Abstract
Spastic diplegic cerebral palsy(SDCP)is a common type of cerebral palsy (CP), which presents as a group of motor-impairment syndromes. Previous conventional MRI studies have reported abnormal structural changes in SDCP, such as periventricular leucomalacia. However, there are roughly 27.8% SDCP patients presenting normal appearance in conventional MRI, which were considered as occult SDCP. In this study, sixteen patients with occult SDCP and 16 age- and sex-matched healthy control subjects were collected and the data were acquired on a 3T MR system. We applied voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis to investigate whole brain grey and white matter injury in occult SDCP. By using VBM method, the grey matter volume reduction was revealed in the bilateral basal ganglia regions, thalamus, insula, and left cerebral peduncle, whereas the white matter atrophy was found to be located in the posterior part of corpus callosum and right posterior corona radiata in the occult SDCP patients. By using TBSS, reduced fractional anisotropy (FA) values were detected in multiple white matter regions, including bilateral white matter tracts in prefrontal lobe, temporal lobe, internal and external capsule, corpus callosum, cingulum, thalamus, brainstem and cerebellum. Additionally, several regions of white matter tracts injury were found to be significantly correlated with motor dysfunction. These results collectively revealed the spatial patterns of whole brain grey and white matter injury in occult SDCP.
Highlights
Cerebral palsy (CP) is a motor-impairment syndrome resulting from genetic or acquired disorders in the early brain development
Grey matter and white matter volume loss in occult SDCP using Voxel-based morphometry (VBM) method Grey matter volume reduction was found in the bilateral basal ganglia regions, thalamus, insula, and left cerebral peduncle in the occult SDCP patients, compared with the normal controls (Figure 1 and Table 2)
In contrast with the normal controls, white matter volume reduction was located in the posterior part of corpus callosum and right posterior corona radiata in the occult SDCP patients (Figure 2 and Table 2)
Summary
Cerebral palsy (CP) is a motor-impairment syndrome resulting from genetic or acquired disorders in the early brain development. About 70 to 90% of CP children presented grey and white matter abnormality on the conventional magnetic resonance imaging (MRI). Conventional MRI is valuable in the identification of brain injuries, there are still 10–30% CP patients presenting normal appearance in conventional MRI [1,2]. We take those patients as occult CP. No attempt has been made to investigate grey and white matter changes in occult CP using this automated methodology. We applied VBM to occult CP to explore the possible grey and white matter injury
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