Assessment of cortical activity, functional connectivity, and neuroplasticity in cerebral palsy using functional near-infrared spectroscopy: A scoping review

Abstract

Cerebral palsy (CP) is caused by an early brain injury and can lead to lifelong movement challenges. Understanding brain function in CP is important for designing effective treatments, but traditional brain imaging methods are costly, require children to stay still, and cannot measure brain activity during real-world tasks.

This review examined how functional near-infrared spectroscopy (fNIRS), an innovative tool that uses light to measure brain activity, contributes to understanding brain function in individuals with CP. Unlike conventional imaging, fNIRS is child-friendly, portable, and affordable, making it ideal for studying brain activity in everyday settings. Sixteen studies that used fNIRS in children and adults with CP aged 3 to 43 years were analyzed.

Key findings included: (1) Brain activity in individuals with CP is different from typically developing peers, even during simple movements. (2) Higher activity in motor regions of the brain often reflect more severe movement difficulties. (3) Therapy-induced changes in brain activity are frequently linked to functional improvements.

Despite its benefits, fNIRS has limitations. It cannot assess brain structure or activity of the deeper regions of the brain, and data collection can be challenging for individuals with darker skin tones or thick hair. Other challenges include small study sizes, inconsistent research methods, uncertain reliability, and underrepresentation of individuals with severe CP, making comparisons with other studies difficult.

The authors recommend larger, standardized studies that involve families in study planning and design, and include individuals with severe CP. They also suggest using fNIRS to study brain activity during real-world tasks (such as playing or walking in everyday settings at home or in therapy clinics) to address practical challenges and reflect the needs of people living with CP.