Neural activation within the prefrontal cortices during the goal-directed motor actions of children with hemiplegic cerebral palsy

The primary aim of the study was to explore the prefrontal cortical (PFC) activation while performing a shape-matching motor task in children with hemiplegic cerebral palsy (HCP) as compared with typically developing (TD) children. Fifteen TD children (age = 5.9 × 1.1 years) and 12 children with HCP (age = 6.8 × 2.9 years) were included. We assessed the PFC activation while performing an ecologically valid upper extremity shape-matching task of different complexities by measuring the concentration of oxygenated hemoglobin (HbO) using functional near-infrared spectroscopy. The motor task performance was assessed by quantifying the average number of shapes matched, reaction time (RT), task errors, nine-hole peg test (NHPT), and the box and block test (BBT). Overall, there was a systematic increase in the HbO in the PFC across the shape-matching complexity conditions. Our results also revealed that the children with HCP had an increased amount of PFC activation while performing all of the shape-matching tasks. The increased PFC activation paralleled the differences in the number of shapes matched, RT, task errors, NHPT, and BBT. The atypical motor actions seen in children with HCP may be partially related to the greater cognitive demands placed on the PFC.