Intervention-Related Changes in Motor Cortex GABA in Children with Perinatal Stroke
Date
2024-04-15
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Abstract
Perinatal stroke (PS) is a focal, vascular brain injury that often damages the motor system and can leave patients with lifelong motor disability in the form of hemiparetic cerebral palsy. Current treatment is limited to waiting for the appearance of clinical signs and rehabilitation therapy; however, non-invasive brain stimulation is an emerging area of interest for this population. Transcranial direct current stimulation (tDCS) is a safe, non-invasive method of applying weak electrical current to the brain to enhance motor learning. How tDCS may alter motor cortex chemistry is unclear, however magnetic resonance spectroscopy (MRS) allows us to study brain metabolites and their changes in vivo. It is unknown how γ-aminobutyric acid (GABA), a primary inhibitory neurotransmitter may be altered in the motor cortices of children with PS and how it may change following intervention. Our study investigated the underlying neurochemical changes in children with perinatal stroke following intensive motor therapy and non-invasive brain stimulation interventions. Of those who were recruited and completed the Stimulation for Optimizing Perinatal Stroke Optimizing Recovery Trajectories (SPORT) Trial, data from 49 participants was used in this study. Trial participants (6-18 years) attended a two-week day-camp which included intensive individual motor therapy as well as were randomized to receive either active cathodal or sham tDCS. Motor function assessments and neuroimaging using MRI, including MRS, was completed at baseline, post-intervention, and 6-months following intervention. At baseline and post-intervention, GABA between hemispheres were different (p<0.001; p=0.044 respectively), and at the 6-month follow-up GABA was not different. Motor function significantly increased following the camp (p<0.001), however there was no correlation of GABA to the objective measures of motor function. There was no observed effect of tDCS on GABA over time. This project contributes to an understanding of GABA levels and other brain metabolites in children with perinatal stroke at baseline and following intensive motor therapy and tDCS interventions. Our results support the use of motor therapy for improving motor function in children with PS, however the potential effects of tDCS intervention warrant further investigation.
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Keywords
Neurodevelopment, Perinatal stroke, Cerebral palsy, Magnetic resonance spectroscopy, GABA, Transcranial direct current stimulation
Citation
Hart, P. M. B. (2024). Intervention-related changes in motor cortex GABA in children with perinatal stroke (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.