title: CST recovery in pediatric hemiplegic patients: Diffusion tensor tractography study.
abstract: Many diffusion tensor imaging (DTI) studies have reported an association between corticospinal tract (CST) injury and motor dysfunction. In this study, we investigated CST recovery in 29 pediatric patients with clinical hemiplegia using DTI. We measured the fractional anisotropy (FA), apparent diffusion coefficient (ADC), and asymmetric anisotropy (AA) of both CSTs. The patients were classified into three groups according to severity of CST disruption of the more affected hemisphere. DTI was followed up for 9.34 ± 2.07 months after initial evaluation. The FA value of the more affected CST showed a significant decrease compared to the opposite side at initial and follow up evaluation, respectively (p<0.05). The FA value of both CSTs showed a significant increase at follow up compared to the initial evaluation, while more changes were observed on the more affected side, compared with the less affected side (p<0.05). AA showed a significant decrease at follow up, and showed significant correlation with interval change of FA value of the more affected side, not with that of the less affected side (r=0.543, p<0.05). 19 patients showed change of CST integrity. In the current study, the results of DTI showed recovery of the CST and provided radiologic evidence for a scientific basis of brain plasticity in pediatric patients.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Republic of Korea.
authors.forename: Seung Ok
authors.initials: SO
authors.lastname: Baek
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Eusil
authors.initials: E
authors.lastname: Lee
authors.forename: Saeyoon
authors.initials: S
authors.lastname: Kim
authors.forename: Jeong Ok
authors.initials: JO
authors.lastname: Hah
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Park
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Su Min
authors.initials: SM
authors.lastname: Son
mesh_terms: D016880:Anisotropy; D056324:Diffusion Tensor Imaging; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D011712:Pyramidal Tracts / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology*
keywords: Cerebral palsy; Corticospinal tract; Diffusion tensor; Hemiplegia; Motor