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Caldú X, Reid LB, Pannek K, Fripp J, Ballester-Plané J, Leiva D, Boyd RN, Pueyo R, Laporta-Hoyos O. Tractography of sensorimotor pathways in dyskinetic cerebral palsy: Association with motor function. Ann Clin Transl Neurol 2024. [PMID: 39257055 DOI: 10.1002/acn3.52174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/13/2024] [Accepted: 07/22/2024] [Indexed: 09/12/2024] Open
Abstract
OBJECTIVES Neuroimaging studies of dyskinetic cerebral palsy (CP) are scarce and the neuropathological underpinnings are not fully understood. We delineated the corticospinal tract (CST) and cortico-striatal-thalamocortical (CSTC) pathways with probabilistic tractography to assess their (1) integrity and (2) association with motor functioning in people with dyskinetic CP. METHODS Diffusion weighted magnetic resonance images were obtained for 33 individuals with dyskinetic CP and 33 controls. Fractional anisotropy (FA) and mean diffusivity (MD) for the CST and the CSTC pathways were compared between groups. Correlation analyses were performed between tensor metric values and motor function scores of participants with dyskinetic CP as assessed by the Gross Motor Function Classification System (GMFCS), the Bimanual Fine Motor Function (BFMF), and the Manual Ability Classification System (MACS). RESULTS White matter integrity in both the CST and the CSTC pathways was reduced in people with dyskinetic CP. The GMFCS, MACS and, less commonly, the BFMF were associated with FA and, particularly, MD in most portions of these pathways. INTERPRETATION The present study advances our understanding of the involvement of white matter microstructure in sensorimotor pathways and its relationship with motor impairment in people with dyskinetic CP. Our results are consistent with well-described relationships between upper limb function and white matter integrity in the CST and CSTC pathways in other forms of CP. This knowledge may ultimately help prognosis and therapeutic programmes.
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Affiliation(s)
- Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Pg. Vall d'Hebron, 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Lee B Reid
- Department of Psychiatry, University of California San Francisco, San Francisco, California, USA
| | - Kerstin Pannek
- Australian E-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Jurgen Fripp
- Australian E-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Pg. Vall d'Hebron, 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - David Leiva
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Barcelona, Spain
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Pg. Vall d'Hebron, 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Pg. Vall d'Hebron, 171, Barcelona, 08035, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
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Sudati IP, Damiano D, Rovai G, de Campos AC. Neural Correlates of Mobility in Children with Cerebral Palsy: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1039. [PMID: 39200649 PMCID: PMC11354175 DOI: 10.3390/ijerph21081039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 09/02/2024]
Abstract
Recent advances in brain mapping tools have enabled the study of brain activity during functional tasks, revealing neuroplasticity after early brain injuries and resulting from rehabilitation. Understanding the neural correlates of mobility limitations is crucial for treating individuals with cerebral palsy (CP). The aim is to summarize the neural correlates of mobility in children with CP and to describe the brain mapping methods that have been utilized in the existing literature. This systematic review was conducted based on PRISMA guidelines and was registered on PROSPERO (n° CRD42021240296). The literature search was conducted in the PubMed and Embase databases. Observational studies involving participants with CP, with a mean age of up to 18 years, that utilized brain mapping techniques and correlated these with mobility outcomes were included. The results were analyzed in terms of sample characteristics, brain mapping methods, mobility measures, and main results. The risk of bias was evaluated using a checklist previously created by our research group, based on STROBE guidelines, the Cochrane Handbook, and the Critical Appraisal Skills Programme (CASP). A total of 15 studies comprising 313 children with CP and 229 with typical development using both static and mobile techniques met the inclusion criteria. The studies indicate that children"with'CP have increased cerebral activity and higher variability in brain reorganization during mobility activities, such as gait, quiet standing, cycling, and gross motor tasks when compared with children with typical development. Altered brain activity and reorganization underline the importance of conducting more studies to investigate the neural correlates during mobility activities in children with CP. Such information could guide neurorehabilitation strategies targeting brain neuroplasticity for functional gains.
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Affiliation(s)
- Isabella Pessóta Sudati
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
| | - Diane Damiano
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health (NIH), Bethesda, MD 20892, USA;
| | - Gabriela Rovai
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
| | - Ana Carolina de Campos
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
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Errante A, Bozzetti F, Piras A, Beccani L, Filippi M, Costi S, Ferrari A, Fogassi L. Lesion mapping and functional characterization of hemiplegic children with different patterns of hand manipulation. Neuroimage Clin 2024; 41:103575. [PMID: 38354671 PMCID: PMC10944177 DOI: 10.1016/j.nicl.2024.103575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/22/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
Brain damage in children with unilateral cerebral palsy (UCP) affects motor function, with varying severity, making it difficult the performance of daily actions. Recently, qualitative and semi-quantitative methods have been developed for lesion classification, but studies on mild to moderate hand impairment are lacking. The present study aimed to characterize lesion topography and preserved brain areas in UCP children with specific patterns of hand manipulation. A homogeneous sample of 16 UCP children, aged 9 to 14 years, was enrolled in the study. Motor assessment included the characterization of the specific pattern of hand manipulation, by means of unimanual and bimanual measures (Kinematic Hand Classification, KHC; Manual Ability Classification System, MACS; House Functional Classification System, HFCS; Melbourne Unilateral Upper Limb Assessment, MUUL; Assisting Hand Assessment, AHA). The MRI morphological study included multiple methods: (a) qualitative lesion classification, (b) semi-quantitative classification (sq-MRI), (c) voxel-based morphometry comparing UCP and typically developed children (VBM-DARTEL), and (d) quantitative brain tissue segmentation (q-BTS). In addition, functional MRI was used to assess spared functional activations and cluster lateralization in the ipsilesional and contralesional hemispheres of UCP children during the execution of simple movements and grasping actions with the more affected hand. Lesions most frequently involved the periventricular white matter, corpus callosum, posterior limb of the internal capsule, thalamus, basal ganglia and brainstem. VMB-DARTEL analysis allowed to detect mainly white matter lesions. Both sq-MRI classification and q-BTS identified lesions of thalamus, brainstem, and basal ganglia. In particular, UCP patients with synergic hand pattern showed larger involvement of subcortical structures, as compared to those with semi-functional hand. Furthermore, sparing of gray matter in basal ganglia and thalamus was positively correlated with MUUL and AHA scores. Concerning white matter, q-BTS revealed a larger damage of fronto-striatal connections in patients with synergic hand, as compared to those with semi-functional hand. The volume of these connections was correlated to unimanual function (MUUL score). The fMRI results showed that all patients, but one, including those with cortical lesions, had activation in ipsilesional areas, regardless of lesion timing. Children with synergic hand showed more lateralized activation in the ipsilesional hemisphere both during grasping and simple movements, while children with semi-functional hand exhibited more bilateral activation during grasping. The study demonstrates that lesion localization, rather than lesion type based on the timing of their occurrence, is more associated with the functional level of hand manipulation. Overall, the preservation of subcortical structures and white matter can predict a better functional outcome. Future studies integrating different techniques (structural and functional imaging, TMS) could provide further evidence on the relation between brain reorganization and specific pattern of manipulation in UCP children.
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Affiliation(s)
- Antonino Errante
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Diagnostics, Neuroradiology Unit, University Hospital of Parma, Parma, Italy
| | - Francesca Bozzetti
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Diagnostics, Neuroradiology Unit, University Hospital of Parma, Parma, Italy
| | - Alessandro Piras
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Laura Beccani
- Unità per le gravi disabilità dell'età evolutiva, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mariacristina Filippi
- Unità per le gravi disabilità dell'età evolutiva, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Unità per le gravi disabilità dell'età evolutiva, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Adriano Ferrari
- Unità per le gravi disabilità dell'età evolutiva, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Fogassi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
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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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Martinie O, Karan P, Traverse E, Mercier C, Descoteaux M, Robert MT. The Challenge of Diffusion Magnetic Resonance Imaging in Cerebral Palsy: A Proposed Method to Identify White Matter Pathways. Brain Sci 2023; 13:1386. [PMID: 37891755 PMCID: PMC10605121 DOI: 10.3390/brainsci13101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Cerebral palsy (CP), a neuromotor disorder characterized by prenatal brain lesions, leads to white matter alterations and sensorimotor deficits. However, the CP-related diffusion neuroimaging literature lacks rigorous and consensual methodology for preprocessing and analyzing data due to methodological challenges caused by the lesion extent. Advanced methods are available to reconstruct diffusion signals and can update current advances in CP. Our study demonstrates the feasibility of analyzing diffusion CP data using a standardized and open-source pipeline. Eight children with CP (8-12 years old) underwent a single diffusion magnetic resonance imaging (MRI) session on a 3T scanner (Achieva 3.0T (TX), Philips Healthcare Medical Systems, Best, The Netherlands). Exclusion criteria were contraindication to MRI and claustrophobia. Anatomical and diffusion images were acquired. Data were corrected and analyzed using Tractoflow 2.3.0 version, an open-source and robust tool. The tracts were extracted with customized procedures based on existing atlases and freely accessed standardized libraries (ANTs, Scilpy). DTI, CSD, and NODDI metrics were computed for each tract. Despite lesion heterogeneity and size, we successfully reconstructed major pathways, except for a participant with a larger lesion. Our results highlight the feasibility of identifying and quantifying subtle white matter pathways. Ultimately, this will increase our understanding of the clinical symptoms to provide precision medicine and optimize rehabilitation.
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Affiliation(s)
- Ophélie Martinie
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC G1M 2S8, Canada; (O.M.); (E.T.); (C.M.)
- Department of Rehabilitation, Université Laval, Québec, QC G1V 0A6, Canada
| | - Philippe Karan
- Department of Computer Sciences, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (P.K.); (M.D.)
| | - Elodie Traverse
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC G1M 2S8, Canada; (O.M.); (E.T.); (C.M.)
- Department of Rehabilitation, Université Laval, Québec, QC G1V 0A6, Canada
| | - Catherine Mercier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC G1M 2S8, Canada; (O.M.); (E.T.); (C.M.)
- Department of Rehabilitation, Université Laval, Québec, QC G1V 0A6, Canada
| | - Maxime Descoteaux
- Department of Computer Sciences, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (P.K.); (M.D.)
| | - Maxime T. Robert
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC G1M 2S8, Canada; (O.M.); (E.T.); (C.M.)
- Department of Rehabilitation, Université Laval, Québec, QC G1V 0A6, Canada
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Jaatela J, Aydogan DB, Nurmi T, Vallinoja J, Mäenpää H, Piitulainen H. Limb-specific thalamocortical tracts are impaired differently in hemiplegic and diplegic subtypes of cerebral palsy. Cereb Cortex 2023; 33:10245-10257. [PMID: 37595205 PMCID: PMC10545439 DOI: 10.1093/cercor/bhad279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 08/20/2023] Open
Abstract
Thalamocortical pathways are considered crucial in the sensorimotor functioning of children with cerebral palsy (CP). However, previous research has been limited by non-specific tractography seeding and the lack of comparison between different CP subtypes. We compared limb-specific thalamocortical tracts between children with hemiplegic (HP, N = 15) or diplegic (DP, N = 10) CP and typically developed peers (N = 19). The cortical seed-points for the upper and lower extremities were selected (i) manually based on anatomical landmarks or (ii) using functional magnetic resonance imaging (fMRI) activations following proprioceptive-limb stimulation. Correlations were investigated between tract structure (mean diffusivity, MD; fractional anisotropy, FA; apparent fiber density, AFD) and sensorimotor performance (hand skill and postural stability). Compared to controls, our results revealed increased MD in both upper and lower limb thalamocortical tracts in the non-dominant hemisphere in HP and bilaterally in DP subgroup. MD was strongly lateralized in participants with hemiplegia, while AFD seemed lateralized only in controls. fMRI-based tractography results were comparable. The correlation analysis indicated an association between the white matter structure and sensorimotor performance. These findings suggest distinct impairment of functionally relevant thalamocortical pathways in HP and DP subtypes. Thus, the organization of thalamocortical white matter tracts may offer valuable guidance for targeted, life-long rehabilitation in children with CP.
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Affiliation(s)
- Julia Jaatela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, FI-02150 Espoo, Finland
| | - Dogu Baran Aydogan
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, FI-02150 Espoo, Finland
- A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, FI-70211 Kuopio, Finland
| | - Timo Nurmi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, FI-02150 Espoo, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Jaakko Vallinoja
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, FI-02150 Espoo, Finland
| | - Helena Mäenpää
- Pediatric Neurology, New Children’s Hospital, Helsinki University Hospital, FI-00029 Helsinki, Finland
| | - Harri Piitulainen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, FI-02150 Espoo, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
- Pediatric Neurology, New Children’s Hospital, Helsinki University Hospital, FI-00029 Helsinki, Finland
- Aalto NeuroImaging, Aalto University, FI-02150 Espoo, Finland
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Magnetic resonance imaging findings and the clinical characteristics of children with cerebral palsy at a public sector hospital in Gauteng Province, South Africa. SOUTH AFRICAN JOURNAL OF CHILD HEALTH 2022. [DOI: 10.7196/sajch.2022.v16i4.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background. Cerebral palsy (CP) is a common cause of physical impairment in children. Brain magnetic resonance imaging (MRI) can define different neuropathological patterns of brain injury in CP. There are limited data available on MRI findings of children with CP in Africa.
Objective. To describe the clinical characteristics, risk factors and MRI findings of children with CP attending a developmental clinic at a tertiary hospital in South Africa; and to assess possible associations between the clinical characteristics and pathogenic neuro-imaging patterns.
Methods. This was a retrospective cross-sectional study. The cohort of 112 children was identified from the clinic’s REDcap database. Clinical information was obtained from existing medical records of the patients. Findings from brain MRI reports were classified according to the MRI classification system (MRICS) for CP. The MRI reports were rated independently by two study investigators. A descriptive analysis was conducted.
Results. A total of 112 patient files and MRI brain reports were reviewed. Spastic CP was the most common type of CP (n=75%). The most common perinatal risk factors included prematurity (31%) and low birthweight (28%). Nineteen (17%) children acquired CP after the neonatal period. CP sub-type showed a significant association with functional motor impairment classified as per the gross motor function classification system (GMFCS), p<0.001. Predominant grey matter injury (PGMI) was the most common pathogenic MRI pattern identified (30%). The radiological findings (per MRICS) had a significant association with both the CP sub-type (p<0.005) and functional impairment according to the GMFCS (p<0.001).
Conclusion. Standardised classification of neuro-imaging findings can assist in defining the pathogenesis and clinical manifestations of CP.
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Zhang JJ, Yang YL, Hu J, Zhao CF, He XH, Yang QY, Qi XS, Lu H, He C, Liu H. Development and validation of a novel model based on hand knob score and white matter injury on MRI to predict hand function in children with cerebral palsy. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1102. [PMID: 36388818 PMCID: PMC9652546 DOI: 10.21037/atm-22-4112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/30/2022] [Indexed: 08/30/2023]
Abstract
BACKGROUND Childhood hand function is considered to be one of the strongest predictors of the ability to participate in daily activities as children with cerebral palsy (CP) reach adulthood. The manual ability classification system (MACS) is currently the most widely used for grading hand function in children with CP. However, the MACS method is subjective and may be affected by the raters' experience. Hand knob is an important control center for hand movement. Therefor this study aimed to develop and validate an objective model for hand function estimation in children with CP and visualize it as a nomogram. METHODS A total of 70 Children (2-12 years old) with CP underwent magnetic resonance imaging (MRI) scanning, MACS assessment. According to MACS, children with CP were divided into mild impairment group (grade I-III) and severe impairment group (grade IV-V). Hand function prediction models based on (I) hand knob score, (II) clinical features, and (III) the combination of clinical features and hand knob score were developed and validated separately. The models were subjected to stepwise regression according to the maximum likelihood method, and the Akaike information criterion was used to select the best model. Model discrimination was assessed using receiver operating characteristic (ROC) and calibration curves. The nomogram was finally built according to the best model. RESULTS The area under the curve (AUC) of the hand knob score model in the training set was 0.752, the clinical features model was 0.819, and the hand knob score and clinical features combined model was 0.880. The AUC of the hand knob score model in the validation set was 0.765, the clinical features model was 0.782, and the combined model was 0.894. The best model was the hand knob score-clinical features combined model, and the nomogram finally incorporated two assessment items: the hand knob score and white matter injury. The estimated probability of hand function injury degree of the combined model displayed good agreement with the actual occurrence probability. CONCLUSIONS The hand knob score-clinical features combined model can be used to preliminarily assess the degree of hand impairment in children with CP, with good calibration.
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Affiliation(s)
- Jing-Jing Zhang
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Radiology, Mianyang Hospital of T.C.M, Mianyang, China
| | - Yan-Li Yang
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jie Hu
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Chun-Feng Zhao
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xing-Hong He
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qian-Yu Yang
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xiao-Shan Qi
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Hong Lu
- Department of Radiology, The Seventh People’s Hospital of Chongqing, The Central Hospital Affiliated to Chongqing University of Technology, Chongqing, China
| | - Cheng He
- Medical Imaging Department, Chongqing University Central Hospital, Chongqing, China
| | - Heng Liu
- Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Cao M, Gu T, Jin C, Li X, Jing J. Sugar-Sweetened Beverage Intake and Motor Function Among Autistic and Typically Developed Children. Front Nutr 2022; 9:905025. [PMID: 35911101 PMCID: PMC9330586 DOI: 10.3389/fnut.2022.905025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives The relationship between brain function and sugar-sweetened beverages (SSBs) is widely explored, but the motor function was not included. We aim to explore the relationship between SSBs and motor function among children with or without autism. Methods Participants were a representative autism sample (ASD, n = 106) comprising ages ranging 6-9 years and their age-matched typical counterparts (TD, n = 207), recruited in the research center of Guangzhou, China. Valid questionnaires of parent-reported including weekly SSBs intake, physical activity (PA), sedentary time (ST), and motor coordination function was used to collect relevant information. SSBs intake was further classified as no intake (no habit of taking SSBs), small to medium intake (<375 ml/week), and large intake (375 ml/week or more). Physical activity, sedentary time, and motor coordination function among the mentioned three groups as well as ASD vs. TD was compared via general linear models. Results Compared with TD children, ASD children showed less vigorous PA (4.23 ± 0.34 h vs. 2.77 ± 0.49 h, p = 0.015) as well as overall sedentary time (5.52 ± 1.89 h vs. 3.67 ± 0.28 h, 3.49 ± 0.16 h vs. 2.68 ± 0.24 h, and 34.59 ± 1.15 h vs. 23.69 ± 1.69 h, TD vs. ASD, sedentary time at weekdays, weekends and total ST in a week, respectively, all p < 0.05), lower scores in the developmental coordination disorder questionnaire (fine motor and handwriting: 14.21 ± 0.26 vs. 12.30 ± 0.38, general coordination: 28.90 ± 0.36 vs. 25.17 ± 0.53, control during movement: 24.56 ± 0.36 vs. 18.86 ± 0.53, and total score: 67.67 ± 0.75 vs. 56.33 ± 1.10, TD vs. ASD, all p < 0.05). Stratified by SSBs intake, TD children with small to medium SSBs intake showed the lowest sedentary time both on weekdays and weekends (all p < 0.05), they also performed worst in fine motor and handwriting skills (p < 0.05). Conclusion The association between SSBs and motor function was observed in typical development children, but not autistic children. A larger sample size study with a longitudinal design is warranted to confirm the association between SSBs and sedentary time among typically developed children and the potential causation direction.
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Affiliation(s)
| | | | | | | | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Mahanna AM, El-Toukhy NAEG, Mousa AE, Megahed KF, Ashamallah GA. Does motor deficit in children with cerebral palsy correlate with diffusion tensor metrics abnormalities in thalamocortical pathways? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00463-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cerebral palsy (CP) is a group of motor-impairment signs secondary to many disorders that interfere with early brain development and are usually related to white matter injury in children. Most studies are focused on the study of motor tracts, mainly the corticospinal tract (CST). Diffusion tensor imaging (DTI) is a reliable imaging modality providing an appropriate method of detection of white matter microstructure abnormalities. The purpose of this study is to investigate the relationship between DTI observed motor CST injury, sensory pathways (thalamic radiations) injury, and motor functions.
Results
This study shows significant involvement (reduction in DTI fiber count) of the superior thalamic radiation (in severe cases) with atrophy of the anterior thalamic radiations (ATR) or posterior thalamic radiations (PTR) in most cases with a significant reduction in fractional anisotropy (FA) and elevation in mean diffusivity (MD) values. In addition, the degree of motor affection shows a significant negative correlation with FA and a significant positive correlation with MD values. Diffusion tensor imaging shows a significant reduction in FA within the examined tracts between CP and control at the Rt CST, Lt CST, Rt corticothalamic radiation (CTR), and Lt CTR with significant cutoff values of ≤ 0.449, ≤ 0.472, ≤ 0.432, and ≤ 0.44, respectively.
Conclusions
This study demonstrates disruption of thalamocortical and corticospinal tracts in CP patients, which reflects that both sensory and motor tract affection have a valuable role in the pathophysiology of motor dysfunction in CP patients.
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Papavasiliou A, Ben-Pazi H, Mastroyianni S, Ortibus E. Editorial: Cerebral Palsy: New Developments. Front Neurol 2021; 12:738921. [PMID: 34456856 PMCID: PMC8386682 DOI: 10.3389/fneur.2021.738921] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Hilla Ben-Pazi
- Department of Pediatric Orthopedics, Assuta Ashdod Hospital, Ashdod, Israel
| | - Sotiria Mastroyianni
- Department of Pediatric Neurology, Pan and Aglaia Kyriakou Children's Hospital, Athens, Greece
| | - Els Ortibus
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Pediatric Neurology, University Hospitals Leuven, Leuven, Belgium
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Upper Limb Motor Planning in Individuals with Cerebral Palsy Aged between 3 and 21 Years Old: A Systematic Review. Brain Sci 2021; 11:brainsci11070920. [PMID: 34356154 PMCID: PMC8306670 DOI: 10.3390/brainsci11070920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 11/17/2022] Open
Abstract
Individuals with cerebral palsy have difficulties performing activities of daily living. Beyond motor execution impairments, they exhibit motor planning deficits contributing to their difficulties. The objective of this review is to synthesize the behavioral evidence of motor planning deficits during an upper limb motor task in children, adolescents and young adults with cerebral palsy aged between 3 and 21 years. Methods: The inclusion criteria were: (1) including individuals with cerebral palsy from 3 to 21 years old; (2) assessing upper limb motor planning. Six databases were screened. The quality assessment of the studies was performed. Results: Forty-six studies and 686 participants were included. Five articles have been identified as very high quality, 12 as high, 20 as moderate, six as low, three as very low. Force planning studies reported a deficit for the more affected hand but adequate performances for the less affected hand. Object-manipulation studies reported hand posture planning deficits irrespectively of the hand assessed. Conclusions: Motor planning deficits has been shown in the more affected hand for force scaling, while the results for other variables showed overall deficits. Hence, variables affected by motor planning deficits in both hands should be considered in children with cerebral palsy to optimize intervention.
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ŞIK N, SARIOĞLU FC, ÖZTEKİN Ö, SARIOĞLU B. Evaluation of the relationship between cranial magnetic resonance imaging findings and clinical status in children with cerebral palsy. Turk J Med Sci 2021; 51:1296-1301. [PMID: 33460326 PMCID: PMC8283442 DOI: 10.3906/sag-2010-187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/17/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim The objective of this study was to evaluate the relationship between cranial magnetic resonance imaging (MRI) findings and clinical features in cerebral palsy (CP). Materials and methods Children aged 3 to 18 years, who were followed with the diagnosis of CP between January 2012 and September 2015, were included. The type of CP was classified using the European Cerebral Palsy Monitoring Group’s classification system and then, patients were divided into two groups as spastic or nonspastic groups. The Gross Motor Function Classification System (GMFCS) was used to determine the level of mobility. According to the GMFCS, levels 1, 2, and 3 were grouped as mobile, and levels 4 and 5 were grouped as immobile. Cranial MRI findings were reevaluated by a voluntarily radiologist and grouped as periventricular leukomalacia (PVL) (grades 1, 2, and 3), cerebral atrophy, migration anomaly, cerebellar involvement, basal ganglion involvement, and normal MRI findings. Results Sixty-two patients were enrolled. The rate of mobile patients did not differ between the spastic and nonspastic groups. The incidence of PVL was significantly higher in cases of prematurity and spastic CP (p < 0.05). The rate of mobilization was significantly lower and the rate of epilepsy was significantly higher in patients with PVL. Immobile patients were more common among cases of grade 3 PVL (p < 0.05). Conclusion The most common cranial MRI pathology was PVL, and the presence of PVL and its grade might help clinically assess the patient’s CP type and level of mobilization. While pathology was observed mostly in cranial MRI in cases of CP with similar clinical features, the fact that cranial MRI was completely normal for 14.5% of the cases suggests that there may be some pathologies that we could not identify with today’s imaging technology.
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Affiliation(s)
- Nihan ŞIK
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylül University, Faculty of Medicine, İzmirTurkey
| | - Fatma Ceren SARIOĞLU
- Division of Pediatric Radiology, Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmirTurkey
| | - Özgür ÖZTEKİN
- Department of Radiology, Health Sciences University, İzmir Tepecik Training and Research Hospital, İzmirTurkey
| | - Berrak SARIOĞLU
- Division of Pediatric Neurology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmirTurkey
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Filley CM. Cognition in cerebral palsy: White matter matters. Eur J Paediatr Neurol 2021; 32:A1. [PMID: 33975788 DOI: 10.1016/j.ejpn.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Christopher M Filley
- University of Colorado School of Medicine, Marcus Institute for Brain Health, USA.
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Hadders-Algra M. Early Diagnostics and Early Intervention in Neurodevelopmental Disorders-Age-Dependent Challenges and Opportunities. J Clin Med 2021; 10:861. [PMID: 33669727 PMCID: PMC7922888 DOI: 10.3390/jcm10040861] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 12/20/2022] Open
Abstract
This review discusses early diagnostics and early intervention in developmental disorders in the light of brain development. The best instruments for early detection of cerebral palsy (CP) with or without intellectual disability are neonatal magnetic resonance imaging, general movements assessment at 2-4 months and from 2-4 months onwards, the Hammersmith Infant Neurological Examination and Standardized Infant NeuroDevelopmental Assessment. Early detection of autism spectrum disorders (ASD) is difficult; its first signs emerge at the end of the first year. Prediction with the Modified Checklist for Autism in Toddlers and Infant Toddler Checklist is possible to some extent and improves during the second year, especially in children at familial risk of ASD. Thus, prediction improves substantially when transient brain structures have been replaced by permanent circuitries. At around 3 months the cortical subplate has dissolved in primary motor and sensory cortices; around 12 months the cortical subplate in prefrontal and parieto-temporal cortices and cerebellar external granular layer have disappeared. This review stresses that families are pivotal in early intervention. It summarizes evidence on the effectiveness of early intervention in medically fragile neonates, infants at low to moderate risk, infants with or at high risk of CP and with or at high risk of ASD.
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Affiliation(s)
- Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics-Section Developmental Neurology, 9713 GZ Groningen, The Netherlands
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