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Neurorehabil Neural Repair. 2013 Jan;27(1):72-8. doi: 10.1177/1545968312446950. Epub 2012 Jun 6.

Neuroradiology can predict the development of hand function in children with unilateral cerebral palsy.

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1
School of Health and Medical Sciences, Örebro University, Örebro, Sweden. marie.holmefur@oru.se

Abstract

BACKGROUND:

Much variation is found in the development of hand function in children with unilateral cerebral palsy (CP).

OBJECTIVE:

. To explore how anatomic brain abnormalities can be used to predict the development of hand function.

METHODS:

A total of 32 children with unilateral CP (16 boys and 16 girls) were evaluated at least once a year by the Assisting Hand Assessment (AHA). The data collection covered an age range from 18 months to 8 years (mean time in study, 4 years and 6 months). Computerized tomography or magnetic resonance imaging of the brain were assessed for patterns of brain damage, including the location of gray and extent of white-matter damage. The children were divided into groups according to lesion characteristics, and a series of univariate models were analyzed with a nonlinear mixed-effects model. The rate and maximum limit of development were calculated.

RESULTS:

The highest predictive power of better development of hand function was the absence of a concurrent lesion to the basal ganglia and thalamus, independent of the basic type of brain lesion. This model predicted both the rate of increasing ability and hand function at age 8 years. Hand function was also predicted by the basic pattern of damage and by the extent of white-matter damage. The presence of unilateral or bilateral damage had no predictive value.

CONCLUSIONS:

Neuroradiological findings can be used to make a crude prediction of the future development of the use of the affected hand in young children with unilateral CP.

PMID:
22677505
DOI:
10.1177/1545968312446950
[Indexed for MEDLINE]

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