New rehabilitation programs based on action observation therapy (AOT) are effective in improving motor function in children with congenital hemiplegia. In this pilot study we tested the potential effects of AOT on the reorganization of the motor system by functional magnetic resonance imaging (fMRI). As part of a randomized trial, eight subjects (age range: 6.2–14.5 years) with congenital hemiplegia were randomly assigned to an experimental (EG) or control (CG) group. All children underwent a clinical and neurophysiological assessment with Assisting Hand Assessment (AHA), MRI, and fMRI at baseline (T0), 1(T1), and 8(T2) weeks after the end of 3‐week treatment. For the EG, AOT consisted in the observation of uni/bimanual goal‐directed actions followed by their execution. CG watched same‐duration computer games and then performed the same actions in the same order used in the EG. fMRI study was carried out using two different paradigms, for exploring sensory‐motor network (SMN) localization and action observation network (AON). The pattern of brain activation was generally similar between T0 and T1 for both groups, while it was more widespread at T2, compared to T0 and T1, in the EG. This enlargement was coupled with functional improvement at AHA. Single‐subject analysis shows a reduction of lateralization indexes both for the AON and the SMN. This pilot study, despite the small sample, showed the fMRI feasibility for providing relevant biomarkers of brain plasticity for monitoring the AOT response in children with congenital hemiplegia. The study was registered at http://www.clinicaltrials.gov (identifier NCT01016496).

中文翻译：

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先天性偏瘫儿童动作观察治疗后动作观察和感觉运动网络的重组：一项初步研究

基于行动观察疗法 (AOT) 的新康复计划可有效改善先天性偏瘫儿童的运动功能。在这项初步研究中，我们通过功能磁共振成像 (fMRI) 测试了 AOT 对运动系统重组的潜在影响。作为随机试验的一部分，八名先天性偏瘫受试者（年龄范围：6.2-14.5 岁）被随机分配到实验 (EG) 或对照组 (CG)。在 3 周治疗结束后的基线 (T0)、1(T1) 和 8(T2) 周，所有儿童都接受了辅助手评估 (AHA)、MRI 和 fMRI 的临床和神经生理学评估。对于 EG，AOT 包括观察单/双手目标导向的动作，然后执行。CG 观看相同时长的电脑游戏，然后按照 EG 中使用的相同顺序执行相同的动作。fMRI 研究使用两种不同的范式进行，用于探索感觉运动网络 (SMN) 定位和动作观察网络 (AON)。两组的 T0 和 T1 之间的大脑激活模式通常相似，而在 EG 中，与 T0 和 T1 相比，T2 的脑激活模式更为普遍。这种扩大与 AHA 的功能改善相结合。单受试者分析显示 AON 和 SMN 的侧化指数均降低。尽管样本量很小，但这项初步研究表明，fMRI 可以提供大脑可塑性的相关生物标志物，以监测先天性偏瘫儿童的 AOT 反应。该研究在 http://www.clinicaltrials 上注册。