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The impact of brain lesion characteristics and the corticospinal tract wiring on mirror movements in unilateral cerebral palsy

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posted on 2023-07-10, 06:17 authored by C Simon-Martinez, L Decraene, I Zielinski, Brian HoareBrian Hoare, J Williams, L Mailleux, B Steenbergen, E Ortibus, H Feys, K Klingels
Mirror movements (MM) influence bimanual performance in children with unilateral cerebral palsy (uCP). Whilst MM are related to brain lesion characteristics and the corticospinal tract (CST) wiring pattern, the combined impact of these neurological factors remains unknown. Forty-nine children with uCP (mean age 10y6mo) performed a repetitive squeezing task to quantify similarity (MM-similarity) and strength (MM-intensity) of the MM activity. We used MRI data to evaluate lesion type (periventricular white matter, N = 30; cortico-subcortical, N = 19), extent of ipsilesional damage, presence of bilateral lesions, and damage to basal ganglia, thalamus and corpus callosum. The CST wiring was assessed with Transcranial Magnetic Stimulation (17 CSTcontralateral, 16 CSTipsilateral, 16 CSTbilateral). Data was analyzed with regression analyses. In the more-affected hand, MM-similarity and intensity were higher with CSTbilateral/ipsilateral. In the less-affected hand, MM-similarity was higher in children with (1) CSTcontra with CSC lesions, (2) CSTbilat/ipsi with PVL lesions and (3) CSTbilat/ipsi with unilateralized lesions. MM-intensity was higher with larger damage to the corpus callosum and unilateral lesions. A complex combination of neurological factors influences MM characteristics, and the mechanisms differ between hands.


This work is funded by the Fund Scientific Research Flanders (FWO project, grants G087213N and G0C4919N), the Special Research Fund, KU Leuven (OT/14/127, project grant 3M140230) and the Cerebral Palsy International Research Foundation (CPIRF, #R-801-11). During the revision of this work, CSM was funded by the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 890641.


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