Bimanual Skill Learning after Transcranial Direct Current Stimulation in Children with Unilateral Cerebral Palsy: A Brief Report

ABSTRACT

Bimanual skills are important for goal-oriented activities. Children with unilateral cerebral palsy (UCP) have deficits in unimanual and bimanual motor control and learning. The application of non-invasive brain stimulation with existing motor training may further promote motor learning; however, the effects of stimulation on bimanual learning have not been examined. Here, we assessed the performance of a novel bimanual skill (modified Speed Stacks task) in eight children with UCP before, during, and after a combined motor training and brain stimulation intervention. Participants received 10 days (120 min/day) of goal-oriented bimanual therapy combined initially with transcranial direct current stimulation (tDCS, 20 min/day). Results showed task improvement tapered (p < 0.001) during and after the intervention and task variability decreased in 6/8 participants, indicating the potential impact of novel rehabilitation to improve skill learning in children with UCP. Future work is required to understand how both tDCS and bimanual training contribute to learning bimanual tasks.

KEYWORDS:

• Bimanual learning
• unilateral cerebral palsy
• transcranial direct current stimulation

Acknowledgments

This study was supported the National Institutes of Health (NIH) Eunice Kennedy Shriver National Institutes of Child Health and Development K01 Award (HD078484-01A1), the Cerebral Palsy Foundation, the Foundation for Physical Therapy Magistro Family Grant, the University of Minnesota’s MnDRIVE (Minnesota’s Discovery, Research, and Innovation Economy) initiative, and the University of Minnesota Marie Louise Wales Fellowship. The project described was also supported in part by Award UL1 TR000114 and KL2 TR000113. The authors thank the Center for Neurobehavioral Development at the University of Minnesota, the student interventionists and the families, caregivers, and participants involved in this study. No potential conflict of interest is disclosed by the authors.

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [HD078484-01A1];University of Minnesota Marie Louise Wales Fellowship; University of Minnestoa’s MnDRIVE (Minnesota’s Discovery, Research, and Innovation Economy) initiative; Foundation for Physical Therapy Magistro Family Grant; Cerebral Palsy Foundation.