Article

Children with unilateral spastic cerebral palsy (CP) often have mirror movements,
i.e. involuntary imitations of unilateral voluntary movements of the
contralateral upper extremity. The pathophysiology of mirror movements has been
investigated in small and heterogeneous cohorts in the literature. Specific
pathophysiology of mirror movements and their impact on upper extremity function
require systematic investigation in larger and homogeneous cohorts of children
with unilateral spastic CP.
Here we review two possible neurophysiological
mechanisms underlying mirror movements in children with CP and those with typical
development: (1) an ipsilateral corticospinal tract projecting from the
contralesional motor cortex (M1) to both upper extremities; (2) insufficient
interhemispheric inhibition between the two M1s. We also discuss clinical
implications of mirror movements in children with unilateral CP and suggest that
a thorough examination of the relationship between the pathophysiology and
clinical manifestations of mirror movements is warranted. We suggest two
premises: (1) the presence of mirror movements is indicative of an ipsilateral
corticospinal tract reorganization; and (2) the corticospinal tract organization
may affect patients' responses to certain treatment. If these premises are
supported through future research, mirror movements should be clinically
evaluated for patient selection to maximize benefits of therapy, hence promoting
individualized medicine in this population. WHAT THIS PAPER ADDS: Mirror
movements may be indicative of the underlying corticospinal tract reorganization
in children with unilateral spastic cerebral palsy (CP). Future research will
benefit from systematic investigations of the relationship between mirror
movements and its pathophysiology. Mirror movements may be a potential biomarker
for individualized medicine in children with unilateral spastic CP.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS