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Crotti M, Genoe S, Ben Itzhak N, Mailleux L, Ortibus E. The relation between neuroimaging and visual impairment in children and adolescents with cerebral palsy: A systematic review. Brain Dev 2024; 46:75-92. [PMID: 38016876 DOI: 10.1016/j.braindev.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE The structure-function relation between magnetic resonance imaging (MRI) and visual impairment (VI) in children with cerebral palsy (CP) has not been fully unravelled. The present systematic review aims to summarize the relation between brain lesions on MRI and VI in children and adolescents with CP. METHODS PubMed, Embase, Web of Science Core Collection, and Cochrane Database were systematically searched according to the PRISMA checklist. A total of 45 articles met the inclusion criteria. RESULTS White matter lesions were most frequently associated with VI. Only 25 studies described lesions within specific structures, mainly in the optic radiations. Only four studies reported on the thalamus. 8.4% of children with CP showed no brain abnormalities on MRI. Diffusion-weighted MRI studies showed that decreased structural connectivity in the optic radiations, superior longitudinal fasciculus, posterior limb of the internal capsule, and occipital lobe is associated with more severe VI. CONCLUSIONS All types of brain lesions lead to visual dysfunctions, arguing for a comprehensive visual assessment in all children with CP. Whereas white matter damage is a well-known contributor, the exact contribution of specific visual structures requires further investigation, to enable early prediction, detection, and intervention.
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Affiliation(s)
- Monica Crotti
- KU Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium; KU Leuven, Child and Youth Institute, B-3000 Leuven, Belgium.
| | - Sarah Genoe
- KU Leuven, Faculty of Medicine, B-3000 Leuven, Belgium.
| | - Nofar Ben Itzhak
- KU Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium; KU Leuven, Child and Youth Institute, B-3000 Leuven, Belgium.
| | - Lisa Mailleux
- KU Leuven, Child and Youth Institute, B-3000 Leuven, Belgium; KU Leuven, Department of Rehabilitation Sciences, Research group for Neurorehabilitation, B-3000 Leuven, Belgium.
| | - Els Ortibus
- KU Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium; KU Leuven, Child and Youth Institute, B-3000 Leuven, Belgium.
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2
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Galli J, Loi E, Franzoni A, Accorsi P, Micheletti S, Pansera L, Fazzi E. Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero. Neuropediatrics 2023; 54:412-416. [PMID: 37579766 DOI: 10.1055/s-0043-1771388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Methadone is used as a substitute for illicit opioids during pregnancy. However, the real effect of this molecule on visual and neurodevelopmental outcomes of the children exposed is not fully understood, since studies considered subjects born to polydrug-dependent mothers and followed for few months/years. We report the long-term outcomes of two infants with congenital nystagmus solely exposed to methadone in utero. Neurological and neurovisual evaluations were performed every year from the first year of life to 11 years of age. One child was diagnosed with developmental coordination disorder. Both cases presented with ophthalmologic (refractive errors), oculomotor (nystagmus and fixation, smooth pursuit, and saccades dysfunctions), and perceptive problems (reduced visual acuity and contrast sensitivity). While nystagmus and other oculomotor dysfunctions remained stable over time, visual acuity and contrast sensitivity improved; refractive errors worsened and required corrective lenses. Both children showed normal neurodevelopmental and cognitive profile. This report highlights the long-term visual and developmental outcomes of two children exclusively exposed to methadone underlining the possibility of a visual dysfunction and motor coordination disorder. These observations prompt the need to investigate prenatal drug exposure as a cause of congenital nystagmus.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Erika Loi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandra Franzoni
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Patrizia Accorsi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Laura Pansera
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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3
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Jacobs NPT, Pouwels PJW, van der Krogt MM, Meyns P, Zhu K, Nelissen L, Schoonmade LJ, Buizer AI, van de Pol LA. Brain structural and functional connectivity and network organization in cerebral palsy: A scoping review. Dev Med Child Neurol 2023. [PMID: 36750309 DOI: 10.1111/dmcn.15516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 02/09/2023]
Abstract
AIM To explore altered structural and functional connectivity and network organization in cerebral palsy (CP), by clinical CP subtype (unilateral spastic, bilateral spastic, dyskinetic, and ataxic CP). METHOD PubMed and Embase databases were systematically searched. Extracted data included clinical characteristics, analyses, outcome measures, and results. RESULTS Sixty-five studies were included, of which 50 investigated structural connectivity, and 20 investigated functional connectivity using functional magnetic resonance imaging (14 studies) or electroencephalography (six studies). Five of the 50 studies of structural connectivity and one of 14 of functional connectivity investigated whole-brain network organization. Most studies included patients with unilateral spastic CP; none included ataxic CP. INTERPRETATION Differences in structural and functional connectivity were observed between investigated clinical CP subtypes and typically developing individuals on a wide variety of measures, including efferent, afferent, interhemispheric, and intrahemispheric connections. Directions for future research include extending knowledge in underrepresented CP subtypes and methodologies, evaluating the prognostic potential of specific connectivity and network measures in neonates, and understanding therapeutic effects on brain connectivity.
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Affiliation(s)
- Nina P T Jacobs
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Petra J W Pouwels
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Marjolein M van der Krogt
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Pieter Meyns
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Kangdi Zhu
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Loïs Nelissen
- Department of Pediatric Neurology, Emma Children's Hospital, Amsterdam UMC, location Vrije Universiteit, Amsterdam, the Netherlands
| | - Linda J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.,Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Laura A van de Pol
- Department of Pediatric Neurology, Emma Children's Hospital, Amsterdam UMC, location Vrije Universiteit, Amsterdam, the Netherlands
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4
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Galli J, Loi E, Strobio C, Micheletti S, Martelli P, Merabet LB, Pasini N, Semeraro F, Fazzi E. Neurovisual profile in children affected by Angelman syndrome. Brain Dev 2023; 45:117-125. [PMID: 36344336 DOI: 10.1016/j.braindev.2022.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/09/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Angelman syndrome (AS) is a rare neurogenetic disorder caused by altered expression of the maternal copy of the UBE3A gene. Together with motor, cognitive, and speech impairment, ophthalmological findings including strabismus, and ocular fundus hypopigmentation characterize the clinical phenotype. The aim of this study was to detail the neurovisual profile of children affected by AS and to explore any possible genotype-phenotype correlations. METHODS Thirty-seven children (23 females, mean age 102.8 ± 54.4 months, age range 22 to 251 months) with molecular confirmed diagnosis of AS were enrolled in the study. All underwent a comprehensive video-recorded neurovisual evaluation including the assessment of ophthalmological aspects, oculomotor functions, and basic visual abilities. RESULTS All children had visual impairments mainly characterized by refractive errors, ocular fundus changes, strabismus, discontinuous/jerky smooth pursuit and altered saccadic movements, and/or reduced visual acuity. Comparing the neurovisual profiles between the deletion and non-deletion genetic subgroups, we found a significant statistical correlation between genotype and ocular fundus hypopigmentation (p = 0.03), discontinuous smooth pursuit (p < 0.05), and contrast sensitivity abnormalities (p < 0.01) being more frequent in the deletion subgroup. CONCLUSIONS Subjects affected by AS present a wide spectrum of neurovisual impairments that lead to a clinical profile consistent with cerebral visual impairment (CVI). Moreover, subjects with a chromosome deletion show a more severe visual phenotype with respect to ocular fundus changes, smooth pursuit movements, and contrast sensitivity. Early detection of these impaired visual functions may help promote the introduction of neurovisual habilitative programs which can improve children's visual, neuromotor, and cognitive outcomes.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Caterina Strobio
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Paola Martelli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Nadia Pasini
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Italy
| | - Francesco Semeraro
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Italy; University of Brescia, Eye Clinic, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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5
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Galli J, Loi E, Molinaro A, Calza S, Franzoni A, Micheletti S, Rossi A, Semeraro F, Fazzi E. Age-Related Effects on the Spectrum of Cerebral Visual Impairment in Children With Cerebral Palsy. Front Hum Neurosci 2022; 16:750464. [PMID: 35308614 PMCID: PMC8924515 DOI: 10.3389/fnhum.2022.750464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Cerebral Visual Impairment (CVI) is a very common finding in children affected by Cerebral Palsy (CP). In this paper we studied the characteristics of CVI of a large group of children with CP and CVI, describing their neurovisual profiles according to three different age subgroups (subgroup 1: infants 6 months–2 years; subgroup 2: pre-school age 3–5 years; subgroup 3: school age ≥ 6 years). Methods We enrolled 180 subjects (104 males, mean age 66 ± 42.6 months; range 6–192 months) with CP and CVI for the study. We carried out a demographic and clinical data collection, neurological examination, developmental or cognitive assessment, and a video-recorded visual function assessment including an evaluation of ophthalmological characteristics, oculomotor functions, and basic visual functions. In school-aged children, we also performed an evaluation of their cognitive-visual profiles. Results There were signs of CVI in all the three subgroups. Subgroup 1 (62 children) and subgroup 2 (50 children) were different for fixation (p = 0.02), visual acuity (p = 0.03) and contrast sensitivity (p < 0.01), being more frequently impaired in younger children. Comparing subgroup 2 with subgroup 3 (68 children), the older children presented more frequently myopia (p = 0.02) while the younger ones esotropia (p = 0.02) and alteration in smooth pursuit (p = 0.03) and saccades (p < 0.01). Furthermore, fixation, smooth pursuit, visual acuity, contrast sensitivity and visual filed (p < 0.01) were more frequently impaired in younger children (subgroup 1) compared to the older ones. Multiple correspondence analysis (MCA) confirmed the different neurovisual profiles according to age: younger children with CP showed more signs of CVI compared to the older ones. 34 out of 68 children belonging to subgroup 3 underwent the cognitive visual evaluation; an impairment of cognitive visual skills was detected in 21 subjects. Conclusion Younger children with CP showed more signs of CVI compared to the older ones, likely for the physiological maturation of visual system and mechanisms of neuroplasticity. In this direction, we suggest an early neurovisual evaluation to detect any weak visual functions.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- *Correspondence: Jessica Galli,
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Anna Molinaro
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Stefano Calza
- BDbiomed, BODaI Lab, University of Brescia, Brescia, Italy
| | - Alessandra Franzoni
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Francesco Semeraro
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
- Eye Clinic, University of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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6
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The Effects of Preterm Birth on Musculoskeletal Health-Related Disorders. J Clin Med 2021; 10:jcm10215082. [PMID: 34768599 PMCID: PMC8584797 DOI: 10.3390/jcm10215082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/21/2022] Open
Abstract
Preterm birth is associated with various diseases and conditions which demand multidisciplinary medical care. Approximately 10% of all neonates are born prematurely with an increasing survival rate in almost all Western countries. This ongoing, yet desirable trend is creating new challenges for sufficient medical treatment regimens, which should be upheld throughout the patients’ lives. Orthopedic surgeons are focused on musculoskeletal disorders and the improvement of patients’ ability to cope with the challenges of everyday life. The most common conditions associated with preterm birth are cerebral palsy and a dysregulation of the calcium/phosphorus metabolism, which may lead to fractures. These diseases may vary greatly in their organic manifestation and clinical presentation. This demands multidisciplinary cooperation and parental support. Clinical management is aimed on the early enhancement of a patient’s physical, as well as neurological condition, and to prevent the development of secondary musculoskeletal disorders. In this article, we give an overview of the current literature on the most common musculoskeletal disorders associated with preterm birth and critically discuss state of the art diagnostic standards and treatment algorithms.
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7
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Pehere NK, Dutton GN. Perceptual visual dysfunction in children - An Indian perspective. Indian J Ophthalmol 2021; 69:2004-2011. [PMID: 34304166 PMCID: PMC8482924 DOI: 10.4103/ijo.ijo_1996_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Perceptual visual dysfunction (PVD) comprises a group of vision disorders resulting from dysfunction of the posterior parietal and/or temporal lobes. Often, affected children have normal/near normal visual acuities and/or visual fields, but have difficulties in activities of daily living involving the use of vision. PVDs are known to be common among children with risk factors such as a history of prematurity and/or neurodevelopmental disorders. The inferior temporal lobes and ventral stream transform visual signals into perception, while the posterior parietal lobes and dorsal stream transform visual signals to non-consciously map the scene to guide action and facilitate attention. Dysfunction of these can lead to specific visual impairments that need to be identified during history taking, triggering ascertainment of further details by a structured inventory approach. Clinical tests to elicit dorsal and ventral stream visual dysfunctions have good specificity but low sensitivity. Neuropsychologists are rarely available in the developing world to perform detailed assessments, but there are a few tests that can be used by eye care professionals with some training. Optical coherence tomography (OCT) showing thinning of the ganglion cell layer and retinal nerve fiber layer is being explored as a potential tool for rapid assessment in the clinic. The behavioral outcomes of PVD can mimic psychological conditions including autism spectrum disorder, attention deficit hyperactivity disorder, specific learning disability, and intellectual impairment, and one needs to be aware of overlap among these differential diagnoses. A practical functional approach providing working solutions for each child's set of difficulties in day-to-day activities is needed.
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Affiliation(s)
- Niranjan K Pehere
- Liberia Eye Center (L V Prasad Eye Institute Liberia Inc), John F Kennedy Memorial Medical Center, Monrovia, Liberia
| | - Gordon N Dutton
- Department of Vision Science, Glasgow Caledonian University, Glasgow, United Kingdom
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Abstract
Faces hold a substantial value for effective social interactions and sharing. Covering faces with masks, due to COVID-19 regulations, may lead to difficulties in using social signals, in particular, in individuals with neurodevelopmental conditions. Daily-life social participation of individuals who were born preterm is of immense importance for their quality of life. Here we examined face tuning in individuals (aged 12.79 ± 1.89 years) who were born preterm and exhibited signs of periventricular leukomalacia (PVL), a dominant form of brain injury in preterm birth survivors. For assessing the face sensitivity in this population, we implemented a recently developed experimental tool, a set of Face-n-Food images bordering on the style of Giuseppe Arcimboldo. The key benefit of these images is that single components do not trigger face processing. Although a coarse face schema is thought to be hardwired in the brain, former preterms exhibit substantial shortages in the face tuning not only compared with typically developing controls but also with individuals with autistic spectrum disorders. The lack of correlations between the face sensitivity and other cognitive abilities indicates that these deficits are domain-specific. This underscores impact of preterm birth sequelae for social functioning at large. Comparison of the findings with data in individuals with other neurodevelopmental and neuropsychiatric conditions provides novel insights into the origins of deficient face processing.
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9
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VerMaas JR, Lew BJ, Trevarrow MP, Wilson TW, Kurz MJ. Children with Cerebral Palsy Have Altered Occipital Cortical Oscillations during a Visuospatial Attention Task. Cereb Cortex 2021; 31:3353-3362. [PMID: 33611348 DOI: 10.1093/cercor/bhab016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/28/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
Dynamically allocating neural resources to salient features or objects within our visual space is fundamental to making rapid and accurate decisions. Impairments in such visuospatial abilities have been consistently documented in the clinical literature on individuals with cerebral palsy (CP), although the underlying neural mechanisms are poorly understood. In this study, we used magnetoencephalography (MEG) and oscillatory analysis methods to examine visuospatial processing in children with CP and demographically matched typically developing (TD) children. Our results indicated robust oscillations in the theta (4-8 Hz), alpha (8-14 Hz), and gamma (64-80 Hz) frequency bands in the occipital cortex of both groups during visuospatial processing. Importantly, the group with CP exhibited weaker cortical oscillations in the theta and gamma frequency bands, as well as slower response times and worse accuracy during task performance compared to the TD children. Furthermore, we found that weaker theta and gamma oscillations were related to greater visuospatial performance deficits across both groups. We propose that the weaker occipital oscillations seen in children with CP may reflect poor bottom-up processing of incoming visual information, which subsequently affects the higher-order visual computations essential for accurate visual perception and integration for decision-making.
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Affiliation(s)
- Jacy R VerMaas
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA.,Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Brandon J Lew
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
| | - Michael P Trevarrow
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
| | - Max J Kurz
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
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10
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Fluss J, Lidzba K. Cognitive and academic profiles in children with cerebral palsy: A narrative review. Ann Phys Rehabil Med 2020; 63:447-456. [DOI: 10.1016/j.rehab.2020.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/11/2020] [Accepted: 01/29/2020] [Indexed: 12/19/2022]
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Koshiyama D, Fukunaga M, Okada N, Morita K, Nemoto K, Yamashita F, Yamamori H, Yasuda Y, Matsumoto J, Fujimoto M, Kudo N, Azechi H, Watanabe Y, Kasai K, Hashimoto R. Association between the superior longitudinal fasciculus and perceptual organization and working memory: A diffusion tensor imaging study. Neurosci Lett 2020; 738:135349. [PMID: 32889005 DOI: 10.1016/j.neulet.2020.135349] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 12/31/2022]
Abstract
The superior longitudinal fasciculus (SLF) is a white matter structure that has long bidirectional projections among the prefrontal, temporal, occipital, and parietal cortices and extends over a wide area in a human brain. Recently, anatomical details of the SLF have been clarified using a diffusion tensor imaging (DTI) template of subjects from the Human Connectome Project. However, the neurobehavioral functions of the SLF have not been fully elucidated. It is speculated that the SLF contributes to a broad cognitive domain including visuospatial nonverbal cognitive ability and verbal memory ability because of its anatomical location; however, previous findings in imaging studies are inconsistent. Showing the contribution of the SLF to cognitive function may be important for improving our understanding of the functional role of white matter structures in the human brain. This study aimed to identify the relationship between DTI indices of the SLF and the Verbal Comprehension, Perceptual Organization, Working Memory and Processing Speed Indices of the Wechsler Adult Intelligence Scale-Third Edition using regression analysis, accounting for the effects of age, sex and scanner type in 583 healthy volunteers. We showed significant correlations between the fractional anisotropy of the left SLF and the Perceptual Organization Index (β = 0.21, p = 4.5×10-4) and Working Memory Index (β = 0.19, p = 4.0×10-4). These findings may have implications for the rehabilitation of cognitive function in patients with neurological disorders.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Kentaro Morita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan; Japan Community Health Care Organization, Osaka Hospital, Osaka, Japan; Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Life Grow Brilliant Mental Clinic, Medical Corporation Foster, Osaka, Japan
| | - Junya Matsumoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Noriko Kudo
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hirotsugu Azechi
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Shiga, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan.
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
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12
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Jacobson L, Lennartsson F, Nilsson M. Retinal ganglion cell topography predicts visual field function in spastic cerebral palsy. Dev Med Child Neurol 2020; 62:1100-1106. [PMID: 32314356 DOI: 10.1111/dmcn.14545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2020] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the use of optical coherence tomography (OCT) to identify and assess visual field defects caused by primary damage to the optic radiation in individuals with spastic cerebral palsy (CP). Ten individuals with spastic CP (six females, four males, with a median age of 21 years [range 17-38y]) had their brain lesions documented with conventional magnetic resonance imaging (MRI) and diffusion-weighted MRI fibre tractography. Their macular ganglion cell layer (GCL) and inner plexiform layer (IPL) were examined with OCT and their visual fields were plotted. All participants had good visual acuity and were able to cooperate with the MRI and OCT examinations, as well as undergoing reliable perimetry. We found focal thinning of the GCL+IPL and corresponding homonymous visual field defects in individuals with brain damage affecting the optic radiation. We used GCL+IPL sector asymmetry as a sensitive OCT parameter to identify focal visual field defects. We observed no such sector asymmetry in GCL+IPL, or focal visual field defects, in individuals with normal MRI optic radiation imaging. Lesions affecting the optic radiation cause retrograde trans-synaptic degeneration of retinal ganglion cells. OCT examination of the GCL in the macula identified corresponding focal damage to the optic radiation in individuals with spastic CP and can be used to predict focal visual field defects. WHAT THIS PAPER ADDS: Spastic cerebral palsy (CP) may be associated with damage to the optic radiation. Damage to the optic radiation causes retrograde trans-synaptic degeneration (RTSD). RTSD can be mapped using optical coherence tomography. Ganglion cell topography can predict visual field defects in individuals with spastic CP.
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Affiliation(s)
- Lena Jacobson
- Section for Eye and Vision, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Finn Lennartsson
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Maria Nilsson
- Unit of Optometry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Philip SS, Guzzetta A, Chorna O, Gole G, Boyd RN. Relationship between brain structure and Cerebral Visual Impairment in children with Cerebral Palsy: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 99:103580. [PMID: 32004872 DOI: 10.1016/j.ridd.2020.103580] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/17/2020] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cerebral Visual Impairment (CVI) is very common yet often unrecognised visual dysfunction in children with Cerebral Palsy (CP). Magnetic Resonance Imaging (MRI) is the diagnostic tool in the investigation of brain lesions in children with CP and CVI. AIM The aim of this systematic review is to evaluate the relationship between brain structure and CVI, as determined by MRI in children with CP. METHODS AND PROCEDURES A comprehensive search of 5 database (PubMed, EMBASE, SCOPUS, CINAHL and Cochrane Database) was undertaken up until June 2019. The PRISMA checklist was then utilised to report on the process of selecting eligible papers. A total of 30 observational studies met the full inclusion criteria. Further, STROBE checklist was employed to report on the observational studies. OUTCOMES AND RESULTS Periventricular leucomalacia on MRI was found to have a strong association with CVI in all 30 studies. Only 13 (43 %) studies described dorsal and/ ventral stream dysfunction. There was ambiguity in the definition of CVI. CONCLUSIONS AND IMPLICATIONS The overall level of evidence correlating different patterns of CVI and CP (based on GMFCS, motor type and distribution) and MRI was low. Further studies utilising advances in MRI are needed to understand brain reorganisation and patterns of CVI and suggest rehabilitation therapy inclusive of vision.
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Affiliation(s)
- Swetha Sara Philip
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Brisbane, Australia.
| | - Andrea Guzzetta
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Olena Chorna
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Glen Gole
- Dept of Ophthalmology, Queensland Children's Hospital, Brisbane, Australia
| | - Roslyn N Boyd
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Brisbane, Australia
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Zhang W, Zhang S, Zhu M, Tang J, Zhao X, Wang Y, Liu Y, Zhang L, Xu H. Changes of Structural Brain Network Following Repetitive Transcranial Magnetic Stimulation in Children With Bilateral Spastic Cerebral Palsy: A Diffusion Tensor Imaging Study. Front Pediatr 2020; 8:617548. [PMID: 33520901 PMCID: PMC7844328 DOI: 10.3389/fped.2020.617548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction: Bilateral spastic cerebral palsy (BSCP) is the most common subtype of cerebral palsy (CP), which is characterized by various motor and cognitive impairments, as well as emotional instability. However, the neural basis of these problems and how repetitive transcranial magnetic stimulation (rTMS) can make potential impacts on the disrupted structural brain network in BSCP remain unclear. This study was aimed to explore the topological characteristics of the structural brain network in BSCP following the treatment of rTMS. Methods: Fourteen children with BSCP underwent 4 weeks of TMS and 15 matched healthy children (HC) were enrolled. Diffusion tensor imaging (DTI) data were acquired from children with bilateral spastic cerebral palsy before treatment (CP1), children with bilateral spastic cerebral palsy following treatment (CP2) and HC. The graph theory analysis was applied to construct the structural brain network. Then nodal clustering coefficient (C i ) and shortest path length (L i ) were measured and compared among groups. Results: Brain regions with significant group differences in C i were located in the left precental gyrus, middle frontal gyrus, calcarine fissure, cuneus, lingual gyrus, postcentral gyrus, inferior parietal gyri, angular gyrus, precuneus, paracentral lobule and the right inferior frontal gyrus (triangular part), insula, posterior cingulate gyrus, precuneus, paracentral lobule, pallidum. In addition, significant differences were detected in the L i of the left precental gyrus, lingual gyrus, superior occipital gyrus, middle occipital gyrus, superior parietal gyrus, precuneus and the right median cingulate gyrus, posterior cingulate gyrus, hippocampus, putamen, thalamus. Post hoc t-test revealed that the CP2 group exhibited increased C i in the right inferior frontal gyrus, pallidum and decreased L i in the right putamen, thalamus when compared with the CP1 group. Conclusion: Significant differences of node-level metrics were found in various brain regions of BSCP, which indicated a disruption in structural brain connectivity in BSCP. The alterations of the structural brain network provided a basis for understanding of the pathophysiological mechanisms of motor and cognitive impairments in BSCP. Moreover, the right inferior frontal gyrus, putamen, thalamus could potentially be biomarkers for predicting the efficacy of TMS.
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Affiliation(s)
- Wenxin Zhang
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Shang Zhang
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Min Zhu
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Tang
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoke Zhao
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Wang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yuting Liu
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ling Zhang
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hong Xu
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
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Maioli C, Falciati L, Galli J, Micheletti S, Turetti L, Balconi M, Fazzi EM. Visuospatial Attention and Saccadic Inhibitory Control in Children With Cerebral Palsy. Front Hum Neurosci 2019; 13:392. [PMID: 31780913 PMCID: PMC6856641 DOI: 10.3389/fnhum.2019.00392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/21/2019] [Indexed: 11/30/2022] Open
Abstract
Cerebral palsy (CP) is a non-progressive syndrome due to a pre-, peri- or post-natal brain injury, which frequently involves an impairment of non-motor abilities. The aim of this article was to examine visuospatial attention and inhibitory control of prepotent motor responses in children with CP showing a normal IQ or mild cognitive impairment, measuring their performance in oculomotor tasks. Ten children (9–16-year-old) with spastic CP and 13 age-matched, typically developing children (TDC) participated in the study. Subjects performed a simple visually-guided saccade task and a cue-target task, in which they performed a saccade towards a peripheral target, after a non-informative visual cue was flashed 150 ms before the imperative target, either at the same (valid) or at a different (invalid) spatial position. Children with CP showed severe executive deficits in maintaining sustained attention and complying with task instructions. Furthermore, saccadic inhibitory control appeared to be significantly impaired in the presence of both stimulus-driven and goal-directed captures of attention. In fact, patients showed great difficulties in suppressing saccades not only to the cue stimuli but also to the always-present target placeholders, which represented powerful attentional attractors that had to be covertly attended throughout the task execution. Moreover, impairment did not affect in equal manner the whole visual field but showed a marked spatial selectivity in each individual subject. Saccade latencies in the cue-target task were faster in the valid than in the invalid condition in both child groups, indicating the preservation of low-level visuospatial attentive capabilities. Finally, this study provides evidence that these impairments of executive skills and in inhibitory control, following early brain injuries, manifest in childhood but recover to virtually normal level during adolescence.
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Affiliation(s)
- Claudio Maioli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luca Falciati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Luisa Turetti
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Michela Balconi
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Elisa M Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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Ortibus E, Fazzi E, Dale N. Cerebral Visual Impairment and Clinical Assessment: The European Perspective. Semin Pediatr Neurol 2019; 31:15-24. [PMID: 31548019 DOI: 10.1016/j.spen.2019.05.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This paper summarizes the multidisciplinary pediatric assessment methods of 3 European centers for identifying and assessing cerebral visual impairment in childhood. It describes a comprehensive neurodevelopmental assessment evaluation in which visual aspects play an important part. Developmental trajectories and the heterogeneity of the clinical picture are emphasized. Multidisciplinary ophthalmology and neurodisability/neurology teamwork together with the parent and teachers, to reach an integrated and individualized perspective for the individual child, are described. This comprehensive assessment is the starting point for habilitation programs and interventions, that can support and meet the child's needs and help them reach their optimal potential. Future developments in classification of the cerebral visual impairment conditions, building on the child's individual assessment profile, will further enhance the direction of clinical, educational, and research progress.
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Affiliation(s)
- Els Ortibus
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Department of Pediatric Neurology, University Hospitals Leuven, Belgium.
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Child Neurology and Psychiatry Unit, ASST Civil Hospital -Brescia, Italy; Department of Pediatric Neurology, University Hospitals Leuven, Belgium
| | - Naomi Dale
- Department of Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, and Neurodisability Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Department of Pediatric Neurology, University Hospitals Leuven, Belgium
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