Diffuse reduction of white matter connectivity in cerebral palsy with specific vulnerability of long range fiber tracts.
Diffuse reduction of white matter connectivity in cerebral palsy with specific vulnerability of long range fiber tracts.
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DOI：
10.1016/j.nicl.2013.03.006
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发表时间：
2013
影响因子：
4.2
通讯作者：
Song, Allen W.
中科院分区：
文献类型：
--
作者：
Englander, Zoe A.;Pizoli, Carolyn E.;Batrachenko, Anastasiya;Sun, Jessica;Worley, Gordon;Mikati, Mohamad A.;Kurtzberg, Joanne;Song, Allen W.
脑性瘫痪（CP）是一组异质性的非进行性运动障碍，由发育中的胎儿或婴儿大脑损伤引起。虽然CP的定义特征是运动障碍，但许多其他神经发育障碍与CP相关，并对其发病率有很大影响。CP的脑结构和神经发育结果之间的关系是复杂的，目前的证据表明，运动和发育结果与脑损伤的空间模式和程度有关。考虑到多种残疾经常与CP相关，并且随着运动严重程度的增加，神经发育残疾的负担越来越大，对17名双侧CP儿童的全球白色物质（WM）连接进行了检查，以检验在严重影响组中会看到全球WM损害增加的假设。（粗大运动功能分类量表（GMFCS）IV级）与中度受累（GMFCS II或III级）个体相比。进行弥散张量纤维束成像，并对解剖学定义的脑区域之间的纤维进行定量，并分析与GMFCS水平的关系。总体而言，观察到重度与中度CP中整个大脑的总WM连接减少，包括但不限于与感觉运动系统相关的区域。我们的研究结果还显示，在整个大脑中，以区域间纤维计数为代表的严重性组之间的全球区域间连接性弥漫性显著减少。此外，还观察到，与中度CP患者相比，重度CP患者的远程连接存在显著差异（p = 0.02），而两组之间的短程连接相似。这一新的发现，这是以前没有在CP文献中报道，表明CP可能涉及分布式，网络级的结构中断。采用DTI技术分析脑瘫患儿脑白质的连接情况。儿童表现出运动和认知缺陷。重度和中度CP之间的连通性弥漫性降低。证明了组间远程连接的具体减少。CP可能涉及分布式的网络级结构中断。
Cerebral palsy (CP) is a heterogeneous group of non-progressive motor disorders caused by injury to the developing fetal or infant brain. Although the defining feature of CP is motor impairment, numerous other neurodevelopmental disabilities are associated with CP and contribute greatly to its morbidity. The relationship between brain structure and neurodevelopmental outcomes in CP is complex, and current evidence suggests that motor and developmental outcomes are related to the spatial pattern and extent of brain injury. Given that multiple disabilities are frequently associated with CP, and that there is increasing burden of neurodevelopmental disability with increasing motor severity, global white matter (WM) connectivity was examined in a cohort of 17 children with bilateral CP to test the hypothesis that increased global WM damage will be seen in the group of severely affected (Gross Motor Function Classification Scale (GMFCS) level of IV) as compared to moderately affected (GMFCS of II or III) individuals. Diffusion tensor tractography was performed and the resulting fibers between anatomically defined brain regions were quantified and analyzed in relation to GMFCS levels. Overall, a reduction in total WM connectivity throughout the brain in severe versus moderate CP was observed, including but not limited to regions associated with the sensorimotor system. Our results also show a diffuse and significant reduction in global inter-regional connectivity between severity groups, represented by inter-regional fiber count, throughout the brain. Furthermore, it was also observed that there is a significant difference (p = 0.02) in long-range connectivity in patients with severe CP as compared to those with moderate CP, whereas short-range connectivity was similar between groups. This new finding, which has not been previously reported in the CP literature, demonstrates that CP may involve distributed, network-level structural disruptions. DTI was used to analyze WM connectivity in children with CP. Children showed both motor and cognitive deficits. Diffuse reduction in connectivity between severe and moderate CP was demonstrated. Specific reduction in long-range connectivity between groups was demonstrated. CP may involve distributed, network-level structural disruptions.
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DOI：
10.1073/pnas.0503892102
发表时间：
2005-07-05
影响因子：
11.1
作者：
Miller, MI;Beg, MF;Stark, C
通讯作者：
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影响因子：
9.8
作者：
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影响因子：
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作者：
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Sugimoto, Tohru
影响因子：
14.5
作者：
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Little, Deborah M.