title: DTI correlates of cognition in term children with spastic diplegic cerebral palsy.
abstract: OBJECTIVE
  Presently, there is no published study that shows association between cognition and white matter injury in spastic cerebral palsy. We aimed to correlate cognitive functions with diffusion tensor imaging derived metrics in spastic diplegic children.
  
  
  METHODS
  Twenty-two term children with spastic diplegia and 22 healthy controls were recruited. All patients were graded on the basis of gross motor function. The Indian children intelligence Test was used to quantify cognition and diffusion tensor imaging was used to quantify microstructural changes in various white matter regions. Diffusion tensor imaging metrics were quantified by placing regions of interests in different white matter regions like corona radiata, anterior limb of internal capsule, posterior limb of internal capsule, mid brain, pons, medulla, genu, splenium, temporal white matter, parietal white matter, frontal white matter and occipital white matter.
  
  
  RESULTS
  Spastic diplegic children showed significantly lower neuropsychological test scores as compared to controls. A significantly decreased fractional anisotropy values were observed in corona radiata, anterior limb of internal capsule, posterior limb of internal capsule, mid brain, pons, medulla, genu, splenium and occipital white matter; however significantly increased mean diffusivity values were observed in corona radiata, anterior limb of internal capsule, posterior limb of internal capsule, mid brain, pons and genu in spastic diplegic as compared to controls. A significant positive correlation in fractional anisotropy and negative correlation in mean diffusivity was observed with neuropsychological test scores.
  
  
  CONCLUSIONS
  These results suggest that these imaging metrics may be used as a biomarker of cognitive functions in term children with spastic diplegia.
authors.affiliation: Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India.
authors.forename: Yogita
authors.initials: Y
authors.lastname: Rai
authors.forename: Saurabh
authors.initials: S
authors.lastname: Chaturvedi
authors.forename: Vimal Kumar
authors.initials: VK
authors.lastname: Paliwal
authors.forename: Puneet
authors.initials: P
authors.lastname: Goyal
authors.forename: Ankita
authors.initials: A
authors.lastname: Chourasia
authors.forename: Ram Kishore
authors.initials: RK
authors.lastname: Singh Rathore
authors.forename: Abhishek
authors.initials: A
authors.lastname: Yadav
authors.forename: Chandra Mani
authors.initials: CM
authors.lastname: Pandey
authors.forename: Rakesh Shyam
authors.initials: RS
authors.lastname: Lalla
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Gupta
mesh_terms: D016880:Anisotropy; D015415:Biomarkers; D002547:Cerebral Palsy / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis*; D056324:Diffusion Tensor Imaging / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000175:diagnosis*; D008297:Male; D009483:Neuropsychological Tests
chemical_list: D015415:Biomarkers