RT Journal Article
SR Electronic
T1 Improved Myelination following Camp Leg Power, a Selective Motor Control Intervention for Children with Spastic Bilateral Cerebral Palsy: A Diffusion Tensor MRI Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 700
OP 706
DO 10.3174/ajnr.A7860
VO 44
IS 6
A1 Vuong, A.
A1 Joshi, S.H.
A1 Staudt, L.A.
A1 Matsumoto, J.H.
A1 Fowler, E.G.
YR 2023
UL http://www.ajnr.org/content/44/6/700.abstract
AB BACKGROUND AND PURPOSE: Children with spastic cerebral palsy have motor deficits associated with periventricular leukomalacia indicating WM damage to the corticospinal tracts. We investigated whether practice of skilled lower extremity selective motor control movements would elicit neuroplasticity.MATERIALS AND METHODS: Twelve children with spastic bilateral cerebral palsy and periventricular leukomalacia born preterm (mean age, 11.5 years; age range, 7.3–16.6 years) participated in a lower extremity selective motor control intervention, Camp Leg Power. Activities promoted isolated joint movement including isokinetic knee exercises, ankle-controlled gaming, gait training, and sensorimotor activities (3 hours/day, 15 sessions, 1 month). DWI scans were collected pre- and postintervention. Tract-Based Spatial Statistics was used to analyze changes in fractional anisotropy, radial diffusivity, axial diffusivity, and mean diffusivity.RESULTS: Significantly reduced radial diffusivity (P < . 05) was found within corticospinal tract ROIs, including 28.4% of the left and 3.6% of the right posterior limb of the internal capsule and 14.1% of the left superior corona radiata. Reduced mean diffusivity was found within the same ROIs (13.3%, 11.6%, and 6.6%, respectively). Additionally, decreased radial diffusivity was observed in the left primary motor cortex. Additional WM tracts had decreased radial diffusivity and mean diffusivity, including the anterior limb of the internal capsule, external capsule, anterior corona radiata, and corpus callosum body and genu.CONCLUSIONS: Myelination of the corticospinal tracts improved following Camp Leg Power. Neighboring WM changes suggest recruitment of additional tracts involved in regulating neuroplasticity of the motor regions. Intensive practice of skilled lower extremity selective motor control movements promotes neuroplasticity in children with spastic bilateral cerebral palsy.ACRanterior corona radiataADaxial diffusivityALICanterior limb of the internal capsuleCCcorpus callosumCerPedcerebral peduncleCPcerebral palsyCSTcorticospinal tractECexternal capsuleFAfractional anisotropyGMFCSGross Motor Function Classification SystemGMFMGross Motor Function MeasureMDmean diffusivityPLICposterior limb of the internal capsulePVLperiventricular leukomalaciaRDradial diffusivitySCALESelective Control Assessment of the Lower ExtremitySCRsuperior corona radiataSMCselective motor controlTBSSTract-Based Spatial Statistics