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New insights into the pathology of white matter tracts in cerebral palsy from diffusion magnetic resonance imaging

SCHECK SM; BOYD RN; ROSE A
DEV MED CHILD NEUROL , 2012, vol. 54, n° 8, p. 684-696
Doc n°: 158624
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1111/j.1469-8749.2012.04332.x
Descripteurs : AJ23 - PARALYSIE CEREBRALE, AK15 - IRM

Structural connectivity analysis using diffusion magnetic resonance imaging
(dMRI) and tractography has become the method of choice for studying white matter
pathology and reorganization in children with congenital hemiplegia. To evaluate
its role in the research domain, we systematically reviewed the literature about
children with cerebral palsy (CP) to document common findings and identify
strengths and possible limitations of this neuroimaging technology. METHOD: A literature search was performed for peer-reviewed studies pertaining to dMRI and
CP. RESULTS: Twenty-two studies met the inclusion criteria. The corticospinal
tract was studied in greatest detail (18/22).
The most common finding was
decreased fractional anisotropy and/or increased mean diffusivity, indicating
significant loss in the integrity of these corticomotor pathways. Fewer studies
assessed ascending sensorimotor pathways including the posterior and superior
thalamic radiations, which also showed decreased fractional anisotropy.
Anisotropy indices (fractional anisotropy, mean diffusivity) obtained for both
corticomotor and sensorimotor tracts were repeatedly shown to correlate with
clinical measures. Other tracts studied included commissural and association
fibres, which showed conflicting results. INTERPRETATION: There is sound evidence
that dMRI-based connectivity techniques are useful for improving our
understanding of the structure-function relationships of corticomotor and sensorimotor neural networks in CP.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS

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