Abstract
Bilateral cerebral palsy (BCP) is a common movement disorder in children, which often results in lifelong motor disability. One main symptom of BCP is the limitation of hand function in everyday activities. However, the neuroanatomical basis of this prominent hand impairment is yet to discover. Recent advances mainly focus on the lesions of BCP, but the views on the atypical development of cortical parcellations are extremely lacking. Here, in our study, neuroimaging with network analysis was employed to evaluate the changes of structural covariance networks (SCNs) in BCP children. We aimed to elucidate the alteration of SCNs based on cortical thickness (CT), and to reveal the relationship of CT and hand function in the participants with BCP. SCNs were constructed using covariance between regional CT, which was acquired from T1-weighted images of 19 children with BCP and 19 demographically matched healthy controls (HCs). Compared with HCs, BCP children showed increased CT in several regions involving the bilateral areas (lateral occipital, lingual, and fusiform) and right areas (cuneus, pericalcarine, inferior temporal, middle temporal, superior temporal, and insula). Decreased CT was found in the left superior temporal and right superior parietal cortices. Global network analyses revealed significantly decreased normalized clustering and small-worldness in the BCP network. The area under the curve (AUC) of global network measures varied slightly between the BCP and HC networks. The resistance of the both SCNs to the target and random attack showed no significant difference. Also, the BCP foci (right superior temporal and subtemporal cortex) showed a significantly negative correlation between the CT and manual ability. In this work, we identified the CT-based SCNs changes in children with BCP. The abnormal topological organization of SCNs was revealed, indicating abnormal CT, incongruous development of structural wiring, destructive nodal profiles of betweenness, and moved hub distribution in BCP children. This may provide a neuroanatomical hallmark of BCP in the developing brain. Therefore, our results may not only reflect neurodevelopmental aberrations but also compensatory mechanisms.
Highlights
Cerebral palsy (CP) describes impaired motor and sensory disorders caused by a brain lesion
We investigated differences in cortical thickness (CT) and structural covariance networks (SCNs) between Bilateral cerebral palsy (BCP) children and healthy controls (HCs) to identify the effects of brain lesions on the developing brain
We did not find a significant association between the hand function classification in children with BCP and CT in primary sensorimotor and supplemental motor areas, we found significant negative correlations between the CT in the right temporal lobe and hand function
Summary
Cerebral palsy (CP) describes impaired motor and sensory disorders caused by a brain lesion. The wide array of these disorders is due to the heterogeneous nature of the underlying cerebral lesions (Rosenbaum et al, 2007). These lead to a great burden on families and society (Rosenbaum et al, 2007). The affected joints often gradually become rigid and difficult to move, BCP children often exhibit upper limb weakness. The understanding of the neuroanatomical and connectional infrastructure for upper limb weakness in BCP children might help to generate opportunities for primary prevention or provide the valuable intervention strategies
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