Abstract
BackgroundNeuroimaging is increasingly used to locate the lesion that causes cerebral palsy (CP) and its extent in the brains of CP patients. Conventional structural magnetic resonance imaging (MRI) does not indicate the connectional pattern of white matter; however, with the help of diffusion MRI, fibre tracking of white matter can be done.MethodsWe used diffusion MRI and probabilistic tractography to identify the putative white matter connectivity in the brains of 10 CP patients. We tracked the corticospinal tract (CST) of the patients’ upper and lower limbs and calculated the white matter connectivity, as indexed by streamlines representing the probability of connection of the CST.ResultsOur results show that diffusion MRI with probabilistic tractography, while having some relation with the clinical diagnosis of CP, reveals a high degree of individual variation in the streamlines representing the CST for upper and lower limbs.ConclusionDiffusion MRI with probabilistic tractography provides the state of connectivity from lesioned areas to other parts of the brain and is potentially beneficial to be used as an adjunct to the clinical management of CP, providing a means to monitor intervention outcomes.
Highlights
The variable clinical manifestations of cerebral palsy (CP) patients make it imperative for an accurate diagnosis in order to set rehabilitative management strategies and predict outcomes
While a majority of CP patients have structural brain abnormalities present when scanned with conventional structural magnetic resonance imaging (MRI), some do not manifest any abnormalities [2]
We aimed to investigate the association between probabilistic diffusion MRI tractography in CP patients and the type of CP based on clinical diagnosis
Summary
The variable clinical manifestations of cerebral palsy (CP) patients make it imperative for an accurate diagnosis in order to set rehabilitative management strategies and predict outcomes. While a majority of CP patients have structural brain abnormalities present when scanned with conventional structural magnetic resonance imaging (MRI), some do not manifest any abnormalities [2]. This may be because the insult is not grossly anatomic but is more at the connectional level, the need for a more effective imaging technique that is capable of capturing subtle abnormalities, especially lesions involving structural connectivity. Quantification of the orientation preference of diffusion may be related to axonal orientations [9] Such directional dependence of diffusivity is termed anisotropy [10]. Conventional structural magnetic resonance imaging (MRI) does not indicate the connectional pattern of white matter; with the help of diffusion MRI, fibre tracking of white matter can be done
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