Kolobe THA1, Fagg A2, Miller D3, Ding L4
1University of Oklahoma Health Sciences Center, Department of Rehabilitation Sciences, Oklahoma City, United States, 2University of Oklahoma, School of Computer Science, Norman, United States, 3University of Oklahoma, School of Aerospace and Mechanical Engineering, Norman, United States, 4University of Oklahoma, Institute for Biomedical Engineering, Science and Technology, Norman, United States
Background: Research suggests that interventions that produce sustained gains tend to be those that also show changes in brain structure and functioning, however, the brain-behavior relationship during motor development or skill acquisition is poorly understood. Less clear are neural biomarkers of motor performance that can be used to measure change following intervention, or to distinguish between potential specific intervention responders or non-responders.
Purpose: This study examined the utility of electroencephalography (EEG) as a biomarker of motor performance by determining changes in brain activity and movement proficiency during the development of prone locomotion, comparing differences between intervention modes, and between infants with and without Cerebral Palsy (CP).
Methods: We employed repeated measure design with twenty-two 4-5 month old infants with CP and without (TD), who were a part of a larger study on prone locomotion training using the Self-initiated Prone Progression Crawler (SIPPC) robotic system. The TD group (17) was further assigned to three SIPPC training modes resulting in four comparison groups. The study protocol involved weekly baseline recording of the infants' brain activity for 5 minutes using a 124 channels EEG followed by videotaped training in prone locomotion on the SIPPC for 15 minutes bi-weekly for 16 weeks. Movement proficiency scores were coded from the videotaped performance using the Movement Observation Coding System (MOCS). We used repeated measures ANOVA to compare weekly MOCS scores and EEG power densities. The power densities were plotted spectrally and spatially.
Results: The results showed progressively increasing mean MOCS motor proficiency scores over time, with the largest mean change in the TD groups (p 0.01) compared to CP group (p 0.08). Similarly, for the TD groups, the EEG peak distributions showed increasingly higher peak frequencies and mu rhythm shift from 6.6 Hz to 7.3 Hz at 5 to 8 months. Small differences between the TD groups were noted in the alpha, delta, and theta band activity. In contrast, the results of the infants with CP revealed large weekly fluctuations that prevented aggregating EEG data but allowed close inspection. The mu rhythm activity, which emerged around 5 months in the TD group, emerged around 7 months in CP group and showed different distribution patterns.
Conclusion(s): Progressive shifts towards higher alpha and theta band peak frequency and mu-rhythm were consistent with trends in the movement proficiency change scores. However, these preliminary findings revealed important information regarding the potential for EEG as a biomarker of performance and to determine intervention effects that implicate age, type and timing of intervention, type of brain insult, and analytic approaches. Our results also revealed changes in the distribution of EEG rhythmic activity in different parts of the motor cortex that merit further exploration.
Implications: Besides monitoring brain performance during development, a combination of changes in the various EEG rhythmic patterns and their distribution may inform activity-dependent neuroplasticity studies and distinguish potential treatment responders and non-responders.
Keywords: Cerebral Palsy, EEG, Infants
Funding acknowledgements: -
This study was partially funded the National Science Foundation NRI #1208639.
We also acknowledge Patino, testers, coders, and families.
Purpose: This study examined the utility of electroencephalography (EEG) as a biomarker of motor performance by determining changes in brain activity and movement proficiency during the development of prone locomotion, comparing differences between intervention modes, and between infants with and without Cerebral Palsy (CP).
Methods: We employed repeated measure design with twenty-two 4-5 month old infants with CP and without (TD), who were a part of a larger study on prone locomotion training using the Self-initiated Prone Progression Crawler (SIPPC) robotic system. The TD group (17) was further assigned to three SIPPC training modes resulting in four comparison groups. The study protocol involved weekly baseline recording of the infants' brain activity for 5 minutes using a 124 channels EEG followed by videotaped training in prone locomotion on the SIPPC for 15 minutes bi-weekly for 16 weeks. Movement proficiency scores were coded from the videotaped performance using the Movement Observation Coding System (MOCS). We used repeated measures ANOVA to compare weekly MOCS scores and EEG power densities. The power densities were plotted spectrally and spatially.
Results: The results showed progressively increasing mean MOCS motor proficiency scores over time, with the largest mean change in the TD groups (p 0.01) compared to CP group (p 0.08). Similarly, for the TD groups, the EEG peak distributions showed increasingly higher peak frequencies and mu rhythm shift from 6.6 Hz to 7.3 Hz at 5 to 8 months. Small differences between the TD groups were noted in the alpha, delta, and theta band activity. In contrast, the results of the infants with CP revealed large weekly fluctuations that prevented aggregating EEG data but allowed close inspection. The mu rhythm activity, which emerged around 5 months in the TD group, emerged around 7 months in CP group and showed different distribution patterns.
Conclusion(s): Progressive shifts towards higher alpha and theta band peak frequency and mu-rhythm were consistent with trends in the movement proficiency change scores. However, these preliminary findings revealed important information regarding the potential for EEG as a biomarker of performance and to determine intervention effects that implicate age, type and timing of intervention, type of brain insult, and analytic approaches. Our results also revealed changes in the distribution of EEG rhythmic activity in different parts of the motor cortex that merit further exploration.
Implications: Besides monitoring brain performance during development, a combination of changes in the various EEG rhythmic patterns and their distribution may inform activity-dependent neuroplasticity studies and distinguish potential treatment responders and non-responders.
Keywords: Cerebral Palsy, EEG, Infants
Funding acknowledgements: -
This study was partially funded the National Science Foundation NRI #1208639.
We also acknowledge Patino, testers, coders, and families.
Topic: Paediatrics; Robotics & technology; Research methodology & knowledge translation
Ethics approval required: Yes
Institution: University of Oklahoma Health Sciences Center
Ethics committee: IRB Board 4
Ethics number: 5120
All authors, affiliations and abstracts have been published as submitted.
