title: Tractography of the corticospinal tracts in infants with focal perinatal injury: comparison with normal controls and to motor development.
abstract: BACKGROUND
  Our aims were to (1) assess the corticospinal tracts (CSTs) in infants with focal injury and healthy term controls using probabilistic tractography and (2) to correlate the conventional magnetic resonance imaging (MRI) and tractography findings in infants with focal injury with their later motor function.
  
  
  METHODS
  We studied 20 infants with focal lesions and 23 controls using MRI and diffusion tensor imaging. Tract volume, fractional anisotropy (FA), apparent diffusion coefficient (ADC) values, axial diffusivity and radial diffusivity (RD) of the CSTs were determined. Asymmetry indices (AIs) were calculated by comparing ipsilateral to contralateral CSTs. Motor outcome was assessed using a standardized neurological examination.
  
  
  RESULTS
  Conventional MRI was able to predict normal motor development (n = 9) or hemiplegia (n = 6). In children who developed a mild motor asymmetry (n = 5), conventional MRI predicted a hemiplegia in two and normal motor development in three infants. The AIs for tract volume, FA, ADC and RD showed a significant difference between controls and infants who developed a hemiplegia, and RD also showed a significant difference in AI between controls and infants who developed a mild asymmetry.
  
  
  CONCLUSIONS
  Conventional MRI was able to predict subsequent normal motor development or hemiplegia following focal injury in newborn infants. Measures of RD obtained from diffusion tractography may offer additional information for predicting a subsequent asymmetry in motor function.
authors: Centre for the Developing Brain, Imperial College, Hammersmith Campus, London, UK.
authors: Elise
authors: E
authors: Roze
authors: Polly A
authors: PA
authors: Harris
authors: Gareth
authors: G
authors: Ball
authors: Leire Zubiaurre
authors: LZ
authors: Elorza
authors: Rodrigo M
authors: RM
authors: Braga
authors: Joanna M
authors: JM
authors: Allsop
authors: Nazakat
authors: N
authors: Merchant
authors: Emma
authors: E
authors: Porter
authors: Tomoki
authors: T
authors: Arichi
authors: A David
authors: AD
authors: Edwards
authors: Mary A
authors: MA
authors: Rutherford
authors: Frances M
authors: FM
authors: Cowan
authors: Serena J
authors: SJ
authors: Counsell
mesh_terms: D016880:Anisotropy; D020520:Brain Infarction / Q000150:complications*; D002545:Brain Ischemia / Q000150:complications*; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006429:Hemiplegia / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011712:Pyramidal Tracts / Q000293:injuries*; D020521:Stroke / Q000150:complications*