Regional vulnerability of longitudinal cortical association connectivity: Associated with structural network topology alterations in preterm children with cerebral palsy.
Regional vulnerability of longitudinal cortical association connectivity: Associated with structural network topology alterations in preterm children with cerebral palsy.
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DOI：
10.1016/j.nicl.2015.08.021
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Panigrahy A
中科院分区：
文献类型：
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作者：
Ceschin R;Lee VK;Schmithorst V;Panigrahy A
已知患有痉挛性双侧瘫痪型脑瘫和白质损伤或脑室周围白质软化症 (PVL) 的早产儿存在运动、视觉和认知障碍。该组中进行的大多数扩散张量成像 (DTI) 研究均使用平均确定性纤维束成像和基于体素的 DTI 测量结果证明存在广泛的异常。尽管有新的治疗方法并且需要脑成像生物标志物，但人们对早产脑瘫的白质拓扑和重组的结构网络相关性知之甚少。在这里，我们结合了该早产队列中概率纤维束成像数据的新颖后处理方法，使用沿纤维束方法改善纵向皮质关联束异常的空间和区域描绘，并将这些数据与结构 DTI 皮质网络拓扑分析进行比较。 DTI 图像采集于 16 名脑瘫早产儿（平均年龄 5.6 ± 4 岁）和 75 名健康对照者（平均年龄 5.7 ± 3.4 岁）。尽管平均束分析、基于束的空间统计（TBSS）和基于体素的形态测量（VBM）表明所有白质束的分数各向异性（FA）普遍减少，但沿束分析改进了区域束脆弱性的检测。沿束图结构网络拓扑相关性揭示了两个关联：（1）纵向视觉皮层关联束（额枕下束、下纵束、视辐射、丘脑后辐射）的 FA 区域后前梯度降低与区域内（结效率）指标的后前梯度降低相关，而额叶和颞区相对保留； （2）额叶-丘脑-纹状体白质通路（前肢/前丘脑辐射、上纵束和皮质脊髓束）内区域FA的减少与额叶-纹状体和额叶-边缘节点的特征向量中心性、聚类系数（区域间）和参与系数（模块间）变化相关，表明这些通路的重组。沿束和结构拓扑网络测量均与运动和视觉临床结果评分密切相关。这项研究表明，结合沿束分析和结构网络拓扑不仅可以描述脑瘫早产儿的选择性顶叶枕叶区域脆弱性，还可以描述额叶-纹状体和额叶-边缘通路的重组。这些发现也支持这样的观点：脑瘫早产儿广泛但选择性的后前神经网络连接改变可能导致该组神经感觉和认知障碍的发病机制。患有 CP 和 PVL 的早产儿选择性顶叶-枕骨脆弱性我们发现额叶-纹状体和额叶-边缘通路的选择性重组。这些可能导致神经感觉和认知障碍的发病机制。
Preterm born children with spastic diplegia type of cerebral palsy and white matter injury or periventricular leukomalacia (PVL), are known to have motor, visual and cognitive impairments. Most diffusion tensor imaging (DTI) studies performed in this group have demonstrated widespread abnormalities using averaged deterministic tractography and voxel-based DTI measurements. Little is known about structural network correlates of white matter topography and reorganization in preterm cerebral palsy, despite the availability of new therapies and the need for brain imaging biomarkers. Here, we combined novel post-processing methodology of probabilistic tractography data in this preterm cohort to improve spatial and regional delineation of longitudinal cortical association tract abnormalities using an along-tract approach, and compared these data to structural DTI cortical network topology analysis. DTI images were acquired on 16 preterm children with cerebral palsy (mean age 5.6 ± 4) and 75 healthy controls (mean age 5.7 ± 3.4). Despite mean tract analysis, Tract-Based Spatial Statistics (TBSS) and voxel-based morphometry (VBM) demonstrating diffusely reduced fractional anisotropy (FA) reduction in all white matter tracts, the along-tract analysis improved the detection of regional tract vulnerability. The along-tract map-structural network topology correlates revealed two associations: (1) reduced regional posterior–anterior gradient in FA of the longitudinal visual cortical association tracts (inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, optic radiation, posterior thalamic radiation) correlated with reduced posterior–anterior gradient of intra-regional (nodal efficiency) metrics with relative sparing of frontal and temporal regions; and (2) reduced regional FA within frontal–thalamic–striatal white matter pathways (anterior limb/anterior thalamic radiation, superior longitudinal fasciculus and cortical spinal tract) correlated with alteration in eigenvector centrality, clustering coefficient (inter-regional) and participation co-efficient (inter-modular) alterations of frontal–striatal and fronto-limbic nodes suggesting re-organization of these pathways. Both along tract and structural topology network measurements correlated strongly with motor and visual clinical outcome scores. This study shows the value of combining along-tract analysis and structural network topology in depicting not only selective parietal occipital regional vulnerability but also reorganization of frontal–striatal and frontal–limbic pathways in preterm children with cerebral palsy. These finding also support the concept that widespread, but selective posterior–anterior neural network connectivity alterations in preterm children with cerebral palsy likely contribute to the pathogenesis of neurosensory and cognitive impairment in this group. Selective parietal–occipital vulnerability in preterm children with CP and PVL We found selective reorganization of frontal–striatal and frontal–limbic pathways. These likely contribute to pathogenesis of neurosensory and cognitive impairments.