Correlation of quantitative sensorimotor tractography with clinical grade of cerebral palsy
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The purpose of this study was to determine whether tract-specific diffusion tensor imaging measures in somatosensory and motor pathways correlate with clinical grades as defined using the Gross Motor Function Classification System (GMFCS) in cerebral palsy (CP) children.
Quantitative diffusion tensor tractography was performed on 39 patients with spastic quadriparesis (mean age = 8 years) and 14 age/sex-matched controls. All patients were graded on the basis of GMFCS scale into grade II (n = 12), grade IV (n = 22), and grade V (n = 5) CP and quantitative analysis reconstruction of somatosensory and motor tracts performed.
Significant inverse correlation between clinical grade and fractional anisotropy (FA) was observed in both right and left motor and sensory tracts. A significant direct correlation of mean diffusivity values from both motor and sensory tracts was also observed with clinical grades. Successive decrease in FA values was observed in all tracts except for left motor tracts moving from age/sex-matched controls to grade V through grades II and IV.
We conclude that white matter tracts from both the somatosensory and the motor cortex play an important role in the pathophysiology of motor disability in patients with CP.
KeywordsCerebral palsy Diffusion tensor imaging Diffusion tensor tractography Motor pathway Sensory pathway
- 3.Hoon AH Jr, Stashinko EE, Nagae LM, Lin DD, Keller J, Bastian A, Campbell ML, Levey E, Mori S, Johnston MV (2009) Sensory and motor deficits in children with cerebral palsy born preterm correlate with diffusion tensor imaging abnormalities in thalamocortical pathways. Dev Med Child Neurol 51:697–704CrossRefPubMedGoogle Scholar
- 5.Nagae LM, Hoon AH Jr, Stashinko E, Lin D, Zhang W, Levey E, Wakana S, Jiang H, Leite CC, Lucato LT, van Zijl PC, Johnston MV, Mori S (2007) Diffusion tensor imaging in children with periventricular leukomalacia: variability of injuries to white matter tracts. AJNR Am J Neuroradiol 28:1213–1222CrossRefPubMedGoogle Scholar
- 6.Ashwal S, Russman BS, Blasco PA et al (2004) Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 62:851–863PubMedGoogle Scholar
- 30.Trivedi R, Agarwal S, Rathore RK, Saksena S, Tripathi RP, Malik GK, Pandey CM, Gupta RK (2009) Understanding development and lateralization of major cerebral fiber bundles in pediatric population through quantitative diffusion tensor tractography (DTT). Pediatr Res 66:636–641CrossRefPubMedGoogle Scholar
- 33.Crothers B, Paine RS (1988) The natural history of cerebral palsy. In: Mitchell RG (ed) Classics in developmental medicine. MacKeith Press, LondonGoogle Scholar