AIM To quantify the cervicomedullary motor evoked potentials (CMEPs) at the cervical spinal level in adults with cerebral palsy (CP) and determine if altered CMEPs are linked with upper-extremity motor function in this population. METHOD This cross-sectional study consisted of a cohort of adults with CP (n = 15; mean age = 33 years 5 months [SD = 11 years 8 months]); Manual Ability Classification System levels I-IV) and neurotypical controls (n = 18; mean age = 30 years 10 months [SD = 10 years 4 months]), who were recruited to participate at an academic medical center. Adults with CP and typical adults (controls) were stimulated at the cervicomedullary junction to assess CMEPs at the cervical spinal cord level. Upper-extremity motor function was quantified using the Box and Blocks and Purdue Pegboard tests, self-reported upper-extremity function (UEF), and assessments of selective motor control. RESULTS At higher stimulation levels, the contralateral CMEP responses of adults with CP were different from typical adults (p = 0.032). Reduced CMEP was correlated with reduced upper-limb function, including worse performance on the Box and Blocks (rho = 0.625, p = 0.025) and Purdue Pegboard tests (rho = 0.701, p = 0.010), lower self-reported UEF (rho = 0.761, p = 0.009), and overall selective motor control (rho = 0.731, p = 0.007). INTERPRETATION Changes in the activation of spinal motoneurons through corticospinal pathways may have an important role in the altered upper-extremity motor function of individuals with CP.

中文翻译：

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将成人脑瘫患者的皮质脊髓束激活与上肢运动控制联系起来。

目的 量化脑瘫 (CP) 成人颈髓水平的颈髓运动诱发电位 (CMEP)，并确定 CMEP 的改变是否与该人群的上肢运动功能相关。方法 这项横断面研究由一组患有 CP 的成年人组成（n = 15；平均年龄 = 33 岁 5 个月 [SD = 11 岁 8 个月]）；手动能力分类系统 I-IV 级）和神经典型对照（n = 18；平均年龄 = 30 岁 10 个月 [SD = 10 岁 4 个月]），被招募参加学术医疗中心。患有 CP 的成人和典型成人（对照）在颈髓交界处受到刺激，以评估颈髓水平的 CMEP。使用 Box and Blocks 和 Purdue Pegboard 测试、自我报告的上肢功能 (UEF) 以及选择性运动控制的评估来量化上肢运动功能。结果 在较高的刺激水平下，患有 CP 的成人的对侧 CMEP 反应与典型成人不同 (p = 0.032)。CMEP 降低与上肢功能降低相关，包括 Box 和 Blocks 上的表现较差（rho = 0.625，p = 0.025）和普渡 Pegboard 测试（rho = 0.701，p = 0.010），自我报告的 UEF 较低（rho = 0.761，p = 0.009），以及整体选择性运动控制（rho = 0.731，p = 0.007）。解释 脊髓运动神经元通过皮质脊髓通路激活的变化可能在脑瘫患者上肢运动功能改变中发挥重要作用。