Correlation of quantitative sensorimotor tractography with clinical grade of cerebral palsy.
BACKGROUND
The purpose of this study was to determine whether tract-specific diffusion tensor imaging measures in somatosensory and motor pathways correlate with clinical grades as defined using the Gross Motor Function Classification System (GMFCS) in cerebral palsy (CP) children.


METHODS
Quantitative diffusion tensor tractography was performed on 39 patients with spastic quadriparesis (mean age = 8 years) and 14 age/sex-matched controls. All patients were graded on the basis of GMFCS scale into grade II (n = 12), grade IV (n = 22), and grade V (n = 5) CP and quantitative analysis reconstruction of somatosensory and motor tracts performed.


RESULTS
Significant inverse correlation between clinical grade and fractional anisotropy (FA) was observed in both right and left motor and sensory tracts. A significant direct correlation of mean diffusivity values from both motor and sensory tracts was also observed with clinical grades. Successive decrease in FA values was observed in all tracts except for left motor tracts moving from age/sex-matched controls to grade V through grades II and IV.


CONCLUSIONS
We conclude that white matter tracts from both the somatosensory and the motor cortex play an important role in the pathophysiology of motor disability in patients with CP.
Trivedi
Richa
R
Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
Agarwal
Shruti
S
Shah
Vipul
V
Goyel
Puneet
P
Paliwal
Vimal K
VK
Rathore
Ram K S
RK
Gupta
Rakesh K
RK
D016880:Anisotropy; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology; D002547:Cerebral Palsy / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D002552:Cerebral Ventricles / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004185:Disability Evaluation; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D009044:Motor Cortex / Q000473:pathology* / Q000503:physiopathology; D009413:Nerve Fibers, Myelinated / Q000473:pathology* / Q000502:physiology; D009434:Neural Pathways / Q000473:pathology* / Q000503:physiopathology; D009460:Neurologic Examination; D011712:Pyramidal Tracts / Q000473:pathology; D012016:Reference Values; D012984:Software; D013003:Somatosensory Cortex / Q000473:pathology* / Q000503:physiopathology; D013223:Statistics as Topic
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