title: Neuroradiological and neurophysiological characteristics of patients with dyskinetic cerebral palsy.
abstract: OBJECTIVE
  To investigate neuroradiological and neurophysiological characteristics of patients with dyskinetic cerebral palsy (CP), by using magnetic resonance imaging (MRI), voxel-based morphometry (VBM), diffusion tensor tractography (DTT), and motor evoked potential (MEP).
  
  
  METHODS
  Twenty-three patients with dyskinetic CP (13 males, 10 females; mean age 34 years, range 16-50 years) were participated in this study. Functional evaluation was assessed by the Gross Motor Functional Classification System (GMFCS) and Barry-Albright Dystonia Scale (BADS). Brain imaging was performed on 3.0 Tesla MRI, and volume change of the grey matter was assessed using VBM. The corticospinal tract (CST) and superior longitudinal fasciculus (SLF) were analyzed by DTT. MEPs were recorded in the first dorsal interossei, the biceps brachii and the deltoid muscles.
  
  
  RESULTS
  Mean BADS was 16.4±5.0 in ambulatory group (GMFCS levels I, II, and III; n=11) and 21.3±3.9 in non-ambulatory group (GMFCS levels IV and V; n=12). Twelve patients showed normal MRI findings, and eleven patients showed abnormal MRI findings (grade I, n=5; grade II, n=2; grade III, n=4). About half of patients with dyskinetic CP showed putamen and thalamus lesions on MRI. Mean BADS was 20.3±5.7 in normal MRI group and 17.5±4.0 in abnormal MRI group. VBM showed reduced volume of the hippocampus and parahippocampal gyrus. In DTT, no abnormality was observed in CST, but not in SLF. In MEPs, most patients showed normal central motor conduction time.
  
  
  CONCLUSIONS
  These results support that extrapyramidal tract, related with basal ganglia circuitry, may be responsible for the pathophysiology of dyskinetic CP rather than CST abnormality.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Byung-Hyun
authors.initials: BH
authors.lastname: Park
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Jeong-Hwan
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Myoung-Hwan
authors.initials: MH
authors.lastname: Ko
authors.affiliation: Department of Radiology, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Gyung-Ho
authors.initials: GH
authors.lastname: Chung
keywords: Cerebral palsy; Diffusion tensor imaging; Magnetic resonance imaging; Motor evoked potentials