Understanding Brain Reorganization in Infants With Perinatal Stroke Through Neuroexcitability and Neuroimaging

Abstract

Purpose: The primary aim of this proposed study is to evaluate brain reorganization patterns in infants with perinatal stroke between 3 and 5 months of age using transcranial magnetic stimulation and magnetic resonance imaging, with the addition of the General Movements Assessment. A secondary aim is to demonstrate feasibility and safety of infant-appropriate brain assessment protocols.

Methods: Ten infants with perinatal stroke will be enrolled. In this exploratory study, infants will first receive magnetic resonance imaging scanning during natural sleep to examine their corticospinal tract integrity. Infants will then receive transcranial magnetic stimulation to assess their corticomotor excitability. A General Movements Assessment video of at least 5 minutes will also be recorded.

Discussion: Study results will enhance our understanding of brain reorganization in infants with perinatal stroke. We expect these results will also guide the development of early interventions designed to mitigate maladaptive neuroplastic changes and improve long-term motor outcomes.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1

Caregivers will be asked to interact with infants by showing a toy or holding the infant’s hands to facilitate wrist flexor contraction and to trigger transcranial magnetic stimulation pulses. (Demonstration picture)

Fig. 2

EMG activity when the infant’s arm was slightly constrained. (A) Biceps resting EMG activity between ±10 and ±20 μV; (B) wrist flexor with resting EMG activity between ±10 and ±20 μV; and (C) biceps EMG activity with cardiac artifact when bilateral signals were being collected simultaneously. EMG indicates electromyography.