Eeg Modulation In Cerebral Palsy And Healthy Children During Action Observation

Compared To Execution
V. Pippo1, M. Bassolino1, V.Bergamaschi2, V. De Franchis2, C. Campus1, C.Tacchino2, P.Moretti2, T. Pozzo1, A. Inuggi1
1 Robotics,

Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy; 2 Physical Medicine and
Rehabilitation, Institute G. Gaslini, Genoa, Italy

Objectives:
The observation of actions (such as reaching and grasping movements) was proposed as a rehabilitation tool, for upper limb motor impairment
following stroke in adults 1 and in children affected by Cerebral Palsy (CP) 2. However, despites preliminary data in children demonstrated the
effectiveness of these rehabilitation protocols, the underlying neural mechanisms are still poorly understood. In this study we evaluate how
different parameters related to motor processing are jointly affected by CP, considering clinical and functional scales, as well as
neurophysiological measures.

Materials & Methods:

Rolandic mu rhythm is a spontaneous ~8-13 Hz electroencephalographic rhythm maximally recorded over sensorimotor area at rest. Mu rhythm is
attenuated or abolished by motor cortex activation, indeed by movement execution as better as AO 3.
We recruited 9 CP children (5 F, 4 M, mean age 8Y, SD 2Y ) and of
14 control healthy children (CC) (4 F, 6 M, mean age 10 Y, SD 2Y).
EEG analysis:
within the mu (7-13 Hz), beta 1 (13.5-17,5 Hz) and beta2 (1822 Hz) bands, the individual frequency showing the highest
desynchronization (ERD) to impaired movement execution
was calculated.
individually corrected ERD in primary, premotor and
secondary motor areas of both hemispheres.
We considered CP affected hand as non-dominant (A/ND) and the
unaffected hand as dominant (H/D) (11 CC were right handed, 3 CP
had left hemiparesis).

ACTION OBSERVATION

ACTION EXECUTION

We displayed the impaired hand Subjects performed a reaching and

to CP and Non-dominant hand
grasping movement with both
to healthy subjects.
hands.

EEG data of CC left handed or CP with right hemiparesis were swapped across the two hemispheres.
We investigated the GROUP x OBSERVED-ARM model through bootstrap analysis (30000 permutations, FDR correction).
CP children
MACS
Mean

MAS_HAND

1,89 0,78

0,11 0,33

AHA
0,86 0,11

MELBOURNE
RANGE
0,89 0,15

ACCURACY
0,98 0,07

DEXTERITY
0,84 0,15

FLUENCY
0,80 0,18

M/F

AGE

MV_DH

MV_NDH

METRO_DH
F

METRO_NDH

Te

WISC

Te

TOT

CC

7/15 0,52 8,93 2,15

3,8 0,7

3,3 0,6 0,5 0,1 79,6 236,2 0,7 0,1

12,8 172,7

127 12,1

CP

5/12 0,51 9,08 2,27

3,1 0,6

2,2 0,8 0,6 0,2 8,2 182,1 0,9 0,8

51,4 205,8

94,3 24,3

0,429

0,006

T-test

0,88

0,60

0,014

0,001

0,074

0,432

0,260

Results:
We found that both action execution and action observation elicited a mu desynchronization, not only in healthy controls, but,
importantly, also in CP children. The mu ERD during movement execution was stronger in CC than in CP.

Conclusions:
The fact that the mere observation of actions elicit cortical activations related to motor processing also IN children affected by CP
supports the role of this technique in rehabilitative protocols. Therefore, our data suggest that mu ERD may be used as reliable marker
of neural plasticity during action observation trainings.
1. Buccino G. Action observation treatment: a novel tool in neurorehabilitation. Philos Trans R Soc Lond B Biol Sci. 2014;369(1644):20130185.
2. Sgandurra G, Ferrari A, Cossu G, Guzzetta A, Fogassi L, Cioni G. Randomized trial of observation and execution of upper extremity actions versus
action alone in children with unilateral cerebral palsy. Neurorehabil Neural Repair. 2013;27(9):80815.
3. Muthukumaraswamy SD, Johnson BW. Changes in rolandic mu rhythm during observation of a precision grip. Psychophysiology. 2004;41(1):1526.
Valentina Pippo: valentina.pippo@iit.it; Alberto Inuggi: alberto.inuggi@iit.it

IRCCS
Giannina Gaslini