Brain Advance Access originally published online on January 19, 2009
Brain 2009 132(3):684-694; doi:10.1093/brain/awn344
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Neural correlates of motor dysfunction in children with traumatic brain injury: exploration of compensatory recruitment patterns
1 Department of Biomedical Kinesiology, Motor Control Laboratory, Research Center for Motor Control and Neuroplasticity, Group Biomedical Sciences, K.U. Leuven, Belgium 2 Department of Healthcare, Avans+, University for Professionals, Breda, The Netherlands 3 Department of Radiology, University Hospital, K.U. Leuven, Belgium
Correspondence to: Stephan P. Swinnen, Laboratory of Motor Control, Research Center for Motor Control and Neuroplasticity, Group Biomedical Sciences, K.U. Leuven, Tervuursevest 101, B-3001 Heverlee, Belgium E-mail: stephan.swinnen{at}faber.kuleuven.be
Traumatic brain injury (TBI) is a common form of disability in children. Persistent deficits in motor control have been documented following TBI but there has been less emphasis on changes in functional cerebral activity. In the present study, children with moderate to severe TBI (n = 9) and controls (n = 17) were scanned while performing cyclical movements with their dominant and non-dominant hand and foot according to the easy isodirectional (same direction) and more difficult non-isodirectional (opposite direction) mode. Even though the children with TBI were shown to be less successful on various items of a clinical motor test battery than the control group, performance on the coordination task during scanning was similar between groups, allowing a meaningful interpretation of their brain activation differences. fMRI analysis revealed that the TBI children showed enhanced activity in medial and anterior parietal areas as well as posterior cerebellum as compared with the control group. Brain activation generally increased during the non-isodirectional as compared with the isodirectional mode and additional regions were involved, consistent with their differential degree of difficulty. However, this effect did not interact with group. Overall, the findings indicate that motor impairment in TBI children is associated with changes in functional cerebral activity, i.e. they exhibit compensatory activation reflecting increased recruitment of neural resources for attentional deployment and somatosensory processing.
Key Words: Traumatic brain injury; fMRI; motor control; interlimb coordination; children
Abbreviations: DAI, diffuse axonal injury; EPI, echo echoplanar images; FWHM, full width at half maximum; SMA, supplementary motor area; SPM2, Statistical Parametric Mapping 2; TBI, traumatic brain injury; TE, echo time; SVC, small volume correction; TR, repetition time; VOI, volumes of interest
Received May 8, 2008. Revised November 19, 2008. Accepted November 22, 2008.