Anisotropy of transcallosal motor fibres indicates functional impairment in children with periventricular leukomalacia.
OBJECTIVE
In children with bilateral spastic cerebral palsy (CP), periventricular leukomalacia (PVL) is commonly identified on magnetic resonance imaging. We characterized this white matter condition by examining callosal microstructure, interhemispheric inhibitory competence (IIC), and mirror movements.


METHODS
We examined seven children (age range 11y 9mo-17y 9mo, median age 15y 10mo, four females, three males) with bilateral spastic CP/PVL (Gross Motor Function Classification System level I or II, Manual Ability Classification System level I) and 12 age-matched controls (age range 11y 7mo-17y 1mo, median age 15y 6mo, seven females, five males). Fractional anisotropy of the transcallosal motor fibres (TCMF) and the corticospinal tract (CST) of both sides were calculated. The parameters of IIC (transcranial magnetic stimulation) and mirror movements were measured using a standardized clinical examination and a computer-based hand motor test.


RESULTS
Fractional anisotropy was lower in children with bilateral spastic CP/PVL regarding the TCMF, but not the left or right CST. Resting motor threshold was elevated in children with bilateral spastic CP/PVL whereas measures of IIC tended to be lower. Mirror movements were markedly elevated in bilateral spastic CP/PVL.


CONCLUSIONS
This study provides new information on different aspects of motor function in children with bilateral spastic CP/PVL. Decreased fractional anisotropy of TCMF is consistent with impairment of hand motor function in children with bilateral spastic CP/PVL. The previously overlooked microstructure of the TCMF may serve as a potential indicator for hand motor function in patients with bilateral spastic CP/PVL.
Institute of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany. inga.koerte@med.lmu.de
Inga
I
Koerte
Paula
P
Pelavin
Berit
B
Kirmess
Teresa
T
Fuchs
Steffen
S
Berweck
Ruediger P
RP
Laubender
Ingo
I
Borggraefe
Sebastian
S
Schroeder
Adrian
A
Danek
Claudia
C
Rummeny
Maximilian
M
Reiser
Marek
M
Kubicki
Martha E
ME
Shenton
Birgit
B
Ertl-Wagner
Florian
F
Heinen
D000293:Adolescent; D016880:Anisotropy; D001931:Brain Mapping; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000503:physiopathology*; D002648:Child; D003337:Corpus Callosum / Q000473:pathology* / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D004292:Dominance, Cerebral / Q000502:physiology*; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D009046:Motor Neurons / Q000473:pathology* / Q000502:physiology*; D009412:Nerve Fibers / Q000473:pathology / Q000502:physiology*; D009433:Neural Inhibition / Q000502:physiology; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology*; D012684:Sensory Thresholds / Q000502:physiology; D050781:Transcranial Magnetic Stimulation