title: The effects of hemorrhagic parenchymal infarction on the establishment of sensori-motor structural and functional connectivity in early infancy.
abstract: BACKGROUND
  The objective of the study was to characterize alterations of structural and functional connectivity within the developing sensori-motor system in infants with focal perinatal brain injury and at high risk of cerebral palsy.
  
  
  METHODS
  Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) data were used to study the developing functional and structural connectivity framework in six infants born prematurely at term equivalent age. This was first characterised in three infants without focal pathology, which was then compared to that derived from three infants with unilateral haemorrhagic parenchymal infarction and a subsequent focal periventricular white matter lesion who developed later haemiparesis.
  
  
  RESULTS
  Functional responses to passive hand movement were in the contralateral perirolandic cortex, regardless of focal pathology. In infants with unilateral periventricular injury, afferent thalamo-cortical tracts appeared to have developed compensatory trajectories which circumvented areas of damage. In contrast, efferent corticospinal tracts showed marked asymmetry at term equivalent age following focal brain injury. Sensori-motor network analysis suggested that inter-hemispheric functional connectivity is largely preserved despite pathology and that impairment may be associated with adverse neurodevelopmental outcome.
  
  
  CONCLUSIONS
  Following focal perinatal brain injury, altered structural and functional connectivity is already present and can be characterized with MRI at term equivalent age. The results of this small case series suggest that these techniques may provide valuable new information about prognosis and the pathophysiology underlying cerebral palsy.
authors.affiliation: Department of Perinatal Imaging & Health, Division of Imaging Sciences & Biomedical Engineering, Kings College London, St Thomas' Hospital, 1st floor North Wing, Westminster Bridge Road, London, SE1 7EH, UK, tomoki.arichi@kcl.ac.uk.
authors.forename: T
authors.initials: T
authors.lastname: Arichi
authors.forename: S J
authors.initials: SJ
authors.lastname: Counsell
authors.forename: A G
authors.initials: AG
authors.lastname: Allievi
authors.forename: A T
authors.initials: AT
authors.lastname: Chew
authors.forename: M
authors.initials: M
authors.lastname: Martinez-Biarge
authors.forename: V
authors.initials: V
authors.lastname: Mondi
authors.forename: N
authors.initials: N
authors.lastname: Tusor
authors.forename: N
authors.initials: N
authors.lastname: Merchant
authors.forename: E
authors.initials: E
authors.lastname: Burdet
authors.forename: F M
authors.initials: FM
authors.lastname: Cowan
authors.forename: A D
authors.initials: AD
authors.lastname: Edwards
mesh_terms: D020520:Brain Infarction / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D066191:Sensorimotor Cortex / Q000254:growth & development* / Q000473:pathology* / Q000503:physiopathology