates and burden of disease in low- and middle-income countries. CP is a lifelong condition with no cure, presenting diverse challenges such as motor impairment, epilepsy, and mental health disorders. Research progress has been made but more is needed, especially given consumer demands for faster advancements and improvements in the scientific evidence base for interventions.
View Article and Find Full Text PDFAdults with severe cerebral palsy (CP) are susceptible to malnutrition and metabolic disorders due to limited daily physical activity and challenges related to eating. We hypothesized that the condition of being underweight arises from inadequate energy intake due to difficulties in eating, rather than heightened total energy expenditure or an elevated resting metabolic rate. The present study encompassed 17 adults with severe CP (classified as GMFSC III-V).
View Article and Find Full Text PDFMonitoring and quantifying movement behavior is crucial for improving the health of individuals with cerebral palsy (CP). We have modeled and trained an image-based Convolutional Neural Network (CNN) to recognize specific movement classifiers relevant to individuals with CP. This study evaluates CNN's performance and determines the feasibility of 24-h recordings.
View Article and Find Full Text PDFFunctional magnetic resonance imaging (fMRI) studies on the sense of agency (SoA) have yielded heterogeneous findings identifying regional brain activity during tasks that probed SoA. In this review, we argue that the reason behind this between-study heterogeneity is a "synecdochic" way the field conceptualizes and studies SoA. Typically, a single feature is experimentally manipulated and then this is interpreted as covering all aspects of SoA.
View Article and Find Full Text PDFIntroduction: Contractures are frequent causes of reduced mobility in children with cerebral palsy (CP) already at the age of 2-3 years. Reduced muscle use and muscle growth have been suggested as key factors in the development of contractures, suggesting that effective early prevention may have to involve stimuli that can facilitate muscle growth before the age of 1 year. The present study protocol was developed to assess the effectiveness of an early multicomponent intervention, CONTRACT, involving family-oriented and supervised home-based training, diet and electrical muscle stimulation directed at facilitating muscle growth and thus reduce the risk of contractures in children at high risk of CP compared with standard care.
View Article and Find Full Text PDFLiving with a congenital brain lesion may have detrimental effects on the ability to do everyday activities, but contrary to acquired brain lesions, people and in particular children, with congenital brain lesions may have limited or no experience of how their bodies work. This absence of experience gives rise to challenges for habilitation of sensorimotor abilities and derived cognitive abilities. How can motor and cognitive abilities be achieved and trained in an individual with no experience of potential abilities? In this article, we aim to review the existing knowledge about the development of sensorimotor integration.
View Article and Find Full Text PDFBackground: Learning and memory have been shown to be influenced by combination of dietary supplements and exercise in animal models, but there is little available evidence from human subjects. The aim of this pilot study was to investigate the effect of combining a motor- and cognitive exercise program with dietary supplementation consisting of 500 mg docosahexaenoic acid (DHA), 10 μg vitamin D and 1000 mg uridine (DDU-supplement) in 16 prepubescent children (age 8-11 years).
Methods: We designed a randomized, placebo-controlled, double-blinded study lasting 6 weeks in which DDU-supplement or placebo was ingested daily.
Accumulating evidence suggests that parieto-frontal connections play a role in adjusting body ownership during the Rubber Hand Illusion (RHI). Using a motor version of the rubber hand illusion paradigm, we applied single-site and dual-site transcranial magnetic stimulation (TMS) to investigate cortico-spinal and parietal-frontal connectivity during perceived rubber hand ownership. Healthy volunteers received a conditioning TMS pulse over left anterior intraparietal sulcus (aIPS) and a test TMS pulse over left primary motor cortex (M1).
View Article and Find Full Text PDFKey Points: The early postnatal development of functional corticospinal connections in human infants is not fully clarified. Corticospinal drive to upper and lower limb muscle shows developmental changes with an increased functional coupling in infants between 9 and 25 weeks in the beta frequency band. The changes in functional coupling coincide with the developmental period where fidgety movements are present in healthy infants.
View Article and Find Full Text PDFAim: Lack of muscle growth relative to bone growth may be responsible for development of contractures in children with cerebral palsy (CP). Here, we used ultrasonography to compare growth of the medial gastrocnemius muscle in children with and without CP.
Method: Twenty-six children with spastic CP (15 males, 11 females; mean age 35mo, range 8-65mo) and 101 typically developing children (47 males, 54 females; mean age 29mo, range 1-69mo) were included.
In the present study we tested whether sense of agency (SoA) is reflected by changes in coupling between right medio-frontal/supplementary motor area (SMA) and inferior parietal cortex (IPC). Twelve healthy adult volunteers participated in the study. They performed a variation of a line-drawing task (Nielsen, 1963; Fourneret and Jeannerod, 1998), in which they moved a cursor on a digital tablet with their right hand without seeing the hand.
View Article and Find Full Text PDFA large body of fMRI and lesion-literature has provided evidence that the Inferior Parietal Cortex (IPC) is important for sensorimotor integration and sense of agency (SoA). We used repetitive transcranial magnetic stimulation (rTMS) to explore the role of the IPC during a validated SoA detection task. 12 healthy, right-handed adults were included.
View Article and Find Full Text PDFDeclines in the ability to learn motor skills in older adults are commonly attributed to deficits in the encoding of sensorimotor information during motor practice. We investigated whether aging also impairs motor memory consolidation by assessing the susceptibility to memory interference and off-line gains in motor skill learning after practice in children, young, and older adults. Subjects performed a ballistic task (A) followed by an accuracy-tracking task (B) designed to disrupt the consolidation of A.
View Article and Find Full Text PDFThe ability to decide which of the two stimuli is presented first can be probed using a temporal order judgment (TOJ) task. When the stimuli are delivered to the fingers, TOJ decisions can be confounded by the fact that the hands can be moved to different locations in space. How and where this confounded information is processed in the brain is poorly understood.
View Article and Find Full Text PDFBackground: Children diagnosed with spastic Cerebral Palsy (CP) often show perceptual and cognitive problems, which may contribute to their functional deficit. Here we investigated if altered ability to determine whether an observed movement is performed by themselves (sense of agency) contributes to the motor deficit in children with CP.
Methods: Three groups; 1) CP children, 2) healthy peers, and 3) healthy adults produced straight drawing movements on a pen-tablet which was not visible for the subjects.
Accurate motor execution is achieved by estimating future sensory states via a forward model of limb dynamics. In the current experiment, we probed the time course over which state estimation evolves during movement planning by combining a bimanual arm crossing movement with a temporal order judgment (TOJ) task. Human participants judged which of two successive vibrotactile stimuli delivered to each index finger arrived first as they were preparing to either cross or uncross their hands.
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