• Katerina Gaberova, Iliyana Pacheva, and Ivan Ivanov.
• Department of Pediatrics, St. George University Hospital, Plovdiv, Bulgaria.
• J Eval Clin Pract. 2018 Aug 1; 24 (4): 839850839-850.

RationaleFunctional magnetic resonance imaging (fMRI) is used widely to study reorganization after early brain injuries. Unilateral cerebral palsy (UCP) is an appealing model for studying brain plasticity by fMRI.AimTo summarize the results of task-related fMRI studies in UCP in order to get better understanding of the mechanism of neuroplasticity of the developing brain and its reorganization potential and better translation of this knowledge to clinical practice.MethodsA systematic search was conducted on the PubMed database by keywords: "cerebral palsy", "congenital hemiparesis", "unilateral", "Magnetic resonance imaging" , "fMRI", "reorganization", and "plasticity" The exclusion criteria were as follows: case reports; reviews; studies exploring non-UCP patients; and studies with results of rehabilitation.ResultsWe found 7 articles investigated sensory tasks; 9 studies-motor tasks; 12 studies-speech tasks. Ipsilesional reorganization is dominant in sensory tasks (in 74/77 patients), contralesional-in only 3/77. In motor tasks, bilateral activation is found in 64/83, only contralesional-in 11/83, and only ipsilesional-8/83. Speech perception is bilateral in 35/51, only or dominantly ipsilesional (left-sided) in 8/51, and dominantly contralesional (right-sided) in 8/51. Speech production is only or dominantly contralesional (right-sided) in 88/130, bilateral-26/130, and only or dominantly ipsilesional (left-sided)-in 16/130.DiscussionThe sensory system is the most "rigid" to reorganization probably due to absence of ipsilateral (contralesional) primary somatosensory representation. The motor system is more "flexible" due to ipsilateral (contralesional) motor pathways. The speech perception and production show greater flexibility resulting in more bilateral or contralateral activation.ConclusionsThe models of reorganization are variable, depending on the development and function of each neural system and the extent and timing of the damage. The plasticity patterns may guide therapeutic intervention and prognostics, thus proving the fruitiness of the translational approach in neurosciences.© 2018 John Wiley & Sons, Ltd.

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