title: Medial lemniscus lesion in pediatric hemiplegic patients without corticospinal tract and posterior thalamic radiation lesion.
abstract: OBJECTIVE
  Using diffusion tensor imaging (DTI), we investigated the state of medial lemniscus (ML), corticospinal tract (CST), and posterior thalamic radiation (PTR), which were expected as probable reasons for clinical hemiplegia in pediatric patients, especially those who showed impaired fine motor control and proprioception, but no definite motor weakness or spasticity.
  
  
  METHODS
  We recruited 13 hemiplegic patients and 8 age-matched healthy control subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) for the bilateral ML, CST, and PTR were calculated and compared between the affected hemisphere of the patient (AP), the unaffected hemisphere of the patient (UP), and the mean value of the bilateral hemispheres in control subjects (MC).
  
  
  RESULTS
  FA and ADC values for the CST and PTR did not differ significantly between the AP, UP, and MC subgroups (p > 0.05). However, the FA value for the ML in AP showed a significant decrease, compared with that in UP (p = 0.012) and MC (p = 0.047). DTT for the CST and PTR showed preserved integrity and ML in the UP also had continuity to the cortex; however, ML in AP showed disruption.
  
  
  CONCLUSIONS
  Using DTI, we demonstrated that the ML lesion might be related to clinical hemiplegia in pediatric patients.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
authors.forename: Yong Jae
authors.initials: YJ
authors.lastname: Jung
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Sang Seok
authors.initials: SS
authors.lastname: Yeo
authors.forename: Eunsil
authors.initials: E
authors.lastname: Lee
authors.forename: Saeyoon
authors.initials: S
authors.lastname: Kim
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Lee
authors.forename: Han Sun
authors.initials: HS
authors.lastname: Kim
authors.forename: Su Min
authors.initials: SM
authors.lastname: Son
mesh_terms: D016880:Anisotropy; D002547:Cerebral Palsy / Q000473:pathology*; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D011712:Pyramidal Tracts / Q000473:pathology*; D013788:Thalamus / Q000473:pathology*