CI therapy produces increase in grey matter in brains of children with cerebral palsy

April 23, 2013 by Bob Shepard, University of Alabama at Birmingham
Cortical surface-rendered image of grey matter change. Grey matter increases displayed on a standard brain. Surface rendering was performed with a depth of 20 mm. Color bar values indicate t statistics ranging from 2.0 to 4.7.

Researchers at the University of Alabama at Birmingham (UAB) report that children with cerebral palsy who underwent Constraint Induced Movement therapy (CI therapy) saw a significant increase in grey matter volume in areas of the brain associated with movement. The findings, published online April 22, 2013 in Pediatrics, are the first to show that structural remodeling of the brain occurs during rehabilitation in a pediatric population.

"It is well understood that CI therapy produces a re-wiring of the brain, leading to functional improvement in motor skills in children and adults who have experienced a ," said Edward Taub, Ph.D., the developer of CI therapy and a study co-author. "This study reinforces the idea that CI therapy also remodels the brain, producing a real, physical change in the brain."

is a component of the , consisting primarily of neuronal cell bodies, glial cells and dendrites. The study examined ten children with cerebral palsy, between the ages of 2 and 7, who underwent a three week course of CI therapy. Changes in grey matter were assessed with a technique called voxel-based morphometry (VBM), performed on images acquired through .

"We saw increases in grey matter volume in the sensorimotor on both sides of the brain and in the ," said Chelsey Sterling, M.A., a graduate student in and first author of the study. "These increases were accompanied by large improvements in spontaneous arm use in the home environment. Notably, increases in grey matter correlated with improvement in motor activity."

Sterling says the significant correlation between increases in grey matter volume and magnitude of motor improvement raises the possibility of a .

The researchers suggest the observed increase in grey matter could be due to one or more different processes, including an increase in synaptic density, the creation of new neurons or glial cells or the establishment of new blood vessels within the brain.

"An increase in grey matter is indicative that the brain is capable of supporting increased motor activity and function," said Gitendra Uswatte, Ph.D., a study co-author. "Along with the improvements observed in the dexterity and everyday use of the arm that was the target of rehabilitation, this is a strong indication that a child with can have substantial gains in motor function when provided with the correct stimulation."

VBM analysis was performed three weeks prior to therapy, at the beginning of therapy and at the end of the three week therapy period. The authors say that no significant grey matter change was seen during the three weeks before treatment.

The children underwent intensive motor training for three hours each weekday for a three week period in which the child's less-affected arm was continuously restrained in a long arm cast. Each child's caregiver received a transfer package, which included steps to induce continuation of use of the more-affected arm at home. The MRI scans were performed at Children's of Alabama.

Taub, a university professor in the Department of Psychology, developed the family of techniques called CI therapy. The therapy has been shown to be effective in improving the rehabilitation of movement after stroke and other neurological injuries in both children and adults.

"The motor improvement and changes in grey matter following CI therapy observed in this study are similar to those observed previously in adults," said Taub. "It is further evidence that the has a remarkable capacity to heal itself when presented with an efficacious rehabilitation intervention such as CI therapy."

Explore further: Broken arm? Brain shifts quickly when using a sling or cast

More information: pediatrics.aappublications.org … aappublications.org/

Related Stories

Broken arm? Brain shifts quickly when using a sling or cast

January 16, 2012
Using a sling or cast after injuring an arm may cause your brain to shift quickly to adjust, according to a study published in the January 17, 2012, print issue of Neurology, the medical journal of the American Academy of ...

Recommended for you

New neurons in the adult brain are involved in sensory learning

February 23, 2018
Although we have known for several years that the adult brain can produce new neurons, many questions about the properties conferred by these adult-born neurons were left unanswered. What advantages could they offer that ...

Study in mice suggests personalized stem cell treatment may offer relief for multiple sclerosis

February 22, 2018
Scientists have shown in mice that skin cells re-programmed into brain stem cells, transplanted into the central nervous system, help reduce inflammation and may be able to help repair damage caused by multiple sclerosis ...

Nolan film 'Memento' reveals how the brain remembers and interprets events from clues

February 22, 2018
Key repeating moments in the film give viewers the information they need to understand the storyline. The scenes cause identical reactions in the viewer's brain. The results deepen our understanding of how the brain functions, ...

Biomarker, clues to possible therapy found in novel childhood neurogenetic disease

February 22, 2018
Researchers studying a rare genetic disorder that causes severe, progressive neurological problems in childhood have discovered insights into biological mechanisms that drive the disease, along with early clues that an amino ...

A look at the space between mouse brain cells

February 22, 2018
Between the brain's neurons and glial cells is a critical but understudied structure that's been called neuroscience's final frontier: the extracellular space. With a new imaging paradigm, scientists can now see into and ...

Schizophrenia a side effect of human development

February 21, 2018
Schizophrenia may have evolved as an "unwanted side effect" of the development of the complex human brain, a new study has found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.