Structural network performance for early diagnosis of spastic cerebral palsy in periventricular white matter injury

Abstract Objective Children with spastic cerebral palsy (CP) have gait impairments resulting from decreased selective motor control, an inability to move the leg joints independently of one another, relying on excessive flexion or extension coupling across the 3 joints. Infants with white matter injury are at high risk of CP and have decreased selective motor control as early as 1 month corrected age. An in-home kicking-activated mobile task was developed to motivate more selective hip-knee control of infants at high risk of CP. The purposes of this study were to determine the feasibility of the in-home mobile task and to determine whether infants at high risk of CP and infants with typical development (TD) learn the association between their leg movements and mobile activation. Methods Ten infants at high risk of CP based on neuroimaging and 11 infants with TD participated in this cohort study at 3.5 to 4.5 months corrected age. Each infant participated in the in-home kicking-activated mobile task for 8 to 10 min/d, 5 d/wk, for 6 weeks. Learning was assessed weekly based on an increase in the time that the infant demonstrated the reinforced leg actions when interacting with the kicking-activated mobile compared with spontaneous kicking. Results With regard to feasibility, participation averaged 92% for infants at high risk of CP and 99% for infants with TD. With regard to learning, the group at high risk of CP demonstrated learning of the task for 2 of 6 weeks, whereas the group with TD demonstrated learning for all 6 weeks. Conclusions Infants at high risk of CP demonstrated learning of the kicking-activated mobile task but at a reduced amount compared with infants with TD. Further research is necessary to determine whether the kicking-activated mobile task has potential as an intervention to motivate more selective hip-knee control and improve walking outcomes of infants at high risk of CP. Impact This study investigated the feasibility of an in-home kicking-activated mobile task, a discovery learning task designed to motivate infants at high risk of CP to engage in the intensive task practice necessary to promote their learning abilities and selective motor control. Lay Summary CP is a lifelong disorder of movement caused by abnormal development or early damage to the brain. If an in-home infant kicking-activated mobile task could be used to motivate certain types of age-appropriate leg movements of infants who are at high risk of CP, the task could help improve walking outcomes, which eventually could contribute to improving children’s ability to participate in daily life. This study showed that infants at high risk of CP did learn the infant kicking-activated mobile task but at a much reduced amount compared with infants who are developing typically; so, this is a first step in determining whether the task has potential to motivate more age-appropriate leg movements in infants at high risk of cerebral palsy.

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Hemiplegic (unilateral) cerebral palsy in northern Stockholm: clinical assessment, brain imaging, EEG, epilepsy and aetiologic background factors

BMC Pediatrics ◽

10.1186/s12887-020-1955-z ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Elsa Tillberg ◽

Bengt Isberg ◽

Jonas K. E. Persson

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

White Matter ◽

Diagnostic Delay ◽

Motor Impairment ◽

Population Based ◽

White Matter Injury ◽

Background Factors ◽

Hemiplegic Cerebral Palsy ◽

First Year Of Life

Abstract Background The purpose of this study was to describe clinical presentation, epilepsy, EEG, extent and site of the underlying cerebral lesion with special reference towards aetiologic background factors in a population-based group of children with hemiplegic cerebral palsy. Methods Forty-seven children of school- age, fulfilling the SPCE (Surveillance of Cerebral palsy in Europe)-criteria of hemiplegic cerebral palsy, identified via the Swedish cerebral palsy register, were invited and asked to participate in the study. Results Fifteen boys and six girls participated. Of the sixteen children born at term, five had no risk factors for cerebral palsy. Two out of five preterm children presented additional risk factors. Debut of motor impairment was observed in the first year of life in sixteen children. Age at diagnosis varied from 2 months to 6 years. Epilepsy was common and associated with grey- and white matter injury. Conclusions Recognizing the importance of risk factors for cerebral palsy, any child with these risk factors should be offered a check-up by a paediatrician or a paediatric neurologist. Thereby reducing diagnostic delay. Epilepsy is common in hemiplegic cerebral palsy and associated with grey- and white matter injury in this cohort.

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164: Glial fibrillary acidic protein as a serum biomarker for the early identification of neonatal periventricular white matter injury in preterm neonates

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2011.10.182 ◽

2012 ◽

Vol 206 (1) ◽

pp. S86

Author(s):

Amanda Stewart ◽

Jacky Jennings ◽

Aylin Tekes ◽

Huisman Thierry ◽

Frances Northington ◽

...

Keyword(s):

White Matter ◽

Glial Fibrillary Acidic Protein ◽

Early Identification ◽

Acidic Protein ◽

White Matter Injury ◽

Serum Biomarker ◽

Preterm Neonates ◽

Periventricular White Matter

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White Matter Injury Correlates with Hypertonia in an Animal Model of Cerebral Palsy

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/sj.jcbfm.9600333 ◽

2006 ◽

Vol 27 (2) ◽

pp. 270-281 ◽

Cited By ~ 64

Author(s):

Alexander Drobyshevsky ◽

Matthew Derrick ◽

Alice Mary Wyrwicz ◽

Xinhai Ji ◽

Ila Englof ◽

...

Keyword(s):

Animal Model ◽

Cerebral Palsy ◽

White Matter ◽

White Matter Injury

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525: Peripheral glucose levels at birth and diagnosis of periventricular white matter injury in premature neonates

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2012.10.691 ◽

2013 ◽

Vol 208 (1) ◽

pp. S225

Author(s):

Sarahn Wheeler ◽

Elisabeth Nigrini ◽

Andrew Satin ◽

Michael Johnston ◽

Ernest Graham ◽

...

Keyword(s):

White Matter ◽

White Matter Injury ◽

Periventricular White Matter ◽

Premature Neonates ◽

Glucose Levels

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Periventricular White Matter Injury in the Premature Infant Is Associated with a Reduction in Cerebral Cortical Gray Matter Volume at Term

Pediatric Research ◽

10.1203/00006450-199904020-02039 ◽

1999 ◽

Vol 45 (4, Part 2 of 2) ◽

pp. 343A-343A

Author(s):

Terrie E Inder ◽

Petra S Huppi ◽

Simon Warfield ◽

Ron Kikinis ◽

Gary P Zientara ◽

...

Keyword(s):

White Matter ◽

Premature Infant ◽

Gray Matter ◽

Gray Matter Volume ◽

White Matter Injury ◽

Periventricular White Matter ◽

Matter Volume ◽

Cortical Gray Matter

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Neurovisualization features of brain anatomy in children with spastic cerebral palsy revealed by magnetic resonance tractography

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2021-3-54-61 ◽

2021 ◽

Vol 20 (3) ◽

pp. 54-61

Author(s):

E. A. Klyuev ◽

G. E. Sheiko ◽

M. G. Dunaev ◽

E. V. Lobanova ◽

M. V. Rasteryaeva ◽

...

Keyword(s):

Cerebral Palsy ◽

White Matter ◽

Magnetic Resonance ◽

Corpus Callosum ◽

Fractional Anisotropy ◽

Absolute Number ◽

Spastic Cerebral Palsy ◽

White Matter Tract ◽

Motor Disturbance ◽

Apparent Diffusion

Aim. To perform quantitative evaluation of the degree of white matter tract abnormalities in children with spastic cerebral palsy by magnetic resonance tractography to determine severity of the disease, as well as to carry out a dynamic assessment of treatment effectiveness.Materials and methods. The study included 46 children (32 males, 14 females; average age 5.4 ± 1.1 years). The participants were divided into two groups. The experimental group consisted of 23 children with spastic cerebral palsy. The control group included 23 children without any neurological disorder. Examination of the brain was performed on the Siemens Essenza 1,5 Т system (Siemens, Germany) and included magnetic resonance tractography to reconstruct the major white matter tracts. The number of fibers, average fractional anisotropy value, apparent diffusion coefficient, and coefficient of myelination of major white matter tracts in the brain were calculated and analyzed.Results. We found a significant difference in the above-stated parameters between the groups. The experimental group showed a decrease in the absolute number of fibers at the central and posterior segments of the corpus callosum, corticospinal tracts, and left inferior longitudinal fasciculus. Besides, we detected a decrease in fractional anisotropy at 2–5 segments of the corpus callosum and right lateral corticospinal tract, an increase in the apparent diffusion coefficient at 2, 4, and 5 segments of the corpus callosum and left lateral corticospinal tract, and a decrease in the myelination coefficient in all the examined tracts, except for superior longitudinal fasciculus. We revealed a positive correlation between the intensity of the motor disturbance and the coefficient of myelination at the anterior corpus callosum and inferior longitudinal fasciculus.Conclusion. Magnetic resonance tractography is an informative technique for unbiased evaluation of white matter tract anatomy, as well the level and degree of motor tract damage. The most useful characteristics of white matter tract anatomy are the absolute number of fibers in the tract, fractional anisotropy, and coefficient of myelination. Some of them correlated with the intensity of motor disturbance, so they can be regarded as potential predictors of rehabilitation potential.

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