Cerebral Palsy (CP), a common form of neurological pediatric disability, results from pre- or perinatal brain injury. Although there is growing evidence of the efficacy of motor learning-based therapies, several factors interact to produce variability in impairment and limit the effectiveness of these therapies. The variability of hand function present in children with CP indicates that a range of developmental pathways must contribute to the manifestation of individually unique characteristics of impairment. Despite two decades of progress using therapies derived from understanding the mechanisms controlling hand function, very little is known about the sensorimotor experiences occurring during development that likely shape later functional problems for children with CP. In this "perspective" paper, we propose that the study of the development of motor skills in typically developing infants may reveal experiential factors potentially important for creating remedial therapies for children with CP. Specifically, we use the development of infant handedness, a model of hemispheric specialization of function, as an example of how self-generated experiences and sensorimotor feedback can shape the development of limb control and hemispheric specialization. We illustrate how early sensorimotor asymmetries concatenate into pronounced differences in skill between the two hands. We suggest that this model of infant handedness provides a framework for studying the individual differences manifested in children with CP. These differences likely arise from aberrant sensorimotor experiences created by sensorimotor circuits disrupted by the early brain injury. We conclude that knowledge of the developmental events, including subtle motor behaviors, that shape sensorimotor pathways, can improve treatment options for children with CP.

中文翻译：

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关于半球专业化，婴儿惯性和脑瘫发展的观点。

脑瘫（CP）是神经性儿科残疾的一种常见形式，由产前或围产期脑损伤引起。尽管越来越多的证据表明基于运动学习的疗法的有效性，但仍有多种因素相互作用，导致损伤的变异性并限制了这些疗法的有效性。患有CP的儿童中手功能的可变性表明，一系列发育途径必须有助于表现出个体独特的损伤特征。尽管使用二十年来通过了解控制手部功能的机制获得的治疗方法取得了进展，但对发育过程中发生的感觉运动体验知之甚少，这可能会影响CP儿童的以后的功能问题。在这份“观点”论文中，我们建议对典型发育中的婴儿的运动技能发展进行的研究可能揭示出经验因素，这些经验因素可能对为CP儿童制定治疗方法很重要。具体来说，我们使用婴儿惯用性的发展（一种功能的半球专业化模型）作为自我生成的经验和感觉运动反馈如何影响肢体控制和半球专业化发展的示例。我们说明了早期的感觉运动不对称如何串联成两只手之间明显的技能差异。我们建议这种婴儿惯用手法模型为研究CP儿童所表现出的个体差异提供了一个框架。这些差异可能是由于早期脑损伤破坏了感觉运动回路所产生的异常感觉运动经历所致。我们得出的结论是，对发展事件的了解，包括微妙的运动行为，可以影响感觉运动通路，可以改善患有CP的儿童的治疗选择。