Cortical Reorganization following Injury Early in Life.
The brain has a remarkable capacity for reorganization following injury, especially during the first years of life. Knowledge of structural reorganization and its consequences following perinatal injury is sparse. Here we studied changes in brain tissue volume, morphology, perfusion, and integrity in children with hemiplegia compared to typically developing children, using MRI. Children with hemiplegia demonstrated reduced total cerebral volume, with increased cerebrospinal fluid (CSF) and reduced total white matter volumes, with no differences in total gray matter volume, compared to typically developing children. An increase in cortical thickness at the hemisphere contralateral to the lesion (CLH) was detected in motor and language areas, which may reflect compensation for the gray matter loss in the lesion area or retention of ipsilateral pathways. In addition, reduced cortical thickness, perfusion, and surface area were detected in limbic areas. Increased CSF volume and precentral cortical thickness and reduced white matter volume were correlated with worse motor performance. Brain reorganization of the gray matter within the CLH, while not necessarily indicating better outcome, is suggested as a response to neuronal deficits following injury early in life.
Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Moran
M
Artzi
Department of Radiology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel.
Shelly Irene
SI
Shiran
Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel; Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Bar Ilan, Israel.
Maya
M
Weinstein
Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel.
Vicki
V
Myers
Jaime and Joan Constantiner School of Education, Tel Aviv University, P.O. Box 39040, 69978 Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
Ricardo
R
Tarrasch
Paediatric Neurology Unit, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel.
Mitchell
M
Schertz
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Paediatric Neurology Unit, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel.
Aviva
A
Fattal-Valevski
Diagnostic Imaging, Children's Hospital of Eastern Ontario, 401 Smyth Road Ottawa, ON, Canada K1H 8L1.
Elka
E
Miller
Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 W 120th Street, New York, NY 10027, USA.
Andrew M
AM
Gordon
Department Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Centre for Rehabilitation, Oxford Brookes University, Headington Campus, Headington Road, Oxford OX3 0BP, UK.
Dido
D
Green
Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
Dafna
D
Ben Bashat
D000293:Adolescent; D000367:Age Factors; D001930:Brain Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D005260:Female; D006429:Hemiplegia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000639:trends; D008297:Male; D009929:Organ Size / Q000502:physiology