title: Cortical somatosensory reorganization in children with spastic cerebral palsy: a multimodal neuroimaging study.
abstract: Although cerebral palsy (CP) is among the most common causes of physical disability in early childhood, we know little about the functional and structural changes of this disorder in the developing brain. Here, we investigated with three different neuroimaging modalities [magnetoencephalography (MEG), diffusion tensor imaging (DTI), and resting-state fMRI] whether spastic CP is associated with functional and anatomical abnormalities in the sensorimotor network. Ten children participated in the study: four with diplegic CP (DCP), three with hemiplegic CP (HCP), and three typically developing (TD) children. Somatosensory (SS)-evoked fields (SEFs) were recorded in response to pneumatic stimuli applied to digits D1, D3, and D5 of both hands. Several parameters of water diffusion were calculated from DTI between the thalamus and the pre-central and post-central gyri in both hemispheres. The sensorimotor resting-state networks (RSNs) were examined by using an independent component analysis method. Tactile stimulation of the fingers elicited the first prominent cortical response at ~50 ms, in all except one child, localized over the primary SS cortex (S1). In five CP children, abnormal somatotopic organization was observed in the affected (or more affected) hemisphere. Euclidean distances were markedly different between the two hemispheres in the HCP children, and between DCP and TD children for both hemispheres. DTI analysis revealed decreased fractional anisotropy and increased apparent diffusion coefficient for the thalamocortical pathways in the more affected compared to less affected hemisphere in CP children. Resting-state functional MRI results indicated absent and/or abnormal sensorimotor RSNs for children with HCP and DCP consistent with the severity and location of their lesions. Our findings suggest an abnormal SS processing mechanism in the sensorimotor network of children with CP possibly as a result of diminished thalamocortical projections.
authors.affiliation: Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
authors.forename: Christos
authors.initials: C
authors.lastname: Papadelis
authors.affiliation: Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
authors.forename: Banu
authors.initials: B
authors.lastname: Ahtam
authors.affiliation: Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology , Moscow , Russia ; Centre for Cognition and Decision Making, Faculty of Psychology, Higher School of Economics , Moscow , Russia.
authors.forename: Maria
authors.initials: M
authors.lastname: Nazarova
authors.affiliation: Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Nimec
authors.affiliation: Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Snyder
authors.affiliation: Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Department of Radiology, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
authors.forename: Patricia Ellen
authors.initials: PE
authors.lastname: Grant
authors.affiliation: Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Okada
keywords: MR tractography; cerebral palsy; cortical reorganization; magnetoencephalography; resting-state functional MRI; somatosensory processing