[Cortical reorganization in children with connatal spastic hemiparesis -- a functional magnetic resonance imaging (FMRI) study].
OBJECTIVE
We applied fMRI to investigate atypical cortical activation in patients with connatal spastic hemiparesis using voluntary movements of the hand, foot, and tongue. The relation between the findings from fMRI and the motor dysfunction was examined.


METHODS
11 patients with connatal spastic hemiparesis were studied. Eight of these patients had periventricular leukomalacia (PVL), and three patients had cortical-subcortical lesions. To evaluate the severity of motor impairment tests for the upper and lower limb were performed. fMRI data were obtained in a block design using hand, foot, and tongue movements. As a control group, 14 healthy volunteers were examined with the fMRI protocol.


RESULTS
A laterally cortical representation of the paretic foot was found in three patients with PVL. In patients with cortical-subcortical lesions, tongue movements were associated with cortical activation restricted to the unaffected hemisphere. Movements of the paretic limb showed more ipsilateral activation in patients with PVL than in patients with cortical-subcortical lesions.


CONCLUSIONS
Different types of structural damage such as PVL and cortical-subcortical lesions show differences in fMRI examination.
Möller
F
F
Sektion für Neuroradiologie der Klinik für Neurochirurgie Universitätsklinikum Schleswig-Holstein, Campus Kiel. rieke_moeller@yahoo.de
Ulmer
S
S
Wolff
S
S
Stephani
U
U
Jansen
O
O
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002547:Cerebral Palsy / Q000151:congenital / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology*; D009068:Movement / Q000502:physiology; D012737:Sex Factors