Comparing quantitative tractography metrics of motor and sensory pathways in children with periventricular leukomalacia and different levels of gross motor function
Comparing quantitative tractography metrics of motor and sensory pathways in children with periventricular leukomalacia and different levels of gross motor function
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DOI：
10.1007/s00234-011-0996-2
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发表时间：
2012-06-01
期刊：
影响因子：
2.8
通讯作者：
Park, Eun Sook
中科院分区：
文献类型：
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作者：
Rha, Dong-wook;Chang, Won Hyuk;Park, Eun Sook
脑室周围白质软化引起的痉挛性脑瘫（CP）患儿大运动功能障碍的神经束仍不清楚。本研究使用弥散张量束造影（DTT）对感觉束和运动束进行了研究。本文对19例双侧痉挛性脑瘫患儿（男10例，女9例）进行脑磁共振成像（DTI）分析。DTT由DTI重建。根据大运动功能分类系统（GMFCS）测量的大运动功能对参与者进行分类。GMFCS等级为1 ~ 3级的为高功能组（n = 11）， GMFCS等级为4 ~ 5级的为低功能组（n = 8）。我们比较了两组间基于dtt的指标，如分数各向异性、表观扩散系数、纤维数量和体积。在皮质脊髓束中，高功能组纤维的体积和数量显著增加（p < 0.001），而皮质脊髓束的分数各向异性和表观扩散系数在两组之间无显著差异。在体感束和后丘脑辐射中，各组间DTT参数均无显著差异。具有不同大运动功能水平的双侧痉挛性CP患儿在皮质脊髓束的DTT检测上有相应的差异，但在体感觉束和丘脑后区辐射检测上没有相应的差异。此外，粗大运动功能低的儿童皮质脊髓束纤维的数量和体积比粗大运动功能高的儿童低，而非分数各向异性值或表观扩散系数。
The neural tracts responsible for gross motor dysfunction in children with spastic cerebral palsy (CP) caused by periventricular leukomalacia remain unknown. This study investigated both sensory and motor tracts using diffusion tensor tractography (DTT).Brain MRIs with diffusion tensor imaging (DTI) performed on 19 children (ten boys and nine girls) with bilateral spastic CP were analyzed. DTT was reconstructed from DTI. Participants were classified according to gross motor function measured with Gross Motor Function Classification System (GMFCS). Those with GMFCS levels I-III comprised the high-functioning group (n = 11), and those with GMFCS levels IV-V comprised the low-functioning group (n = 8). We compared DTT-based metrics, such as fractional anisotropy, apparent diffusion coefficient, and fiber number and volume, between the groups.In the corticospinal tract, the volume and number of fibers were significantly higher in the high-functioning group (p < 0.001), whereas the fractional anisotropy and apparent diffusion coefficient of the corticospinal tract did not differ significantly between the groups. In the somotosensory tract and posterior thalamic radiation, none of the DTT parameters differed significantly between the groups.Children with bilateral spastic CP with differing levels of gross motor function have corresponding differences detectable on DTT in their corticospinal tracts but not in their somatosensory tracts and posterior thalamic radiations. In addition, the number and volume of fibers, but not fractional anisotropy values or apparent diffusion coefficients, are lower in the corticospinal tracts in children with low gross motor function than in those with high gross motor function.