title: Anatomical characterization of athetotic and spastic cerebral palsy using an atlas-based analysis.
abstract: OBJECTIVE
  To analyze diffusion tensor imaging (DTI) in two types of cerebral palsy (CP): the athetotic-type and the spastic-type, using an atlas-based anatomical analysis of the entire brain, and to investigate whether these images have unique anatomical characteristics that can support functional diagnoses.
  
  
  METHODS
  We retrospectively analyzed the DTI of seven children with athetotic-type, 11 children with spastic-type, and 20 healthy control children, all age-matched. The severity of motor dysfunction was evaluated with the Gross Motor Function Classification System (GMFCS). The images were normalized using a linear transformation, followed by large deformation diffeomorphic metric mapping. For 205 parcellated brain areas, the volume, fractional anisotropy, and mean diffusivity were measured. Principal component analysis (PCA) was performed for the Z-scores of these parameters.
  
  
  RESULTS
  The GMFCS scores in athetotic-type were significantly higher than those in spastic-type (P < 0.001). PCA extracted anatomical components that comprised the two types of CP, as well as the severity of motor dysfunction. In the athetotic group, the abnormalities were more severe than in the spastic group. In the spastic group, significant changes were concentrated in the lateral ventricle and periventricular structures.
  
  
  CONCLUSIONS
  Our results quantitatively delineated anatomical characteristics that reflected the functional findings in two types of CP.
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Shoko
authors.initials: S
authors.lastname: Yoshida
authors.forename: Andreia V
authors.initials: AV
authors.lastname: Faria
authors.forename: Kenichi
authors.initials: K
authors.lastname: Oishi
authors.forename: Toyoko
authors.initials: T
authors.lastname: Kanda
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Yamori
authors.forename: Naoko
authors.initials: N
authors.lastname: Yoshida
authors.forename: Haruyo
authors.initials: H
authors.lastname: Hirota
authors.forename: Mika
authors.initials: M
authors.lastname: Iwami
authors.forename: Sozo
authors.initials: S
authors.lastname: Okano
authors.forename: John
authors.initials: J
authors.lastname: Hsu
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Hangyi
authors.initials: H
authors.lastname: Jiang
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
authors.forename: Katsumi
authors.initials: K
authors.lastname: Hayakawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Mori
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001921:Brain / Q000473:pathology*; D002547:Cerebral Palsy / Q000145:classification* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013382:Subtraction Technique
keywords: atlas-based analysis; cerebral palsy; diffusion tensor imaging; principal component analysis