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Pubmed for Handhelds

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  • Title: Neuroradiology can predict the development of hand function in children with unilateral cerebral palsy.
    Author: Holmefur M, Kits A, Bergström J, Krumlinde-Sundholm L, Flodmark O, Forssberg H, Eliasson AC.
    Journal: Neurorehabil Neural Repair; 2013 Jan; 27(1):72-8. PubMed ID: 22677505.
    Abstract:
    BACKGROUND: Much variation is found in the development of hand function in children with unilateral cerebral palsy (CP). OBJECTIVE: . To explore how anatomic brain abnormalities can be used to predict the development of hand function. METHODS: A total of 32 children with unilateral CP (16 boys and 16 girls) were evaluated at least once a year by the Assisting Hand Assessment (AHA). The data collection covered an age range from 18 months to 8 years (mean time in study, 4 years and 6 months). Computerized tomography or magnetic resonance imaging of the brain were assessed for patterns of brain damage, including the location of gray and extent of white-matter damage. The children were divided into groups according to lesion characteristics, and a series of univariate models were analyzed with a nonlinear mixed-effects model. The rate and maximum limit of development were calculated. RESULTS: The highest predictive power of better development of hand function was the absence of a concurrent lesion to the basal ganglia and thalamus, independent of the basic type of brain lesion. This model predicted both the rate of increasing ability and hand function at age 8 years. Hand function was also predicted by the basic pattern of damage and by the extent of white-matter damage. The presence of unilateral or bilateral damage had no predictive value. CONCLUSIONS: Neuroradiological findings can be used to make a crude prediction of the future development of the use of the affected hand in young children with unilateral CP.
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