Abstract
Although cerebral palsy (CP) is among the most common causes of physical disability in early childhood, we know little about the functional and structural changes of this disorder in the developing brain. Here, we investigated with three different neuroimaging modalities [magnetoencephalography (MEG), diffusion tensor imaging (DTI), and resting-state fMRI] whether spastic CP is associated with functional and anatomical abnormalities in the sensorimotor network. Ten children participated in the study: four with diplegic CP (DCP), three with hemiplegic CP (HCP), and three typically developing (TD) children. Somatosensory (SS)-evoked fields (SEFs) were recorded in response to pneumatic stimuli applied to digits D1, D3, and D5 of both hands. Several parameters of water diffusion were calculated from DTI between the thalamus and the pre-central and post-central gyri in both hemispheres. The sensorimotor resting-state networks (RSNs) were examined by using an independent component analysis method. Tactile stimulation of the fingers elicited the first prominent cortical response at ~50 ms, in all except one child, localized over the primary SS cortex (S1). In five CP children, abnormal somatotopic organization was observed in the affected (or more affected) hemisphere. Euclidean distances were markedly different between the two hemispheres in the HCP children, and between DCP and TD children for both hemispheres. DTI analysis revealed decreased fractional anisotropy and increased apparent diffusion coefficient for the thalamocortical pathways in the more affected compared to less affected hemisphere in CP children. Resting-state functional MRI results indicated absent and/or abnormal sensorimotor RSNs for children with HCP and DCP consistent with the severity and location of their lesions. Our findings suggest an abnormal SS processing mechanism in the sensorimotor network of children with CP possibly as a result of diminished thalamocortical projections.
Highlights
Cerebral palsy (CP) is a well-recognized group of motor and postural neurodevelopmental disorders beginning in early childhood and persisting through the lifespan
Mean fractional anisotropy (FA) values for the thalamocortical fibers from thalamus to post-central gyrus were lower for the affected compared to the non-affected hemisphere in both CP groups and this difference was clearly visible in the hemiplegic CP (HCP) group (Figure 5 – upper panel)
Mean apparent diffusion coefficient (ADC), axial diffusivity (AD), and radial diffusivity (RD) values for the thalamocortical fibers from thalamus to post-central gyrus were markedly higher for the affected than the non-affected hemisphere in both CP groups, where the difference was more pronounced in the HCP group (Figure 5 – upper panel)
Summary
Cerebral palsy (CP) is a well-recognized group of motor and postural neurodevelopmental disorders beginning in early childhood and persisting through the lifespan. CP causes serious motor impairments often accompanied by disturbances of sensation and perception (Bax et al, 2005) and is the most common cause of physical disability in early childhood (Krageloh-Mann and Cans, 2009). Aside from motor and postural impairments, children with SCP frequently experience sensory deficits such as altered tactile, proprioceptive, kinesthetic, and pain awareness (Van Heest et al, 1993; Cooper et al, 1995; Krumlinde-Sundholm and Eliasson, 2002; Sanger and Kukke, 2007; Wingert et al, 2009; Riquelme et al, 2011).
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