Functional Connectivity Alterations in Children with Spastic and Dyskinetic Cerebral Palsy.

Yun Qin,Dezhong Yao,Chengyan Sun,Bo Sun,Tao Zhang,Rui Peng,Cheng Luo,Jianfu Li,Yanan Li,Hui He

doi:10.1155/2018/7058953

Abstract

Cerebral palsy (CP) has long been investigated to be associated with a range of motor and cognitive dysfunction. As the two most common CP subtypes, spastic cerebral palsy (SCP) and dyskinetic cerebral palsy (DCP) may share common and distinct elements in their pathophysiology. However, the common and distinct dysfunctional characteristics between SCP and DCP on the brain network level are less known. This study aims to detect the alteration of brain functional connectivity in children with SCP and DCP based on resting-state functional MRI (fMRI). Resting-state networks (RSNs) were established based on the independent component analysis (ICA), and the functional network connectivity (FNC) was performed on the fMRI data from 16 DCP, 18 bilateral SCP, and 18 healthy children. Compared with healthy controls, altered functional connectivity within the cerebellum network, sensorimotor network (SMN), left frontoparietal network (LFPN), and salience network (SN) were found in DCP and SCP groups. Furthermore, the disconnections of the FNC consistently focused on the visual pathway; covariance of the default mode network (DMN) with other networks was observed both in DCP and SCP groups, while the DCP group had a distinct connectivity abnormality in motor pathway and self-referential processing-related connections. Correlations between the functional disconnection and the motor-related clinical measurement in children with CP were also found. These findings indicate functional connectivity impairment and altered integration widely exist in children with CP, suggesting that the abnormal functional connectivity is a pathophysiological mechanism of motor and cognitive dysfunction of CP.

Highlights

Cerebral palsy (CP) is the most common cause of physical disability in early childhood, occurring at a rate of around 2 per 1000 live births [1, 2]
After the functional MRI (fMRI) data head-motion checking, the final cohort in this study consisted of 16 Dyskinetic CP (DCP), 18 Spastic cerebral palsy (SCP), and 18 healthy control group (HC) children
Correlations between the functional disconnection and Gross Motor Function Classification System (GMFCS)/activities of daily living (ADL) scores were found. These findings indicate functional connectivity impairment, and altered integration widely exists in children with CP, and exploring the common and distinct functional connectivity patterns may contribute to our understanding of the neuropathophysiological mechanism of different CP subtypes

Summary

Introduction

Cerebral palsy (CP) is the most common cause of physical disability in early childhood, occurring at a rate of around 2 per 1000 live births [1, 2]. Dyskinetic CP (DCP) is the second common subtype, affecting 15%–20% of children with CP [6]. Both SCP and DCP subtypes tend to be associated with visual and auditory impairment and cognitive impairments such as intellectual and learning disability [1, 7]. Evidence points to abnormal sensorimotor reorganization, attention, and executive function deficits, as well as visual-perceptual impairments in children with DCP and SCP [9,10,11]

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