Neurological biomarkers in predicting upper limb function and treatment effects in children with unilateral cerebral palsy.

Children with unilateral cerebral palsy (CP) face many sensorimotor impairments and limitations in their arm and hand function. In this project, we will use state-of-the art technology including brain imaging and non-invasive brain stimulation to identify which neurological biomarkers best predict upper limb (UL) function in children with unilateral CP. This proposal is triggered by the current inability to provide well-targeted UL treatment plans for the individual child, which arises from insufficient understanding of the complex neuropathology underlying UL dysfunction. Further, little is known on how brain lesion characteristics and reorganization may influence response to treatment The objectives of the project are (1) to identify neurological biomarkers for predicting UL function in unilateral CP, (2) to assess whether neuroimaging data can be used to predict how children respond to intensive training approaches. We will use state-of-the art technology including brain imaging and non-invasive brain stimulation to assess (1) the anatomical characterization of the brain lesion as identified by magnetic resonance imaging (MRI), (2) structural and functional brain connectivity within the motor and sensory system, as quantified by diffusion MRI (dMRI) and resting state functional MRI (rs-fMRI), and (3) cortical reorganization as measured by transcranial magnetic stimulation (TMS) and mirror movements. The impact of these neurological biomarkers on UL function and treatment response will be studied, using an integrated sensorimotor evaluation. This evaluation will include clinical measures as well as a quantitative assessment of UL pathology with three-dimensional movement analysis and surface electromyography.

Keywords:Rehabilitation, Neuroimaging, Evaluation, Upper limb function, Cerebral palsy

Disciplines:Orthopaedics, Neurosciences, Biological and physiological psychology, Cognitive science and intelligent systems, Developmental psychology and ageing, Paediatrics and neonatology, Nursing, Human movement and sports sciences, Rehabilitation sciences