title: Comparing quantitative tractography metrics of motor and sensory pathways in children with periventricular leukomalacia and different levels of gross motor function.
abstract: BACKGROUND
  The neural tracts responsible for gross motor dysfunction in children with spastic cerebral palsy (CP) caused by periventricular leukomalacia remain unknown. This study investigated both sensory and motor tracts using diffusion tensor tractography (DTT).
  
  
  METHODS
  Brain MRIs with diffusion tensor imaging (DTI) performed on 19 children (ten boys and nine girls) with bilateral spastic CP were analyzed. DTT was reconstructed from DTI. Participants were classified according to gross motor function measured with Gross Motor Function Classification System (GMFCS). Those with GMFCS levels I-III comprised the high-functioning group (n = 11), and those with GMFCS levels IV-V comprised the low-functioning group (n = 8). We compared DTT-based metrics, such as fractional anisotropy, apparent diffusion coefficient, and fiber number and volume, between the groups.
  
  
  RESULTS
  In the corticospinal tract, the volume and number of fibers were significantly higher in the high-functioning group (p < 0.001), whereas the fractional anisotropy and apparent diffusion coefficient of the corticospinal tract did not differ significantly between the groups. In the somotosensory tract and posterior thalamic radiation, none of the DTT parameters differed significantly between the groups.
  
  
  CONCLUSIONS
  Children with bilateral spastic CP with differing levels of gross motor function have corresponding differences detectable on DTT in their corticospinal tracts but not in their somatosensory tracts and posterior thalamic radiations. In addition, the number and volume of fibers, but not fractional anisotropy values or apparent diffusion coefficients, are lower in the corticospinal tracts in children with low gross motor function than in those with high gross motor function.
authors.affiliation: Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
authors.forename: Dong-wook
authors.initials: DW
authors.lastname: Rha
authors.forename: Won Hyuk
authors.initials: WH
authors.lastname: Chang
authors.forename: Jinna
authors.initials: J
authors.lastname: Kim
authors.forename: Eun Geol
authors.initials: EG
authors.lastname: Sim
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Park
mesh_terms: D002547:Cerebral Palsy / Q000473:pathology* / Q000503:physiopathology*; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology; D009048:Motor Skills; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009434:Neural Pathways / Q000473:pathology; D012720:Severity of Illness Index; D013003:Somatosensory Cortex / Q000473:pathology / Q000503:physiopathology