title: Diffusion tensor imaging demonstrates focal lesions of the corticospinal tract in hemiparetic patients with cerebral palsy.
abstract: The purpose of this study was to use diffusion tensor imaging (DTI) with fiber tractography (FT) to demonstrate focal lesions of the corticospinal tract (CST) in hemiparetic patients with cerebral palsy (CP) who showed no specific focal lesions on conventional brain MRI. Four hemiparetic patients with CP (three left hemiparesis, mean age: 2.5 years, range: 0.9-7.0) and four age-matched controls were recruited. DTI was performed using a 1.5-T system with a synergy-L Sensitivity Encoding head coil. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) were measured using the region of interest (ROI) method. We estimated the asymmetric anisotropy index (AA) and asymmetric mean diffusivity index (AD) to evaluate the asymmetry between right and left CSTs. All four patients showed interrupted FT at the affected periventricular white matter (PVWM) level compared to that of the opposite side; this was not detected on conventional brain MRI and explained the hemiparesis of these patients. Compared to the data of controls, all patients showed significant AA and AD only at the PVWM level. DTI with FT demonstrated focal lesions at the PVWM level. We conclude that DTI with FT may be a useful modality for investigating focal lesions in hemiparetic patients with CP.
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Eulji University, Daejeon, Republic of Korea.
authors.forename: Su Min
authors.initials: SM
authors.lastname: Son
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Ahn
authors.forename: Joon
authors.initials: J
authors.lastname: Sakong
authors.forename: Han Ku
authors.initials: HK
authors.lastname: Moon
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Ahn
authors.forename: Ho
authors.initials: H
authors.lastname: Lee
authors.forename: In Kyu
authors.initials: IK
authors.lastname: Yu
authors.forename: Youn Jeong
authors.initials: YJ
authors.lastname: Shin
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
mesh_terms: D016880:Anisotropy; D002547:Cerebral Palsy / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D009412:Nerve Fibers / Q000473:pathology; D010291:Paresis / Q000473:pathology*; D011712:Pyramidal Tracts / Q000473:pathology*