Abstract Details

Title Functional Connectivity among Resting State Networks Increases after Constraint-Induced Movement Therapy in Children with Brain Injury

Topic Neural Repair/Rehabilitation

Presentation(s) S14 - (-)

Poster/Presentation
Number 003

Objective

Background CIMT, a combination of a restraint in the use of the unimpaired limb and intensive training of the affected one, is a strategy to improve upper limb function in pediatric patients with brain injury.

Design/Methods From 14 children with acquired or congenital brain injury and 10 sex- and age-matched healthy controls, RS fMRI data were acquired before CIMT (baseline), at the end of CIMT (week 10) and after 6 months. Independent component analysis was used to identify functionally relevant RS networks (RSN). The Functional network connectivity (FNC) toolbox was used to assess significant interactions among RSNs at baseline, and changes of association between networks at the two follow-up evaluations. Correlations between network connectivity and clinical scores were also assessed.

Results Patients had a significant improvement at clinical scales at the end of CIMT and a further amelioration 6 months after termination of therapy. At baseline, several connections among RSNs, which were significant in healthy controls, were not present in pediatric patients. Specifically, no connectivity was found between the sensorimotor and the visual networks, and between these networks and both the default mode (DM) and salience networks. No connectivity was also found between the auditory, executive control (ECN) and working memory networks. At week 10, patients showed a significantly increased connectivity among several RSNs, which mainly involved the sensorimotor (p=range 0.001-0.01), visual (p=range 0.001-0.04) and DM (p=range 0.001-0.03) networks. These changes were significantly correlated with improvement at clinical scores following CIMT (r=range 0.58-0.80, p=0.002-0.04). This pattern of increased connectivity among RSNs persisted after 6 months.

Conclusions An increase of inter-network connectivity might contribute to explain clinical improvement in pediatric patients with chronic hemiplegia following CIMT.

Authors/Disclosures
Maria A. Rocca (Neuroimaging Research Unit) PRESENTER	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
	No disclosure on file
Bradley C. Hiner, MD (Link Neurosciences Institute)	No disclosure on file
	No disclosure on file
Paola Valsasina	No disclosure on file
Martina Absinta, MD	Dr. Absinta has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Absinta has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abata Therapeutics. The institution of Dr. Absinta has received research support from International MS Alliance. The institution of Dr. Absinta has received research support from FRRB Early Career Award. The institution of Dr. Absinta has received research support from Cariplo Foundation.
	No disclosure on file
	No disclosure on file
Andrea Falini	No disclosure on file
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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