ACKNOWLEDGEMENTS The work described in this paper was carried out at Wake Forest University School of Medicine, Winston-Salem, NC with the collaboration of: Lumy Sawaki, Normann Cabrera, Kathleen Kolaski, Beth Smith, Michael O’Shea, and Andrew Koman. Funding was provided by US Public Health Service Grant No R21 HD049019 to GFW.
Motor mapping in cerebral palsy
Article first published online: 3 SEP 2009
© 2009 The Author Journal compilation © 2009 Mac Keith Press
Developmental Medicine & Child Neurology
Special Issue: Adults with Cerebral Palsy: A workshop to define the challenges of treating and preventing the secondary musculoskeletal and neuromuscular complications in this rapidly growing population.
Volume 51, Issue Supplement s4, pages 134–139, October 2009
How to Cite
WITTENBERG, G. F. (2009), Motor mapping in cerebral palsy. Developmental Medicine & Child Neurology, 51: 134–139. doi: 10.1111/j.1469-8749.2009.03426.x
CONFLICTS OF INTEREST The author declares no conflicts of interest.
- Issue published online: 3 SEP 2009
- Article first published online: 3 SEP 2009
The measurement of motor deficits in individuals with cerebral palsy (CP) has been largely based on clinical criteria. Yet functional imaging and non-invasive stimulation methods provide a means to measure directly abnormalities of the motor system. The size and location of muscles and movement representations can be determined with transcranial magnetic stimulation (TMS) and functional magnetics resonance imaging. Thus the homunculus can be individually mapped in children with CP. Because size of representation within the homunculus relates to quality of motor control, measurement of the distance between body parts provides a metric that may be useful in classifying deficits. Bilateral motor control in one hemisphere, while normal in neonates, persists variably in CP, providing another physiological metric. In this study, we used TMS to measure hand and ankle representations in a convenience sample of children with spastic CP. Overlapping thumb and ankle maps were found in children with both hemiplegia and diplegia, and these maps may be from either side of the body. While more participants are required to make conclusions about disability and compression/bilaterality of the homunculus, it appears as if TMS-derived metrics relate to motor abnormalities. These abnormal motor maps also are a therapeutic target, as stimulation methods are being developed as adjuncts to physical means of rehabilitation.