title: Patterns of structural reorganization of the corticospinal tract in children with Sturge-Weber syndrome.
abstract: BACKGROUND
  Reorganization of the corticospinal tract after early damage can limit motor deficit. In this study, we explored patterns of structural corticospinal tract reorganization in children with Sturge-Weber syndrome.
  
  
  METHODS
  Five children (age 1.5-7 years) with motor deficit resulting from unilateral Sturge-Weber syndrome were studied prospectively and longitudinally (1-2 years follow-up). Corticospinal tract segments belonging to hand and leg movements were separated and their volume was measured by diffusion tensor imaging tractography using a recently validated method. Corticospinal tract segmental volumes were normalized and compared between the Sturge-Weber syndrome children and age-matched healthy controls. Volume changes during follow-up were also compared with clinical motor symptoms.
  
  
  RESULTS
  In the Sturge-Weber syndrome children, hand-related (but not leg-related) corticospinal tract volumes were consistently decreased in the affected cerebral hemisphere at baseline. At follow-up, two distinct patterns of hand corticospinal tract volume changes emerged. (1) Two children with extensive frontal lobe damage showed a corticospinal tract volume decrease in the lesional hemisphere and a concomitant increase in the nonlesional (contralateral) hemisphere. These children developed good hand grasp but no fine motor skills. (2) The three other children, with relative sparing of the frontal lobe, showed an interval increase of the normalized hand corticospinal tract volume in the affected hemisphere; these children showed no gross motor deficit at follow-up.
  
  
  CONCLUSIONS
  Diffusion tensor imaging tractography can detect differential abnormalities in the hand corticospinal tract segment both ipsi- and contralateral to the lesion. Interval increase in the corticospinal tract hand segment suggests structural reorganization, whose pattern may determine clinical motor outcome and could guide strategies for early motor intervention.
authors: Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan.
authors: David O
authors: DO
authors: Kamson
authors: Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan.
authors: Csaba
authors: C
authors: Juhász
authors: Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan.
authors: Joseph
authors: J
authors: Shin
authors: Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan.
authors: Michael E
authors: ME
authors: Behen
authors: Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan.
authors: William C
authors: WC
authors: Guy
authors: Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan.
authors: Harry T
authors: HT
authors: Chugani
authors: Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan. Electronic address: jeongwon@pet.wayne.edu.
authors: Jeong-Won
authors: JW
authors: Jeong
mesh_terms: D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology* / Q000503:physiopathology; D006225:Hand / Q000473:pathology / Q000503:physiopathology; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007223:Infant; D007866:Leg / Q000473:pathology / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009048:Motor Skills / Q000502:physiology; D009473:Neuronal Plasticity; D009929:Organ Size; D011446:Prospective Studies; D011712:Pyramidal Tracts / Q000473:pathology* / Q000503:physiopathology; D013341:Sturge-Weber Syndrome / Q000473:pathology* / Q000503:physiopathology
keywords: Sturge-Weber syndrome; corticospinal tract; diffusion tensor imaging; longitudinal study; motor deficit; reorganization; tractography