Spatial Patterns of Whole Brain Grey and White Matter Injury in Patients with Occult Spastic Diplegic Cerebral Palsy

Abstract

Spastic diplegic cerebral palsy(SDCP)is a common type of cerebral palsy (CP), which presents as a group of motor-impairment syndromes. Previous conventional MRI studies have reported abnormal structural changes in SDCP, such as periventricular leucomalacia. However, there are roughly 27.8% SDCP patients presenting normal appearance in conventional MRI, which were considered as occult SDCP. In this study, sixteen patients with occult SDCP and 16 age- and sex-matched healthy control subjects were collected and the data were acquired on a 3T MR system. We applied voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis to investigate whole brain grey and white matter injury in occult SDCP. By using VBM method, the grey matter volume reduction was revealed in the bilateral basal ganglia regions, thalamus, insula, and left cerebral peduncle, whereas the white matter atrophy was found to be located in the posterior part of corpus callosum and right posterior corona radiata in the occult SDCP patients. By using TBSS, reduced fractional anisotropy (FA) values were detected in multiple white matter regions, including bilateral white matter tracts in prefrontal lobe, temporal lobe, internal and external capsule, corpus callosum, cingulum, thalamus, brainstem and cerebellum. Additionally, several regions of white matter tracts injury were found to be significantly correlated with motor dysfunction. These results collectively revealed the spatial patterns of whole brain grey and white matter injury in occult SDCP.

Relationship between characteristics on magnetic resonance imaging and motor outcomes in children with cerebral palsy and white matter injury

“…Research using diffusion parameters has been able to demonstrate correlation between abnormality in individual WM tracts, believed to reflect abnormal microstructural connectivity, and clinical outcomes (Counsell et al, 2008;Estep et al, 2014;Lee et al, 2011). Thus, a brain that looks normal on conventional imaging may still have injury to WM tracts demonstrated using these or other quantitative techniques (Mu et al, 2014;Scheck, Pannek, Fiori, Boyd, & Rose, 2014). Unfortunately, however, these techniques are not routinely available clinically, at least in Australia, and are mainly used in the research context.…”

Altered regional and circuit resting-state activity in patients with occult spastic diplegic cerebral palsy

“…Previous MRI study employed voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) to detect whole brain gray and white matter injury in patients with occult SDCP. 7 The VBM analysis revealed gray matter atrophy in the bilateral basal ganglia regions, thalamus, insula, and left cerebral peduncle, and white matter atrophy in the posterior part of the corpus callosum and right posterior corona radiata in occult SDCP patients. Using the voxelbased DTI method, reduced fractional anisotropy (FA) values were detected in multiple white matter regions.…”

Developmental Features of Corpus Callosum in Children Revealed by MRI

“…Несмотря на развитие и широкое исполь-зование методов нейровизуализации, к на-стоящему времени отсутствует общепринятая классификация структурных нарушений мозга при ДЦП [12,25,30]. Различные варианты по-ражения белого вещества при этом заболевании встречаются наиболее часто (в 32,9 % случаев) и привлекают исследователей в связи с использо-ванием в качестве возможного прогностического маркера [25,30,43].…”

“…Различные варианты по-ражения белого вещества при этом заболевании встречаются наиболее часто (в 32,9 % случаев) и привлекают исследователей в связи с использо-ванием в качестве возможного прогностического маркера [25,30,43]. К самым чувствительным маркерам деструктивных процессов в централь-ной нервной системе при ДЦП относят мозолистое тело и кортикоспинальный тракт [18,27,41].…”