Anisotropy of transcallosal motor fibres indicates functional impairment in children with periventricular leukomalacia
Anisotropy of transcallosal motor fibres indicates functional impairment in children with periventricular leukomalacia
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DOI：
10.1111/j.1469-8749.2010.03840.x
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发表时间：
2011-02-01
影响因子：
3.8
通讯作者：
Heinen, Florian
中科院分区：
文献类型：
--
作者：
Koerte, Inga;Pelavin, Paula;Heinen, Florian
目的双侧痉挛性脑性瘫痪（CP）患儿的脑室周围白质软化（PVL）常在磁共振成像中被发现。我们通过检查胼胝体的显微结构、半球间抑制能力（IIC）和镜像运动来表征这种白色物质状况。（年龄范围11岁9个月-17岁9个月，中位年龄15岁10个月，4名女性，3名男性），双侧痉挛性CP/PVL（粗大运动功能分类系统I级或II级，手动能力分类系统I级）和12名年龄匹配的对照（年龄范围11岁7个月-17岁1个月，中位年龄15岁6个月，7名女性，5名男性）。计算两侧胼胝体运动纤维（TCMF）和皮质脊髓束（CST）的各向异性分数。IIC（经颅磁刺激）和镜像运动的参数进行了测量，使用标准化的临床检查和基于计算机的手motor test.ResultsFractional各向异性较低的儿童双侧痉挛CP/PVL的TCMF，但不是左或右CST。双侧痉挛性CP/PVL患儿静息运动阈值升高，而IIC指标则有降低的趋势。镜像运动显着升高，在双边痉挛CP/PVL.InterpretationThis研究提供了新的信息，在不同方面的运动功能的儿童与双边痉挛CP/PVL。TCMF各向异性分数的降低与双侧痉挛性CP/PVL儿童的手部运动功能受损一致。以前被忽视的TCMF的微结构可能作为一个潜在的指标，在双侧痉挛CP/PVL患者的手运动功能。
AimIn children with bilateral spastic cerebral palsy (CP), periventricular leukomalacia (PVL) is commonly identified on magnetic resonance imaging. We characterized this white matter condition by examining callosal microstructure, interhemispheric inhibitory competence (IIC), and mirror movements.MethodWe examined seven children (age range 11y 9mo-17y 9mo, median age 15y 10mo, four females, three males) with bilateral spastic CP/PVL (Gross Motor Function Classification System level I or II, Manual Ability Classification System level I) and 12 age-matched controls (age range 11y 7mo-17y 1mo, median age 15y 6mo, seven females, five males). Fractional anisotropy of the transcallosal motor fibres (TCMF) and the corticospinal tract (CST) of both sides were calculated. The parameters of IIC (transcranial magnetic stimulation) and mirror movements were measured using a standardized clinical examination and a computer-based hand motor test.ResultsFractional anisotropy was lower in children with bilateral spastic CP/PVL regarding the TCMF, but not the left or right CST. Resting motor threshold was elevated in children with bilateral spastic CP/PVL whereas measures of IIC tended to be lower. Mirror movements were markedly elevated in bilateral spastic CP/PVL.InterpretationThis study provides new information on different aspects of motor function in children with bilateral spastic CP/PVL. Decreased fractional anisotropy of TCMF is consistent with impairment of hand motor function in children with bilateral spastic CP/PVL. The previously overlooked microstructure of the TCMF may serve as a potential indicator for hand motor function in patients with bilateral spastic CP/PVL.