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Diffusion MRI in corticofugal fibers correlates with hand function in unilateral cerebral palsy

Holmström, Linda ; Lennartsson, F LU ; Eliasson, A-C ; Flodmark, O ; Clark, C ; Tedroff, K ; Forssberg, H and Vollmer, B (2011) In Neurology 77(8). p.83-775
Abstract

UNLABELLED: Diffusion MRI improves detection of abnormalities in white matter tracts in cerebral palsy (CP). Relationships between diffusion measurements and hand function are largely unexplored. We aimed first to assess microstructure of corticofugal fibers, and second to explore associations between tract injury as assessed by quantitative analysis of diffusion MRI and hand function in children with unilateral CP.

METHODS: In this cross-sectional study, 15 children with unilateral CP (6 boys, median age 12.4 years, min 7.2, max 17) and 24 controls were included (9 boys, median age 12.7 years, min 8.8, max 17.3). Hand function was assessed with the Box and Blocks (B&B) test. Magnetic resonance diffusion data (b value = 1,000... (More)

UNLABELLED: Diffusion MRI improves detection of abnormalities in white matter tracts in cerebral palsy (CP). Relationships between diffusion measurements and hand function are largely unexplored. We aimed first to assess microstructure of corticofugal fibers, and second to explore associations between tract injury as assessed by quantitative analysis of diffusion MRI and hand function in children with unilateral CP.

METHODS: In this cross-sectional study, 15 children with unilateral CP (6 boys, median age 12.4 years, min 7.2, max 17) and 24 controls were included (9 boys, median age 12.7 years, min 8.8, max 17.3). Hand function was assessed with the Box and Blocks (B&B) test. Magnetic resonance diffusion data (b value = 1,000 s/mm(2), 45 directions) were collected on a 1.5-T scanner. Fractional anisotropy (FA), mean diffusivity (MD), and tensor eigenvalues were measured bilaterally in the cerebral peduncle (ROI1), the posterior limb of the internal capsule (PLIC, ROI2), and corticofugal fibers connecting these regions.

RESULTS: In children with CP, FA in both ROIs and the partial tract corresponding to the affected hand was significantly lower compared to controls. This was caused by an increase in diffusivity perpendicular to the tract. After controlling for age, mean FA contralateral to the affected hand correlated with B&B scores, which was independent of lesion type or number of voxels in the partial tract, cerebral peduncle, or PLIC.

CONCLUSIONS: FA in corticofugal fibers is a sensitive marker of damage to the motor system and correlates with hand function in CP. Using FA may improve early prediction of outcome.

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publishing date
type
Contribution to journal
publication status
published
keywords
Adolescent, Anisotropy, Brain Mapping, Cerebral Cortex/pathology, Cerebral Palsy/pathology, Child, Cross-Sectional Studies, Diffusion Magnetic Resonance Imaging, Female, Functional Laterality/physiology, Hand/physiopathology, Humans, Image Processing, Computer-Assisted, Male, Nerve Fibers, Myelinated/pathology, Neural Pathways/pathology, Photic Stimulation/methods, Pons/pathology, Statistics as Topic, Statistics, Nonparametric
in
Neurology
volume
77
issue
8
pages
83 - 775
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:21832221
  • scopus:80054015701
ISSN
1526-632X
DOI
10.1212/WNL.0b013e31822b0040
language
English
LU publication?
no
id
19176a48-7ef1-4891-a5da-4efec49bdca8
date added to LUP
2021-10-11 09:46:09
date last changed
2024-02-03 10:45:09
@article{19176a48-7ef1-4891-a5da-4efec49bdca8,
  abstract     = {{<p>UNLABELLED: Diffusion MRI improves detection of abnormalities in white matter tracts in cerebral palsy (CP). Relationships between diffusion measurements and hand function are largely unexplored. We aimed first to assess microstructure of corticofugal fibers, and second to explore associations between tract injury as assessed by quantitative analysis of diffusion MRI and hand function in children with unilateral CP.</p><p>METHODS: In this cross-sectional study, 15 children with unilateral CP (6 boys, median age 12.4 years, min 7.2, max 17) and 24 controls were included (9 boys, median age 12.7 years, min 8.8, max 17.3). Hand function was assessed with the Box and Blocks (B&amp;B) test. Magnetic resonance diffusion data (b value = 1,000 s/mm(2), 45 directions) were collected on a 1.5-T scanner. Fractional anisotropy (FA), mean diffusivity (MD), and tensor eigenvalues were measured bilaterally in the cerebral peduncle (ROI1), the posterior limb of the internal capsule (PLIC, ROI2), and corticofugal fibers connecting these regions.</p><p>RESULTS: In children with CP, FA in both ROIs and the partial tract corresponding to the affected hand was significantly lower compared to controls. This was caused by an increase in diffusivity perpendicular to the tract. After controlling for age, mean FA contralateral to the affected hand correlated with B&amp;B scores, which was independent of lesion type or number of voxels in the partial tract, cerebral peduncle, or PLIC.</p><p>CONCLUSIONS: FA in corticofugal fibers is a sensitive marker of damage to the motor system and correlates with hand function in CP. Using FA may improve early prediction of outcome.</p>}},
  author       = {{Holmström, Linda and Lennartsson, F and Eliasson, A-C and Flodmark, O and Clark, C and Tedroff, K and Forssberg, H and Vollmer, B}},
  issn         = {{1526-632X}},
  keywords     = {{Adolescent; Anisotropy; Brain Mapping; Cerebral Cortex/pathology; Cerebral Palsy/pathology; Child; Cross-Sectional Studies; Diffusion Magnetic Resonance Imaging; Female; Functional Laterality/physiology; Hand/physiopathology; Humans; Image Processing, Computer-Assisted; Male; Nerve Fibers, Myelinated/pathology; Neural Pathways/pathology; Photic Stimulation/methods; Pons/pathology; Statistics as Topic; Statistics, Nonparametric}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{83--775}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Neurology}},
  title        = {{Diffusion MRI in corticofugal fibers correlates with hand function in unilateral cerebral palsy}},
  url          = {{http://dx.doi.org/10.1212/WNL.0b013e31822b0040}},
  doi          = {{10.1212/WNL.0b013e31822b0040}},
  volume       = {{77}},
  year         = {{2011}},
}