Aim: To map and critically appraise the literature on the feasibility and current use of functional near‐infrared spectroscopy (fNIRS) to assess cortical activity, functional connectivity, and neuroplasticity in individuals with cerebral palsy (CP).Method: A scoping review methodology was prospectively registered and reported following Preferred Reporting Items for Systematic review and Meta‐Analysis Extension for Scoping Reviews (PRISMA‐ScR) guidelines. A systematic search was conducted in four databases. Empirical studies using fNIRS to assess neural activity, functional connectivity, or neuroplasticity in individuals with CP aged 3 years or older were included.Results: Sixteen studies met the inclusion criteria. Individuals with CP (age range = 3–43 years; 70% unilateral CP) underwent fNIRS‐based assessment for task‐evoked activity (studies [n] = 15) and/or resting‐state functional connectivity (n = 3). Preliminary observations suggest greater magnitude, extent, and ipsilateral hemispheric lateralization of sensorimotor cortex activity in CP, while magnitude and patterns of prefrontal cortex activity in CP appear dependent on task demands. Normalization of fNIRS‐based activity metrics observed postintervention (n = 3) paralleled improvements in functional outcomes, highlighting their potential as promising biomarkers for functional gains in CP.Interpretation: This review details the use of fNIRS in CP, highlights research gaps and technical limitations, and offers recommendations to support fNIRS implementation for ecologically valid functional neuroimaging in individuals with CP.

Background: Early motor development is fundamental in driving cognitive skill acquisition. Motor delays in children with cerebral palsy (CP) often limit exploratory behaviors, decreasing opportunities or the quality of cognitive development, emphasizing the importance of early intervention. This study aimed to assess immediate and 5-month motor and cognitive changes in infants and toddlers at risk of or with CP after participation in a community-based program. Methods: Twenty-two children (mean age: 22 ± 7 months) classified using the Gross Motor Function Classification System (GMFCS) and mini-Manual Ability Classification System (mini-MACS) participated in a 6-day community-based activity program, with outcomes assessed using the Developmental Assessment of Young Children (DAYC-2). Results: Participants who met their motor goals post-participation had significantly higher cognitive scores (p = 0.006) 5 months after the program. Participants with higher functional motor abilities (GMFCS levels I–II, p = 0.052; mini-MACS levels I–II, p = 0.004) demonstrated better cognitive scores at 5 months, adjusted for baseline scores, than those with lower functional motor abilities. Conclusions: This study highlights the impact of motor improvements following an evidence-based community program on later cognitive development. Prospective studies investigating the mechanisms and mediation of cognitive progress in children with CP should investigate the effects of early motor interventions on long-term developmental trajectories.

Somatosensory dysfunction contributes substantially to mobility impairments in cerebral palsy (CP), yet their somatosensory cortical responses to rhythmic sustained input remains unstudied. This study examined somatosensory cortical entrainment in 28 ambulatory youth with CP (Gross Motor Function Classification System levels I–III; 21.9±6.3y; 14 unilateral CP) and 34 neurotypical controls (23.4±3.8y). Participants underwent magnetoencephalography while an 8 Hz cutaneous electrical stimulation was applied to the right posterior tibial nerve. Rhythmic neural responses were mapped to the contralateral somatosensory cortices using beamforming, and virtual sensor time series were extracted to quantify neural dynamics. The entrainment response declined more steeply over time in CP compared to controls, whereas the concurrent alpha response strengthened progressively in CP but changed minimally in controls (Group×Time interactions, p s<.001). Significant cross-spectral coupling of entrainment×concurrent alpha responses was observed only in CP ( p <.001) and was most pronounced in those with bilateral CP. Weaker cross-spectral coupling was associated with better functional mobility in controls ( p =.004) but brain-behavior links in CP were phenotype-specific. Finally, the second harmonic neural response in CP was weaker ( p <.001) and demonstrated a blunted temporal modulation relative to controls ( p =.003). These findings implicate disrupted somatosensory cortical entrainment responses as possible neurophysiological features of youth with CP.