title: Grey matter injury patterns in cerebral palsy: associations between structural involvement on MRI and clinical outcomes.
abstract: OBJECTIVE
  In a population cohort of children with grey matter injury (GMI) and cerebral palsy (CP), we aimed to describe and classify magnetic resonance imaging characteristics specific to GMI, and to identify key structure-function associations that serve as a basis for rating GMI in clinically relevant ways.
  
  
  METHODS
  Symmetry, extent of cerebral injury, and pathological pattern for 54 children (37 males, 17 females) with CP and a predominant GMI pattern on chronic-phase magnetic resonance imaging were related to gross motor function, motor type and topography, epilepsy, intellectual disability, blindness, and deafness.
  
  
  RESULTS
  Relative to mild GMI where there was no pallidal abnormality, severe GMI, comprising pallidal abnormality alone or in conjunction with other deep nuclear and generalized cortical-subcortical involvement, was strongly associated with Gross Motor Function Classification System levels IV to V (OR 35.7 [95% CI 3.5, 368.8]). Involvement of the basal ganglia was associated with non-spastic/mixed motor types, but predominantly where cortical-subcortical grey and white matter involvement was not extensive. The prevalence of epilepsy was highest where there was diffuse cortical-subcortical involvement and white matter loss.
  
  
  CONCLUSIONS
  Better understanding of structure-function relationships in CP and GMI, and how to rate the severity of GMI, will be helpful in the clinical context and also as a basis for investigation of causal pathways in CP.
authors.affiliation: Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Reid
authors.affiliation: Department of Medical Imaging, Royal Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Charuta D
authors.initials: CD
authors.lastname: Dagia
authors.affiliation: Department of Diagnostic Imaging, Monash Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Ditchfield
authors.affiliation: Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Dinah S
authors.initials: DS
authors.lastname: Reddihough
mesh_terms: D002547:Cerebral Palsy / Q000145:classification* / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D005260:Female; D005917:Globus Pallidus / Q000473:pathology*; D066128:Gray Matter / Q000293:injuries / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012042:Registries; D012720:Severity of Illness Index