The importance of brain mapping for rehabilitation in birth nonprogressive neuromuscular diseases

Front. Neuroimaging, 2024 · DOI: 10.3389/fnimg.2024.1359491 · Published: July 15, 2024

Simple Explanation

This review explores the use of brain mapping techniques like TMS and fMRI to understand how the brain adapts in individuals with motor disorders present from birth, specifically those affecting the spinal cord and peripheral nerves. The review compares these brain adaptations to those seen in people with similar motor conditions acquired later in life, revealing differences in how the brain organizes motor control. The insights gained from brain mapping can help in developing personalized neuromodulation therapies, which use targeted brain stimulation to improve motor recovery in children with these birth-related motor disorders.

Study Duration

Not specified

Participants

Individuals with nonprogressive motor disorders of nonbrain origin present at birth

Evidence Level

Review

Key Findings

1
Individuals with birth-related motor conditions exhibit unique central adaptation features compared to those with acquired conditions, such as nonsomatotopic presentation of involved muscles in the sensorimotor cortex.
2
Cortical reorganization occurs following injury to the spinal cord and peripheral nerves in birth motor disorders, leading to secondary changes in the sensorimotor cortex.
3
Studies on upper limb reduction defects (ULRDs) reveal that congenital motor deficits can lead to dramatic sensorimotor deficits, providing insight into cortical plasticity in OBPP.

Research Summary

This review emphasizes the scarcity of research on brain mapping in children with birth motor deficits of non-brain origin, highlighting a gap in the application of brain stimulation therapy despite surgical treatments. The review contrasts central adaptations between birth and acquired motor conditions to caution clinicians against directly applying existing knowledge from acquired disorders when designing neuromodulation therapy for birth disorders. A comprehensive approach targeting multiple sites (brain cortex, spinal cord, musculoskeletal apparatus) is suggested as the most effective strategy for intervening in deviant motor progression in children with birth motor deficits.

Practical Implications

Personalized Neuromodulation Therapy

Brain mapping can inform the development of personalized neuromodulation therapies to improve motor recovery.

Early Therapeutic Intervention

Early therapeutic intervention in childhood is crucial due to the heightened responsiveness of plastic processes.

Presurgical Evaluation

Motor mapping can facilitate the selection of the best muscle candidate for muscle transfer during presurgical evaluation.

Study Limitations

1
Scarce research on brain mapping in children with birth motor deficits of non-brain origin.
2
Lack of clear conclusions on neuroplastic dynamics in this patient population.
3
Limited application of brain stimulation therapy in this patient group despite surgical treatment.

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