Final Activity Report Summary - CPBRAIN (Neural control of movements in cerebral palsy (CP) - A study on the effects of training on motor function and brain re-organisation in children) This study in children with cerebral palsy as a consequence of early acquired brain lesions aimed to address three main objectives. First, by using sophisticated assessment tools for hand function, the investigation of the effects of therapeutic intervention on hand function, in particular, fine motor co-ordination. Second, to describe with different methods characteristics of brain lesions acquired early in life and examine associations with hand motor function. Third, to explore effects of therapeutic intervention on brain organisation of motor function. The main achievements and results obtained during the funding period are as follows:1. A new tool for assessment of the ability to manipulate unstable objects has been successfully applied to children. This is clinically relevant since the availability of reliable and valid tests for assessment of this ability is important for accurate estimation of the severity of hand function impairment and for planning and evaluation of treatment.2. Results from our study suggest that using a new imaging technique (diffusion magnetic resonance imaging) in combination with standard imaging improves the characterisation of brain lesions and that using measures from diffusion imaging in children with cerebral palsy is a sensitive measure of the sustained damage to the cortico-spinal pathways. The findings are relevant since they allow improved prediction of outcome and more accurately targeted planning of intervention.3.The third objective has not been achieved in its entity during the funding period and is currently work in progress.Taken together, the main findings from the studies so far contribute to a better understanding of the underlying pathology in children with impaired hand function as a consequence of early acquired brain lesions. Furthermore, the achievements made by conducting these studies provide a basis for accurate assessment of fine motor control in typically developing children and children with motor disorders, and thus allow better planning and evaluating treatment.