scholarly journals Motor Organization in Schizencephaly: Outcomes of Transcranial Magnetic Stimulation and Diffusion Tensor Imaging of Motor Tract Projections Correlate with the Different Domains of Hand Function

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Ju-Yul Yoon ◽  
Da-Sol Kim ◽  
Gi-Wook Kim ◽  
Myoung-Hwan Ko ◽  
Jeong-Hwan Seo ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Transcranial Magnetic Stimulation ◽  
Grip Strength ◽  
Magnetic Stimulation ◽  
Diffusion Tensor ◽  
Hand Function ◽  
Symmetry Index ◽  
Affected Side ◽  
Interhemispheric Competition ◽  
Color Map

Objective. Schizencephaly is a rare congenital malformation that causes motor impairment. To determine the treatment strategy, each domain of the motor functions should be appropriately evaluated. We correlated a color map of diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS) with the hand function test (HFT) to identify the type of hand function that each test (DTI and TMS) reflects. Further, we attempted to demonstrate the motor neuron organization in schizencephaly. Method. This retrospective study was conducted on 12 patients with schizencephaly. TMS was conducted in the first dorsal interosseous (FDI), biceps (BB), and deltoid muscles of the upper extremity, and contralateral MEP (cMEP) and ipsilateral MEP (iMEP) were recorded. The HFT included the grip strength, box and block (B&B), and 9-hole peg test. The schizencephalic cleft was confirmed using magnetic resonance imaging, and the corticospinal tract (CST) was identified using the color map of DTI. The symmetry indices for the peduncle and CST at pons level were calculated as the ratios of the cross-sectional area of the less-affected side and that of the more-affected side. Result. In the more-affected hemisphere TMS, no iMEP was obtained. In the less-affected hemisphere TMS, the iMEP response was detected in 9 patients and cMEP in all patients, which was similar to the pattern observed in unilateral lesion. Paretic hand grip strength was strongly correlated with the presence of iMEP ( p = 0.044 ). The symmetry index of the color map of DTI was significantly correlated with the B&B ( p = 0.008 , R 2 = 0.416 ), whereas the symmetry index of the peduncle was not correlated with all HFTs. Conclusion. In patients with schizencephaly, the iMEP response rate is correlated with the hand function related to strength, while the symmetricity of the CST by the color map of DTI is correlated with the hand function associated with dexterity. Additionally, we suggest the possible motor organization pattern of schizencephaly following interhemispheric competition.

scholarly journals Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers

2017 ◽  
Vol 31 (10-11) ◽  
pp. 965-976 ◽  
Author(s):  
Tonya L. Rich ◽  
Jeremiah S. Menk ◽  
Kyle D. Rudser ◽  
Timothy Feyma ◽  
Bernadette T. Gillick
Keyword(s):  
Cerebral Palsy ◽  
Transcranial Magnetic Stimulation ◽  
Grip Strength ◽  
Magnetic Stimulation ◽  
Hand Function ◽  
Dominant Hand ◽  
Motor Threshold ◽  
Motor Representation ◽  
Unilateral Cerebral Palsy ◽  
The Mean

Background. Neurorehabilitation interventions in children with unilateral cerebral palsy (UCP) target motor abilities in daily life yet deficits in hand skills persist. Limitations in the less-affected hand may affect overall bimanual hand skills. Objective. To compare hand function, by timed motor performance on the Jebsen-Taylor Test of Hand Function (JTTHF) and grip strength of children with UCP to children with typical development (CTD), aged 8 to 18 years old. Exploratory analyses compared hand function measures with regard to neurophysiological outcomes measured by transcranial magnetic stimulation and between group comparisons of hemispheric motor threshold. Methods. Baseline hand skills were evaluated in 47 children (21 UCP; 26 CTD). Single-pulse transcranial magnetic stimulation testing assessed corticospinal tract and motor threshold. Results. The mean difference of the less-affected hand of children with UCP to the dominant hand of CTD on the JTTHF was 21.4 seconds (95% CI = 9.32-33.46, P = .001). The mean difference in grip strength was −30.8 N (95% CI = −61.9 to 0.31, P = .052). Resting motor thresholds between groups were not significant, but age was significantly associated with resting motor threshold ( P < .001; P = .001). Children with UCP ipsilateral pattern of motor representation demonstrated greater mean differences between hands than children with contralateral pattern of motor representation ( P < .001). All results were adjusted for age and sex. Conclusions. The less-affected hand in children with UCP underperformed the dominant hand of CTD. Limitations were greater in children with UCP ipsilateral motor pattern. Rehabilitation in the less-affected hand may be warranted. Bilateral hand function in future studies may help identify the optimal rehabilitation and neuromodulatory intervention.

scholarly journals Diffusion Tensor Imaging Evaluation of Neural Network Development in Patients Undergoing Therapeutic Repetitive Transcranial Magnetic Stimulation following Stroke

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Naoki Yamada ◽  
Ryo Ueda ◽  
Wataru Kakuda ◽  
Ryo Momosaki ◽  
Takahiro Kondo ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Transcranial Magnetic Stimulation ◽  
White Matter ◽  
Fractional Anisotropy ◽  
Motor Function ◽  
Magnetic Stimulation ◽  
Diffusion Tensor ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Cerebral White Matter ◽  
Imaging Evaluation

We aimed to investigate plastic changes in cerebral white matter structures using diffusion tensor imaging following a 15-day stroke rehabilitation program. We compared the detection of cerebral plasticity between generalized fractional anisotropy (GFA), a novel tool for investigating white matter structures, and fractional anisotropy (FA). Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) of 2400 pulses applied to the nonlesional hemisphere and 240 min intensive occupation therapy (OT) daily over 15 days. Motor function was evaluated using the Fugl-Meyer assessment (FMA) and Wolf Motor Function Test (WMFT). Patients underwent diffusion tensor magnetic resonance imaging (MRI) on admission and discharge, from which bilateral FA and GFA values in Brodmann area (BA) 4 and BA6 were calculated. Motor function improved following treatment (p<0.001). Treatment increased GFA values for both the lesioned and nonlesioned BA4 (p<0.05, p<0.001, resp.). Changes in GFA value for BA4 of the lesioned hemisphere were significantly inversely correlated with changes in WMFT scores (R2=0.363, p<0.05). Our findings indicate that the GFA may have a potentially more useful ability than FA to detect changes in white matter structures in areas of fiber intersection for any such future investigations.

Sign in / Sign up

Export Citation Format

Share Document