title: Localization of function-specific segments of the primary motor pathway in children with Sturge-Weber syndrome: a multimodal imaging analysis.
abstract: OBJECTIVE
  To explore whether diffusion-weighted imaging (DWI) can localize specific segments of primary motor areas in children with Sturge-Weber syndrome (SWS), this study investigated the corticospinal tract (CST) between precentral gyrus (PCG) and posterior limb of internal capsule (PIC).
  
  
  METHODS
  DWI was performed on 32 healthy children and seven children with unilateral SWS affecting the sensorimotor area variably. A hierarchical dendrogram was applied to find PCG-segments uniquely connected to PIC-segments. The resulting PCG-clusters were used to image primary motor pathways in DWI and find metabolic abnormalities of primary motor areas in positron emission tomography (PET) scans.
  
  
  RESULTS
  In healthy children, five PCG-clusters were found to have unique CST courses, corresponding to CST segments of mouth/lip, fingers, and leg/ankle primary motor areas determined by functional magnetic resonance imaging (fMRI). In children with SWS, reduced streamlines in these PCG clusters were highly correlated with glucose-hypometabolism on PET (R(2) = 0.2312, P = 0.0032). Impaired CST segment corresponding to finger movements correlated with severity of hand motor deficit.
  
  
  CONCLUSIONS
  The presented method can detect impaired CST segments corresponding to specific motor functions in young children who cannot cooperate for fMRI. This approach can be clinically useful for a noninvasive presurgical evaluation of cortical motor areas in such children.
authors: Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA; Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan, USA.
authors: Jeong-Won
authors: JW
authors: Jeong
authors: Harry T
authors: HT
authors: Chugani
authors: Csaba
authors: C
authors: Juhász
mesh_terms: D002648:Child; D063132:Connectome / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods; D004525:Efferent Pathways / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D009044:Motor Cortex / Q000473:pathology*; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013003:Somatosensory Cortex / Q000473:pathology*; D013341:Sturge-Weber Syndrome / Q000473:pathology*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Sturge-Weber syndrome; cortico-spinal tract; diffusion weighted imaging tractography; multimodal analysis; primary motor areas