Extent of altered white matter in unilateral and bilateral periventricular white matter lesions in children with unilateral cerebral palsy.
OBJECTIVE
To investigate the extent of white matter damage in children with unilateral cerebral palsy (UCP) caused by periventricular white matter lesions comparing between unilateral and bilateral lesions; and to investigate a relationship between white matter microstructure and hand function.


METHODS
Diffusion MRI images from 46 children with UCP and 18 children with typical development (CTD) were included. Subjects were grouped by side of hemiparesis and unilateral or bilateral lesions. A voxel-wise white matter analysis was performed to identify regions where fractional anisotropy (FA) was significantly different between UCP groups and CTD; and where FA correlated with either dominant or impaired hand function (using Jebsen Taylor Hand Function Test).


RESULTS
Children with unilateral lesions had reduced FA in the corticospinal tract of the affected hemisphere. Children with bilateral lesions had widespread reduced FA extending into all lobes. In children with left hemiparesis, impaired hand function correlated with FA in the contralateral corticospinal tract. Dominant hand function correlated with FA in the posterior thalamic radiations as well as multiple other regions in both left and right hemiparesis groups.


CONCLUSIONS
Periventricular white matter lesions consist of focal and diffuse components. Focal lesions may cause direct motor fibre insult resulting in motor impairment. Diffuse white matter injury is heterogeneous, and may contribute to more global dysfunction.
The University of Queensland, School of Medicine, Brisbane, Australia; The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia; Wellington Regional Hospital, Department of Obstetrics and Gynaecology, Wellington, New Zealand.
Simon M
SM
Scheck
Australian e-Health Research Centre, CSIRO, Brisbane, Australia.
Jurgen
J
Fripp
The University of Queensland, School of Medicine, Brisbane, Australia; Australian e-Health Research Centre, CSIRO, Brisbane, Australia.
Lee
L
Reid
The University of Queensland, School of Medicine, Brisbane, Australia; Australian e-Health Research Centre, CSIRO, Brisbane, Australia.
Kerstin
K
Pannek
Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy.
Simona
S
Fiori
The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia.
Roslyn N
RN
Boyd
Australian e-Health Research Centre, CSIRO, Brisbane, Australia. Electronic address: Stephen.Rose@csiro.au.
Stephen E
SE
Rose
D000293:Adolescent; D016880:Anisotropy; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002547:Cerebral Palsy / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology; D011712:Pyramidal Tracts / Q000000981:diagnostic imaging / Q000503:physiopathology; D013788:Thalamus / Q000000981:diagnostic imaging / Q000503:physiopathology; D066127:White Matter / Q000000981:diagnostic imaging* / Q000503:physiopathology
Corticospinal tract; Diffusion MRI; Hemiparesis; Periventricular white matter; TBSS; Unilateral cerebral palsy