Brain Reorganization following Intervention in Children with Congenital Hemiplegia: A Systematic Review

Table 3

Neuroimaging and neurophysiological outcome measures and results.

CIMT
Functional magnetic resonance imaging	PH	N-PH	Notes
Active movements fMRI task
Four-finger/wrist extension/flexion [13]	2/4 LI shift to contralateral hemisphere, 2/4 reduced LI (group stat; 𝑛=4)	—
Finger tapping [15]	6/7 (M1c) ↑ area of activation; 2/7 (M1c) ↑ signal (1–3%)	—	3/10 were excluded due to artifacts (2/10) or claustrophobia.; fMRI task was tested on 5 controls who showed M1c activation.
Rubber ball press [17]	1/3 (M1S1c + M1S1i + CBMi + PMC) ↑ area of activation	4/10 M1S1c ↑ area of activation; 1/10 M1S1i ↑ area of activation	3/10 were excluded for PH task due to movement artifacts.
Rubber ball press [18]	(M1S1c + SMA) ↑ area of activation (group stat; 𝑛=5)	No changes (group stat; 𝑛=5)	2/7 were excluded for inability to perform the task.
Rubber ball press [19]	Ipsilesional group: (M1S1c + SMA) ↑ area of activation (group stat; 𝑛=5)	No changes (group stat; 𝑛=5)	2/7 were excluded for inability to perform the task.
	Contralesional group; (M1S1c + CBMi/c) ↑ area of activation; (M1i) ↓activation; (group stat; 𝑛=6)	No changes (group stat; 𝑛=6)	3/9 were excluded for movement artefacts.
Passive movements
Flexion/extension at the metacarpophalangeal of fingers II–V of the patient's hand [17]	4/8 (M1S1c) ↑ area of activation; 1/8 (M1S1i) ↑ area of activation; 2/8 (IHF) ↑ area of activation; 1/8 (CMBi) ↑ area of activation; 4/8 no changes observed	2/10 M1S1c ↑ area of activation; 1/10 IHF ↑ area of activation	2/10 were excluded for PH task due to movement artifacts.
Flexion/extension at the metacarpophalangeal of fingers II–V of the patient's hand [18]	No changes (group stat; 𝑛=7)	No changes (group stat; 𝑛=7)
Flexion/extension at the metacarpophalangeal of fingers II–V of the patient's hand [19]	Ipsilesional group:  no changes; (group stat; 𝑛=7)	Ipsilesional group: no changes; (group stat; 𝑛=7)
	Contralesional group; Parietal operculumc + M2S2c ↓activation; (group stat; 𝑛=9)	Contralesional group; M1S1c ↓activation; (group stat; 𝑛=9)
Voxel-based morphometry	Posttreatment—pretreatment	Pretreatment—baseline	Notes
VBM [14]	(M1S1c + M1i + Hippocampi) ↑ volume (group stat; 𝑛=10)	No changes (group stat; 𝑛=10)
Transcranial magnetic stimulation	PH	N-PH	Notes
TMS [18]	(M1-MEPs) ↑ amplitude; (group stat; 𝑛=7)	No changes; (group stat; 𝑛=7)
TMS [19] amplitude	Ipsilesional group: (M1-MEPs) ↑ amplitude; (group stat; 𝑛=7)	Ipsilesional group: No changes; (group stat; 𝑛=7)
	Contralesional group: (M1-MEPs) ↓amplitude; (group stat; 𝑛=9)	Contralesional group: (M1-MEPs) ↓amplitude; (group stat; 𝑛=9)
TMS [19] conduction time	Ipsilesional group: No changes (group stat; 𝑛=7); Contralesional group: No changes (group stat; 𝑛=9)	Ipsilesional group: No changes (group stat; 𝑛=7); Contralesional group: No changes (group stat; 𝑛=9)
Magnetoencephalography	PH	N-PH	Notes
MEG [19] latency	Ipsilesional group: ↓ early-SEF latency (group stat; 𝑛=7); Contralesional group: No changes in early-SEF latency; (group stat; 𝑛=8)	Ipsilesional group: ↓ early-SEF latency (group stat; 𝑛=7); Contralesional group: No changes in early-SEF latency.; (group stat; 𝑛=8)	1/9 was excluded due to strong magnetic artefacts.
MEG [19] amplitude	Ipsilesional group: ↑ early-SEF amplitude (group stat; 𝑛=7); Contralesional group: ↑ early SEF amplitude; (group stat; 𝑛=8)	Ipsilesional group: ≈ early-SEF amplitude (group stat; 𝑛=7); Contralesional group: No changes SEF amplitude; (group stat; 𝑛=8)	1/9 was excluded due to strong magnetic artefacts.
VR
Functional magnetic resonance imaging	PH	N-PH	Notes
Active movements fMRI task
Hand open/close [16]	2/3 (M1c) ↑ area of activation; 2/3 (CBM) ↑ area of activation	—	Training dose was variable in the 3 cases.

Abbreviations: PH: paretic hand; N-PH: nonparetic hand; fMRI: functional magnetic resonance imaging; VBM: voxel-based morphometry; TMS: transcranial magnetic stimulation, MEG: magnetoencephalography; M1: primary motor cortex; FP: frontoparietal; M1S1: primary sensory motor cortex, M2S2c secondary sensory motor cortex c/i: indicate contralateral/ipsilateral, CBM: cerebellum, IHF interhemispheric fissure (including cingulate motor area supplementary motor area), PMC: premotor cortex; LI: lateral index; LI is calculated [(contralateral − ipsilateral)/(contralateral + ipsilateral)]; SMA: supplementary motor area, MEPs: motor evoked potentials; SEF: somatosensory evoked potentials.