Brain activation patterns underlying upper limb bilateral motor coordination in unilateral cerebral palsy: an fNIRS study.

Only eight analysed participants with unilateral CP, and the authors said the small sample makes the results exploratory. Two of ten CP participants were excluded because their lesions left little brain tissue under the probe, so very large lesions are not represented. The tasks were laboratory squeezing and pouring, not real life hand use. The study did not test any treatment, so it cannot show that a therapy improves hand function. fNIRS measured only superficial cortex and anatomy can be distorted after brain injury; scalp blood flow signals were not used as regressors. Some daily function questionnaires were used beyond validated age ranges for a few participants. No direct hand function measure such as Assisting Hand Assessment was used. Correlations were exploratory and cannot show whether brain activity caused movement changes or vice versa.

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Do not read the brain-activation differences as evidence that asymmetric training improves hand function. This was an observational fNIRS study of eight participants with unilateral CP and nine controls; no treatment was given or tested.