Brain Plasticity in Neonatal Brachial Plexus Palsies: Quantification and Comparison with Adults Brachial Plexus Injuries
Abstract
Abstract Purpose to compare two populations of brachial plexus palsies, one neonatal (NBPP) and the other traumatic (NNBPP) who underwent different nerve transfers, using the Plasticity Grading Scale (PGS) for detecting differences in brain plasticity between both groups. Methods To be included, all patients had to have undergone a nerve transfer as the unique procedure to recover one lost function. The primary outcome was the PGS score. We also assessed patient compliance to rehabilitation using the Rehabilitation Quality Scale (RQS). Statistical analysis of all variables was performed. A p ≤ 0.050 set as criterion for statistical significance. Results a total of 153 NNBPP patients and 35 NBPP babies (with 38 nerve transfers) met the inclusion criteria. The mean age at surgery of the NBPP group was 9 months (SD 5.42, range 4 to 23 months. The mean age of NNBPP patients was 22 years (SD 12 years, range 3 to 69). They were operated around sixth months after the trauma. All transfers performed in NBPP patients had a maximum PGS score of 4. This was not the case for the NNBPP population, that reached a PGS score of 4 in approximately 20% of the cases. This difference was statistically significant (p < 0.001). The RQS was not significantly different between groups Conclusion We found that babies with NBPP have a significantly greater capacity for plastic rewiring than adults with NNBPP. The brain in the very young patient can process the changes induced by the peripheral nerve transfer better than in adults.
Authors 7
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Leiden University · Universidad de Buenos Aires
Affiliation as printed
University of Buenos Aires School of Medicine
Gonzalo Bonilla University of Buenos Aires School of Medicine Ana Lovaglio University of Buenos Aires School of Medicine Danilo Battaglia
Universidad Abierta Interamericana Martijn Malessy Leiden University
University of Buenos Aires School of Medicine Gilda di Masi
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Affiliation as printed
University of Buenos Aires School of Medicine
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Affiliation as printed
University of Buenos Aires School of Medicine
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Affiliation as printed
University of Buenos Aires School of Medicine
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Affiliation as printed
University of Buenos Aires School of Medicine
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Roberto Rosler Aachen
Leiden University · Universidad de Buenos Aires · Universidad Abierta Interamericana
Affiliation as printed
Universidad Abierta Interamericana
Gonzalo Bonilla University of Buenos Aires School of Medicine Ana Lovaglio University of Buenos Aires School of Medicine Danilo Battaglia
Universidad Abierta Interamericana Martijn Malessy Leiden University
University of Buenos Aires School of Medicine
University of Buenos Aires School of Medicine Gilda di Masi
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Martijn J. A. Malessy Aachen
Affiliation as printed
Leiden University
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