title: Diffusion tensor tractography can predict hemiparesis in infants with high risk factors.
abstract: Diffusion tensor tractography (DTT) is known to be useful in detecting white matter lesions. In the current study, we report on two hemiparetic patients with risk factors who showed abnormalities of the corticospinal tract (CST) on diffusion tensor tractography (DTT) prior to the manifestation of hemiparesis. Two hemiparetic patients with risk factors (preterm, low birth weight) and six age-matched normal control subjects were enrolled to this study. Diffusion tensor imaging (DTI) was performed at the age of 43 weeks (patient 1) and 33 weeks (patient 2) using 1.5-T with a Synergy-L Sensitivity Encoding (SENSE) head coil. We measured fractional anisotropy (FA), apparent diffusion coefficients (ADCs), and fiber counts of the CST. There were no definite asymmetric findings on physical examination and conventional brain MRI. By contrast, DTT showed a unilateral CST disruption at the periventricular white matter, low FA values, and low CST fiber counts compared with those of the unaffected CST and controls. These patients were diagnosed with hemiparetic cerebral palsy when we re-evaluated these patients at the age of 6 years (patient 1) and 3 years of age (patient 2), respectively. In these two patients, DTT revealed abnormalities of the CST prior to the manifestation of hemiparesis. Therefore, it seems that DTT would be a useful modality in detecting CST abnormalities in advance of clinical manifestation in infants with high risk factors.
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University, 317-1 Daemyungdong, Namku, Taegu 705-717, Republic of Korea.
authors.forename: Su Min
authors.initials: SM
authors.lastname: Son
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Park
authors.forename: Han Ku
authors.initials: HK
authors.lastname: Moon
authors.forename: Eunsil
authors.initials: E
authors.lastname: Lee
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Ahn
authors.forename: Yun Woo
authors.initials: YW
authors.lastname: Cho
authors.forename: Woo Mok
authors.initials: WM
authors.lastname: Byun
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
mesh_terms: D016880:Anisotropy; D001931:Brain Mapping / Q000379:methods*; D002452:Cell Count; D002547:Cerebral Palsy / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D009044:Motor Cortex / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D010291:Paresis / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011712:Pyramidal Tracts / Q000002:abnormalities* / Q000473:pathology* / Q000503:physiopathology; D012307:Risk Factors