Article

AIM: To investigate relationships between hand function, brain lesions, and
corticomotor projections in children with unilateral cerebral palsy (CP). METHOD:
The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4]
range 7-16 y), with unilateral CP at Gross Motor Function Classification System
level I and Manual Ability Classification System level I or II. Hand function was
assessed with the Box and Blocks test and Assisting Hand Assessment (AHA).
Conventional structural magnetic resonance images were assessed visually for
type, location, and extent of brain lesions. Single-pulse transcranial magnetic
stimulation (TMS) provided information on organization of corticomotor
projections. RESULTS: The most favourable hand function was seen in children who
had white-matter damage of immaturity with mild white-matter loss and
contralateral motor projections. Children with ipsilateral projections had the
most impaired function. Nevertheless, in this subgroup a range of ability was
seen (AHA 29-59%). Motor-projection patterns appeared to be influenced by lesion
extent and location, but not by lesion type. INTERPRETATION: Combining
information from structural magnetic resonance images and TMS can improve
prediction of hand function. A wide variation in hand function was seen within
all motor-projection patterns. Although the most impaired hand function was seen
in the ipsilateral motor-projection group, some children in this group had fairly
good ability. Such information is important for treatment planning.

Langue : ANGLAIS