Structural connectivity changes of primary motor cortex after TMS in cerebral palsy assessed by DTI and non-negative matrix factorization

Motivation: Spastic cerebral palsy (SCP) causes motor dysfunction due to brain damage, with TMS as a potential therapeutic tool. The effects of TMS on structural connectivity remain poorly understood. Goal(s): To evaluate structural connectivity changes in the precentral gyrus of children with SCP before and after TMS treatment using DTI and non-negative matrix factorization (NMF). Approach: Three children with SCP underwent MRI scans before and after a 4-week TMS course. Connectivity changes were analyzed using DTI, probabilistic tractography, and NMF. Results: TMS treatment enhanced structural connectivity in the injured hemisphere, suggesting cortical reorganization, with no significant changes in the unaffected hemisphere. Impact: This study demonstrates that TMS induces structural reorganization in the precentral gyrus of children with spastic cerebral palsy, offering insights into its potential as a targeted neuroplasticity-driven therapeutic approach for motor function improvement.