PTOTSystematic ReviewDevelopmental medicine and child neurology2025

Assessment of cortical activity, functional connectivity, and neuroplasticity in cerebral palsy using functional near-infrared spectroscopy: A scoping review.

Owais A Khan, Simin Rahman, Kanishka Baduni and 1 others

PMID 39963963

WHAT IT FOUND

Functional near-infrared spectroscopy is feasible for measuring brain activity in cerebral palsy, showing exaggerated motor cortex activation during tasks.

However, small samples and a lack of reliability data mean these findings cannot yet guide clinical treatment decisions or track intervention progress.

Key findings

01Fifteen of the sixteen included studies had small samples, ranging from 2 to 24 participants, limiting the generalizability of the findings.

02Participants with cerebral palsy consistently displayed exaggerated sensorimotor cortex activity during motor tasks compared to typically developing individuals.

03There is currently no research confirming the reliability of functional near-infrared spectroscopy in cerebral palsy, undermining confidence in its ability to track intervention effects.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Only 16 studies were included, and sample sizes were very small, ranging from 2 to 24 participants. Individuals with severe impairments were largely excluded; only 10 participants had GMFCS levels IV-V, and only 4 had MACS levels IV-V. No studies were conducted in low- or middle-income countries, limiting global generalizability. There is no existing research confirming the test-retest reliability of fNIRS in cerebral palsy. Methodological heterogeneity across studies prevented meta-analysis, making it impossible to quantify effect sizes. Attrition rates were high in some studies, and practical issues like sensory hypersensitivity to fNIRS caps remain barriers.

Declared interests

Funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the University of Georgia Athletic Association. The authors declared no conflicts of interest.

The easy way to misread this

Do not interpret the exaggerated cortical activity found in these studies as a direct measure of treatment efficacy or a clinical biomarker. The review explicitly states that a lack of reliability data undermines confidence in using fNIRS to track intervention effects, so these findings are currently limited to research contexts.

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