The Relationship Between Hand Function and Overlapping Motor Representations of the Hands in the Contralesional Hemisphere in Unilateral Spastic Cerebral Palsy.

This was a pre-intervention mapping study; no treatment was tested, so it cannot show that any therapy changes brain maps or hand function. Fifty children participated, but six children with contralateral CST patterns were excluded from the main analyses. The analysed children had mild to moderate impairment, so findings may not apply to children with more severe impairments. The less-affected hand map may have been under- or overestimated because stimulation intensity was based on the affected hand's resting motor threshold. Motor responses longer than 40 ms were excluded, and TMS responses could have come from pathways other than the corticospinal tract. The bilateral CST subgroup was small, and larger samples may be needed to detect subgroup differences. Clinical mirror movement ratings were available for 14 of 30 children in the ipsilateral CST group and 7 of 14 in the bilateral CST group, and the correlation with EMG measures was not significant. Some participants' data had been used in earlier studies, though those studies did not address these hypotheses. Four children did not consent to MRI, so their coil locations were placed on a model MRI.

The supplied publication types list N.I.H. extramural and non-U.S. government research support. No author conflict-of-interest or funding declaration appears in the supplied article text.

Do not read the correlations as proof that therapy can increase overlap and improve hand function. This was a pre-intervention mapping study, and it tested no treatment. Do not conclude that larger or more excitable affected-hand motor maps mean better hand function; those measures were not associated with hand function.