Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence

Neuroplasticity studies examining children with hemiparesis (CH) have focused predominantly on unilateral interventions. CH also have bimanual coordination impairments with bimanual interventions showing benefits. We explored neuroplasticity following hand-arm bimanual intensive therapy (HABIT) of 6...

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Main Authors: Maya Weinstein, Vicki Myers, Dido Green, Mitchell Schertz, Shelly I. Shiran, Ronny Geva, Moran Artzi, Andrew M. Gordon, Aviva Fattal-Valevski, Dafna Ben Bashat
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Neural Plasticity
Online Access:http://dx.doi.org/10.1155/2015/798481
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author Maya Weinstein
Vicki Myers
Dido Green
Mitchell Schertz
Shelly I. Shiran
Ronny Geva
Moran Artzi
Andrew M. Gordon
Aviva Fattal-Valevski
Dafna Ben Bashat
author_facet Maya Weinstein
Vicki Myers
Dido Green
Mitchell Schertz
Shelly I. Shiran
Ronny Geva
Moran Artzi
Andrew M. Gordon
Aviva Fattal-Valevski
Dafna Ben Bashat
author_sort Maya Weinstein
collection DOAJ
description Neuroplasticity studies examining children with hemiparesis (CH) have focused predominantly on unilateral interventions. CH also have bimanual coordination impairments with bimanual interventions showing benefits. We explored neuroplasticity following hand-arm bimanual intensive therapy (HABIT) of 60 hours in twelve CH (6 females, mean age 11 ± 3.6 y). Serial behavioral evaluations and MR imaging including diffusion tensor (DTI) and functional (fMRI) imaging were performed before, immediately after, and at 6-week follow-up. Manual skills were assessed repeatedly with the Assisting Hand Assessment, Children’s Hand Experience Questionnaire, and Jebsen-Taylor Test of Hand Function. Beta values, indicating the level of activation, and lateralization index (LI), indicating the pattern of brain activation, were computed from fMRI. White matter integrity of major fibers was assessed using DTI. 11/12 children showed improvement after intervention in at least one measure, with 8/12 improving on two or more tests. Changes were retained in 6/8 children at follow-up. Beta activation in the affected hemisphere increased at follow-up, and LI increased both after intervention and at follow-up. Correlations between LI and motor function emerged after intervention. Increased white matter integrity was detected in the corpus callosum and corticospinal tract after intervention in about half of the participants. Results provide first evidence for neuroplasticity changes following bimanual intervention in CH.
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spelling doaj-art-4d73d8c2c5af49a9be012d10eb8b3ab52025-08-20T03:36:22ZengWileyNeural Plasticity2090-59041687-54432015-01-01201510.1155/2015/798481798481Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary EvidenceMaya Weinstein0Vicki Myers1Dido Green2Mitchell Schertz3Shelly I. Shiran4Ronny Geva5Moran Artzi6Andrew M. Gordon7Aviva Fattal-Valevski8Dafna Ben Bashat9Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6423906 Tel Aviv, IsraelFunctional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6423906 Tel Aviv, IsraelHealth and Life Sciences, Oxford Brookes University, Oxford OX3 3FL, UKChild Development & Pediatric Neurology Service, Meuhedet, 3350127 Haifa, IsraelDepartment of Radiology, Tel Aviv Sourasky Medical Center, 6423906 Tel Aviv, IsraelDepartment of Psychology, Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002 Ramat Gan, IsraelFunctional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6423906 Tel Aviv, IsraelDepartment of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, USAPaediatric Neurology Unit, Tel Aviv Sourasky Medical Center, 6423906 Tel Aviv, IsraelFunctional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6423906 Tel Aviv, IsraelNeuroplasticity studies examining children with hemiparesis (CH) have focused predominantly on unilateral interventions. CH also have bimanual coordination impairments with bimanual interventions showing benefits. We explored neuroplasticity following hand-arm bimanual intensive therapy (HABIT) of 60 hours in twelve CH (6 females, mean age 11 ± 3.6 y). Serial behavioral evaluations and MR imaging including diffusion tensor (DTI) and functional (fMRI) imaging were performed before, immediately after, and at 6-week follow-up. Manual skills were assessed repeatedly with the Assisting Hand Assessment, Children’s Hand Experience Questionnaire, and Jebsen-Taylor Test of Hand Function. Beta values, indicating the level of activation, and lateralization index (LI), indicating the pattern of brain activation, were computed from fMRI. White matter integrity of major fibers was assessed using DTI. 11/12 children showed improvement after intervention in at least one measure, with 8/12 improving on two or more tests. Changes were retained in 6/8 children at follow-up. Beta activation in the affected hemisphere increased at follow-up, and LI increased both after intervention and at follow-up. Correlations between LI and motor function emerged after intervention. Increased white matter integrity was detected in the corpus callosum and corticospinal tract after intervention in about half of the participants. Results provide first evidence for neuroplasticity changes following bimanual intervention in CH.http://dx.doi.org/10.1155/2015/798481
spellingShingle Maya Weinstein
Vicki Myers
Dido Green
Mitchell Schertz
Shelly I. Shiran
Ronny Geva
Moran Artzi
Andrew M. Gordon
Aviva Fattal-Valevski
Dafna Ben Bashat
Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence
Neural Plasticity
title Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence
title_full Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence
title_fullStr Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence
title_full_unstemmed Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence
title_short Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence
title_sort brain plasticity following intensive bimanual therapy in children with hemiparesis preliminary evidence
url http://dx.doi.org/10.1155/2015/798481
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