Action Observation Treatment Improves Upper Limb Motor Functions in Children with Cerebral Palsy: A Combined Clinical and Brain Imaging Study

Table 1

Demographic data, clinical features, and radiological findings in treated participants and controls.

Pt. number	Case/control	Sex (M, F)	GA (wk)	Age (yr, m)	CP type Hagberg	Motor abnormalities	GMFCS	MACS	CFCS	Associated impairments	Total IQ	Verbal IQ	Performance IQ	Radiological findings (brain MRI)
1	Case	M	33	9 yr, 5 m	Right hemiplegia	Unilateral spastic hypertonia	2	2	1	V: CVI; H: no; M/A: no; LD: no; E: no	85	92	82	Right temporooccipital, left occipitoparietal, bilateral periventricular, and left frontotemporal subdural hematomas
2	Case	F	27	8 yr, 2 m	Right hemiplegia	Unilateral spastic hypertonia	1	2	1	V: ROP; H: no; M/A: no; LD: no; E: no	100	106	107	Mild bilateral periventricular leukomalacia, mild ventricular dilatation
3	Control	M	40	7 yr, 10 m	Right hemiplegia	Unilateral spastic hypertonia	2	2	1	V: no; H: no; M/A: no; LD: no; E: no	99	101	97	Left subdural occipitotemporal hematoma and epidural parietotemporal hematoma; hypoxic ischemic encephalopathy characterized by signal alterations in both putamen tail and anterior thalamus
4	Control	M	34	8 yr, 3 m	Tetraplegia	Bilateral spastic hypertonia, left side more affected	4	3	2	V: CVI; H: no; M/A: yes; LD: no; E: no	73	97	50	Hypoxic ischemic injury with thinning of the corpus callosum, enlargement of CSF spaces, widespread hyperintensity of centrum semiovale, corona radiata, and periventricular white matter, dilation of the ventricles
5	Control	F	40	6 yr, 8 m	Tetraplegia	Bilateral spastic hypertonia, left side more affected	4	2	3	V: CVI; H: no; M/A: yes; LD: no; E: no	114	139	77	Diffuse periventricular hyperintensity with parietal bilateral white matter involvement; mild dilatation of bilateral ventricular trigone
6	Case	F	30	11 yr, 9 m	Tetraplegia	Bilateral spastic hypertonia, left side more affected	4	3	2	V: CVI; H: no; M/A: yes; LD: yes; E: yes	56	89	50	Periventricular leukomalacia, fronto-parieto-occipital white matter reduction, ex vacuo enlargement of bilateral ventricles
7	Control	F	37	9 yr, 1 m	Right hemiplegia	Unilateral spastic hypertonia	1	2	1	V: CVI; H: no; M/A: yes; LD: no; E: no	87	84	100	Left periventricular malacic area with gliosis, extended into the corona radiata; left corticospinal projection hyperintensisty with mild cerebellar peduncle hypotrophy (Wallerian degeneration)
8	Control	F	31	8 yr, 9 m	Right hemiplegia	Unilateral spastic hypertonia	2	1	1	V: CVI; H: no; M/A: no; LD: no; E: no	87	99	77	Bilateral parietal cystic periventricular leukomalacia, with centrum semiovale white matter involvement, short distance between cortex and ventricular walls in temporoparietal areas, thinning of the corpus callosum
9	Case	F	Not known	11 yr, 9 m	Left hemiplegia	Unilateral spastic hypertonia	2	2	1	V: no; H: no; M/A: no; LD: no; E: yes	Leiter -R; 82			Right fronto-parieto-temporal malacic area, ex vacuo enlargement of the ventricle and Wallerian degeneration of the corticospinal tract
10	Case	M	32	6 yr, 10 m	Tetraplegia	Bilateral spastic hypertonia, right side more affected	3	2	2	V: CVI; H: no; M/A: yes; LD: no; E: no	89	120	70	Periventricular leukomalacia, corpus callosum hypoplasia, hippocampal commissure agenesis
11	Control	M	38	5 yr, 2 m	Right hemiplegia	Unilateral spastic hypertonia	2	3	2	V: CVI; H: no; M/A: no; LD: no; E: no	98	118	87	Cortical laminar necrosis (left insular cortex, left frontoparietal areas, and left temporal lobe). Signal T2 and FLAIR hyperintensity in the left caudate nucleus and in the left corona radiata (ischemic event)
12	Case	F	31	10 yr, 1 m	Tetraplegia	Bilateral spastic hypertonia, left side more affected	4	3	3	V: CVI; H: no; M/A: yes; LD: no; E: no	85	92	82	Severe periventricular leukomalacia with major involvement of the posterior area, associated with supra- and subtentorial ventricular dilatation and subarachnoid spaces enlargement, thinning of the corpus callosum
13	Case	F	41	8 yr, 2 m	Right hemiplegia	Unilateral spastic hypertonia	3	2	1	V: CVI; H: no; M/A: no; LD: no; E: yes	87	99	77	Left hemispheric atrophy (previous extensive left frontoparietal intraparenchymal hemorrhage, wide left parietal subdural hematoma), ex vacuo dilatation of the ipsilateral ventricles and midline brain right to left shift, Wallerian degeneration of the corticospinal tract and ipsilateral cerebellar peduncle atrophy
14	Case	M	33	5 yr, 10 m	Right hemiplegia	Unilateral spastic hypertonia	2	3	2	V: strabismus; H: no; M/A: no; LD: no; E: no	85	92	82	Left fronto-parieto-temporo-insular polymicrogyria (perisylvian and perirolandic with cortical infolding), mild left temporal atrophy with subarachnoid spaces enlargement
15	Case	F		6 yr, 8 m	Left hemiplegia	Unilateral spastic hypertonia	4	3	1	V: no; H: no; M/A: yes; LD: no; E: yes	100	106	107	Ischemic right frontoparietal malacic area with focal cortical atrophy, gliosis, subarachnoid space enlargement, and mid ipsilateral ventricular dilatation. Mild controlateral periventricular white matter hyperintensity
16	Case	M	38	6 yr, 3 m	Left hemiplegia	Unilateral spastic hypertonia	2	3	2	V: no; H: no; M/A: no; LD: no; E: no	99	101	97	Malacic areas affecting the right middle cerebral artery territory with Wallerian degeneration of the corticospinal tract and of the thalamus, left hemisphere hypotrophy
18	Case	M	40	5 yr, 3 m	Left hemiplegia	Unilateral spastic hypertonia	2	3	1	V: strabismus; H: no; M/A: no; LD: no; E: yes	101	106	100	Right periventricular porencephalic lesion (hemorrhagic venous infarct) with hemosiderin deposition and Wallerian degeneration of the ipsilateral corticospinal tract
18	Control	M	36	6 yr, 4 m	Left hemiplegia	Unilateral spastic hypertonia	1	2	1	V: no; H: no; M/A: no; LD: no; E: no	90	94	93	Supratentorial right malacic areas with right lateral ventricular dilatation; hemosiderin deposition secondary to germinal matrix hemorrhage

M: male; F: female; GA: gestational age; CP: cerebral palsy; GMFCS: Gross Motor Function Classification System; MACS: Manual Ability Classification System; CFCS: Communication Function Classification System; V: vision; CVI: cerebral visual impairment; H: hearing; M/A: memory and attention; LD: learning disabilities (North American usage; mental retardation); E: epilepsy; MRI: magnetic resonance imaging.