Alterations in regional shape on ipsilateral and contralateral cortex contrast in children with unilateral cerebral palsy and are predictive of multiple outcomes.
Congenital brain lesions result in a wide range of cerebral tissue alterations observed in children with cerebral palsy (CP) that are associated with a range of functional impairments. The relationship between injury severity and functional outcomes, however, remains poorly understood. This research investigates the differences in cortical shape between children with congenital brain lesions and typically developing children (TDC) and investigates the correlations between cortical shape and functional outcome in a large cohort of patients diagnosed with unilateral CP. Using 139 structural magnetic resonance images, including 95 patients with clinically diagnosed CP and 44 TDC, cortical segmentations were obtained using a modified expectation maximization algorithm. Three shape characteristics (cortical thickness, curvature, and sulcal depth) were computed within a number of cortical regions. Significant differences in these shape measures compared to the TDC were observed on both the injured hemisphere of children with CP (P < 0.004), as well as on the apparently uninjured hemisphere, illustrating potential compensatory mechanisms in these children. Furthermore, these shape measures were significantly correlated with several functional outcomes, including motor, cognition, vision, and communication (P < 0.012), with three out of these four models performing well on test set validation. This study highlights that cortical neuroplastic effects may be quantified using MR imaging, allowing morphological changes to be studied longitudinally, including any influence of treatment. Ultimately, such approaches could be used for the long term prediction of outcomes and the tailoring of treatment to individuals. Hum Brain Mapp 37:3588-3603, 2016. © 2016 Wiley Periodicals, Inc.
CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.|The School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia.
Alex M
AM
Pagnozzi
CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.
Nicholas
N
Dowson
Stella Maris Scientific Institute, Pisa, Italy.
Simona
S
Fiori
CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.
James
J
Doecke
The School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia.
Andrew P
AP
Bradley
School of Medicine, The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia.
Roslyn N
RN
Boyd
CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.
Stephen
S
Rose
D000293:Adolescent; D000465:Algorithms; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D002547:Cerebral Palsy / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D007839:Functional Laterality; D066128:Gray Matter / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D009473:Neuronal Plasticity; D009929:Organ Size; D012720:Severity of Illness Index
cerebral palsy; cortical gray matter; magnetic resonance imaging; morphology