title: Does Contralesional Hand Function After Neonatal Stroke Only Depend on Lesion Characteristics?
abstract: In children having suffered from neonatal arterial ischemic stroke, the relationship between contralesional hand performance and structural changes in brain areas remote from the infarct site was examined.
  
  
  
  Using voxel-based morphometry, we correlated contralesional gross manual dexterity assessed by the box and block test and whole-brain gray and white-matter volume changes on high-resolution magnetic resonance imaging in 37 7-year-old post-neonatal arterial ischemic stroke children. We also compared the volume of the identified structures with magnetic resonance imaging data of 10 typically developing age-matched children.
  
  
  
  Areas showing the highest positive correlation with the box and block test scores were ipsilesional mediodorsal thalamus, contralesional cerebellar lobule VIIa Crus I, and ipsilesional corticospinal tract at the level of superior corona radiata, the posterior limb of the internal capsule, and the cerebral peduncle and the ipsilesional body of corpus callosum. When compared with typically developing age-matched children, post-neonatal arterial ischemic stroke children with severe contralesional hand motor deficit exhibited significant volume reductions in these structures (except the cerebellum), whereas no differences were found with those with good manual dexterity. No negative correlation was found between box and block test scores and brain areas.
  
  
  
  Contralesional hand performance after neonatal arterial ischemic stroke is correlated with atrophy in brain areas directly or functionally connected but anatomically remote from the infarct. Our study suggests a role of the cerebellar lobule VIIa Crus I and mediodorsal thalamus in manual dexterity.
  
  
  
  URL: https://clinicaltrials.gov. Unique identifier: NCT02511249.
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.). mickael.dinomais@les-capucins-angers.fr.
authors.forename: Mickael
authors.initials: M
authors.lastname: Dinomais
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Lucie
authors.initials: L
authors.lastname: Hertz-Pannier
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Samuel
authors.initials: S
authors.lastname: Groeschel
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Matthieu
authors.initials: M
authors.lastname: Delion
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Béatrice
authors.initials: B
authors.lastname: Husson
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Manoelle
authors.initials: M
authors.lastname: Kossorotoff
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Cyrille
authors.initials: C
authors.lastname: Renaud
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Stéphane
authors.initials: S
authors.lastname: Chabrier
authors.affiliation: From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.).
authors.forename: Sylvie Nguyen
authors.initials: SN
authors.lastname: The Tich
mesh_terms: D001284:Atrophy / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D002648:Child; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging*; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D020521:Stroke / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: atrophy; cerebral palsy; cerebral peduncle; dexterity; magnetic resonance imaging; motor system; stroke