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Neural control of movements in cerebral palsy (CP) - a study on the effects of training on motor function and brain re-organisation in children with hemiplegic CP


Cerebral palsy (CP) is caused by lesions to the developing brain, and has a prevalence of 2/1000 live births. It has significant implications for participation in many areas of society (e.g. employment), and impaired hand motor function plays an important role. Research on effects of intervention is needed to optimise treatment, with the goal to improve integration of individuals with CP into society. For a complete understanding, it is necessary to study intervention effects on different levels (motor func tion, anatomical brain structure, brain activation patterns, integrity of sensory-motor circuits).
This requires a combination of techniques in a multidisciplinary setting. In children, no such study has been performed to date. We will study a group of chi ldren with congenital hemiplegic CP who will receive intensive upper limb training (Constraint Induced Movement Therapy), and assessments before and after training.
We hypothesise that
(i) intervention will lead to improved hand motor function;
(ii) interve ntion will be associated with changes in brain re-organisation; (iii) motor function and re-organisation will be associated with location/extent of lesions.
We will test these hypotheses by using modern tools for assessment of motor function in combination with new magnetic resonance imaging (MRI) techniques (including Diffusion Tensor Imaging and functional MRI), and neurophysiology tools (Transcranial Magnetic Stimulation).
The results of this study will
(i) provide new insights in mechanisms of the brain `s response to early injury and intervention later in life;
(ii) lead to better integration of individuals with CP into society;
(iii) lead to social/economic benefits on a Community level.
For the applicant, participation in this study will be an importan t step in her research career with the ultimate goal of leading an internationally competitive group with the focus on investigation of brain structure-function relationships after early brain lesions.

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