A Correlative Study On Brain Structure With Clinical Manifestation In Children With Cerebral Palsy

ObjectiveTo explore the clinical value of MRI in the diagnosis of children cerebral palsy(CP).MethodsOne hundred and forty three children with CP were involved in this study, the relationsbetween MRI findings and CP types,GMFCS, gestational age at birth wereretrospectively analyzed.ResultsAmong143cases, periventricular white matter injury(PWMI) were found in52cases,diffusive encephalopathy in31cases, brain malformations in19cases, focal cerebralvascular accident in11cases,6cases unclassified and24cases were normal.Distributions of GMFCS were significantly different among various neuroimagingfindings(2=87.974，P=0.000,Fisher exact test). PWMI is commonly seen in preterminfants with spastic diplegia or spastic hemiplegia, and GMFCS levels wereⅠ~Ⅲ.Dyskinetic CP and spastic quadriplegia were commonly found in children withdiffusive encephalopathy，and GMFCS levels were Ⅳ~Ⅴ. Brain malformations andfocal cerebral vascular accident were commonly seen in term infant patients, andGMFCS levels of the former were Ⅳ~Ⅴ,while the latter wereⅠ~Ⅱ. ConclusionsThere is significant correlation between MRI findings and CP types, gross motorfunction and gestational age at birth. It is a good way for MRI to diagnose cerebralpalsy and evaluate its prognosis early. ObjectiveTo explore the relationship between motor function and volume of gray matter inpediatric patients with cerebral palsy (CP) with voxel-based morphometry (VBM).MethodsForty children with CP were recruited in this study. Gross motor function classificationfor children was used to obtain their motor function. The whole-brain threedimensional MRI was performed on a3.0T MRI scanner. The data were segmented byVBM5, and the whole brain volumes of gray matter, white matter and CSF wereproduced. SPM5and SPSS13.0were used for statistical analysis of the3D MRI data.ResultsNo significant differences was found about the total volume of gray matter betweenGMFCSⅠ～Ⅱ and GMFCSⅢ～Ⅴl evel.The volume of the left media orbitofrontallobe(BA10/11)and medial superior frontal gyrus(BA9), bilateralparahippocampal(BA27), bilateral insula, bilateral lingual(BA18), bilateral cerebellum,left caudate, left post cingulum, right miditemporal and midioccipital show negativecorrelation with the GMFCS level. Compaired with GMFCSⅠ～Ⅱ group, thevolumeof the left media orbitofrontal lobe(BA10/11) and media superior frontal gyrus(BA9),bilateral parahippocampal(BA27), bilateral insula, left caudate and anterior cingutate,right miditemporal, left lingual(BA18), bilateral cerebellum, the left precentral gurusand dorsolateral superior frontal gyrus, bilateral middle frontal gyrus was significantlylower in GMFCSⅢ～Ⅴ group. The volume in left meditenporal and inferior temporal gyrus, bilateral thalamus and pallidum, left supramarginal gyrus(BA40), bilateralprecuneus gyrus(BA7), right superior/media occipital gyrus show positive correlationwith the GMFCS level.ConclusionsWith the increase of motor function disorders, the gray matter volume of the frontallobe, parahippocampal gyrus, insula, cerebellum, caudate and occipital lobe decreased,while there are a few brain regions increased due to cerebral plasticity. The reducedbrain area is not only limited to the movement directly related regions such as theprimary motor cortex, cerebellum, basal ganglia; but also learning and emotionmemory, attention networks such as the prefrontal cortex, cingulate gyrus, temporallobe, occipital lobe.