Interhemispheric interaction in the motor domain in children with cerebral palsy.

BACKGROUND The attention of pediatric specialists has been continuously attracted to the problem of cerebral palsy (CP) and the formation of behavioral and motor skills in the initial years of life in these patients. This work aimed at studying the specifics of intra- and interhemispheric connections in the motor domain in children with CP as well as their dynamics in the process of rehabilitation using hand/finger synkineses and and lateral profile as markers. MATERIALS AND METHODS A total of 215 children aged 4-7 years were recruited after obtaining their parents' consent, including 95 patients with the most prevalent forms of CP (spastic diplegia, hemiparetic form) who underwent complex treatment in a neuropsychological sanatorium and 120 healthy children from a kindergarten. Data were analyzed using nonparametric methods and the chi-square test with the help of the statistical program SPSS v.14. RESULTS Changes in the scores and types of synkinesis after rehabilitation indicated that in spastic diplegia the assumed symmetric brain defects were associated with uniform restoration of interhemispheric connections and less disturbance of intrahemispheric connections. In hemiplegia, on the contrary, misbalance in intrahemispheric connections prevailed and compensation was noticed only in left-hemispheric pathology. The magnitude, type, and improvement of hand synkineses in the course of treatment depended on the lateral phenotype. CONCLUSION Hand/finger synkineses in CP children change with rehabilitation. The methods used in the study can be recommended for application in the system of medico-biological and psycho-pedagogical monitoring of children with CP.