Obstetric Brachial Plexus Palsy: Can a Unilateral Birth Onset Peripheral Injury Significantly Affect Brain Development?

ABSTRACT

Purpose: Examine brain structure and function in OBPP and relate to clinical outcomes to better understand the effects of decreased motor activity on early brain development.

Methods: 9 OBPP, 7 controls underwent structural MRI scans. OBPP group completed evaluations of upper-limb function and functional near-infrared spectroscopy (fNIRS) during motor tasks.

Results: Mean primary motor area volume was lower in both OBPP hemispheres. No volume differences across sides seen within groups; however, Asymmetry Ratio in supplementary motor area differed between groups. Greater asymmetry in primary somatosensory area correlated with lower ABILHAND-Kids scores. fNIRS revealed more cortical activity in both hemispheres during affected arm reach.

Conclusion: Cortical volume differences or asymmetry were found in motor and sensory regions in OBPP that related to clinical outcomes. Widespread cortical activity in fNIRS during affected arm reach suggests reorganization in both hemispheres and is relevant to rehabilitation of those with developmental peripheral and brain injuries.

KEYWORDS:

• OBPP
• plasticity
• fNIRS
• MRI

Acknowledgments

Egmar Longo was funded by the J. William Fulbright Foreign Scholarship Board to be a visiting fellow at the Functional and Applied Biomechanics Section (FAB), National Institutes of Health (NIH) during this research. This project was also funded by the Intramural Research Program of the NIH Clinical Center (Protocol #13-CC-0110)

Conflicts of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

This work was supported by the J. William Fulbright Foreign Scholarship Board; the Intramural Research Program at the NIH Clinical Center.