scholarly journals Corticospinal Tract Wiring and Brain Lesion Characteristics in Unilateral Cerebral Palsy: Determinants of Upper Limb Motor and Sensory Function

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Ellen Jaspers ◽  
Lisa Mailleux ◽  
Els Ortibus ◽  
Katrijn Klingels ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Upper Limb ◽  
Corticospinal Tract ◽  
Brain Lesion ◽  
Treatment Strategies ◽  
Sensory Function ◽  
Lesion Location ◽  
Unilateral Cerebral Palsy ◽  
Sensory Functions

Brain lesion characteristics (timing, location, and extent) and the type of corticospinal tract (CST) wiring have been proposed as determinants of upper limb (UL) motor function in unilateral cerebral palsy (uCP), yet an investigation of the relative combined impact of these factors on both motor and sensory functions is still lacking. Here, we first investigated whether structural brain lesion characteristics could predict the underlying CST wiring and we explored the role of CST wiring and brain lesion characteristics to predict UL motor and sensory functions in uCP. Fifty-two participants with uCP (mean age (SD): 11 y and 3 m (3 y and 10 m)) underwent a single-pulse Transcranial Magnetic Stimulation session to determine CST wiring between the motor cortex and the more affected hand (n=17 contralateral, n=19 ipsilateral, and n=16 bilateral) and an MRI to determine lesion timing (n=34 periventricular (PV) lesion, n=18 corticosubcortical (CSC) lesion), location, and extent. Lesion location and extent were evaluated with a semiquantitative scale. A standardized protocol included UL motor (grip strength, unimanual capacity, and bimanual performance) and sensory measures. A combination of lesion locations (damage to the PLIC and frontal lobe) significantly contributed to differentiate between the CST wiring groups, reclassifying the participants in their original group with 57% of accuracy. Motor and sensory functions were influenced by each of the investigated neurological factors. However, multiple regression analyses showed that motor function was predicted by the CST wiring (more preserved in individuals with contralateral CST (p<0.01)), lesion extent, and damage to the basal ganglia and thalamus. Sensory function was predicted by the combination of a large and later lesion and an ipsilateral or bilateral CST wiring, which led to increased sensory deficits (p<0.05). These novel insights contribute to a better understanding of the underlying pathophysiology of UL function and may be useful to delineate individualized treatment strategies.

scholarly journals Sensorimotor functional connectivity in unilateral cerebral palsy: influence of corticospinal tract wiring pattern and clinical correlates

2019 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Ellen Jaspers ◽  
Kaat Alaerts ◽  
Els Ortibus ◽  
Joshua Balsters ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Functional Connectivity ◽  
Upper Limb ◽  
Corticospinal Tract ◽  
Motor Deficits ◽  
Periventricular White Matter ◽  
Healthy Controls ◽  
Sensorimotor Network ◽  
Unilateral Cerebral Palsy ◽  
The Impact

ABSTRACTIn children with unilateral cerebral palsy (uCP), the corticospinal tract (CST) wiring patterns may differ (contralateral, ipsilateral or bilateral), partially determining motor deficits. However, the impact of such CST wiring on functional connectivity remains unknown. Here, we explored differences in functional connectivity of the resting-state sensorimotor network in 26 uCP with periventricular white matter lesions (mean age (SD): 12.87m (±4.5), CST wiring: 9 contralateral, 9 ipsilateral, 6 bilateral) compared to 60 healthy controls (mean age (SD): 14.54 (±4.8)), and between CST wiring patterns. Functional connectivity from each M1 to three bilateral sensorimotor regions of interest (primary sensory cortex, dorsal and ventral premotor cortex) and the supplementary motor area was compared between groups (healthy controls vs. uCP; and healthy controls vs. each CST wiring group). Results from the seed-to-voxel analyses from bilateral M1 were compared between groups. Additionally, relations with upper limb motor deficits were explored. Aberrant sensorimotor functional connectivity seemed to be CST-dependent rather than specific from all the uCP population: in the dominant hemisphere, the contralateral CST group showed increased connectivity between M1 and premotor cortices, whereas the bilateral CST group showed higher connectivity between M1 and somatosensory association areas. These results suggest that functional connectivity of the sensorimotor network is CST wiring-dependent, although the impact on upper limb function remains unclear.

scholarly journals The impact of brain lesion characteristics and the corticospinal tract wiring pattern on mirror movement characteristics in unilateral cerebral palsy

2020 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Ingar Zielinski ◽  
Brian Hoare ◽  
Lisa Decraene ◽  
Jacqueline Williams ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Basal Ganglia ◽  
Corpus Callosum ◽  
Corticospinal Tract ◽  
Brain Lesion ◽  
Periventricular White Matter ◽  
Lesion Type ◽  
Unilateral Cerebral Palsy ◽  
Combined Impact ◽  
The Impact

ABSTRACTBackgroundMirror movements (MM) influence bimanual performance in children with unilateral cerebral palsy (uCP). Whilst MM are related to brain lesion characteristics and the corticospinal tract (CST) wiring pattern, the combined impact of these neurological factors remains unknown.ObjectiveTo investigate the combined impact of neurological factors on MM.MethodsForty-nine children with uCP (mean age 10y6mo) performed a repetitive squeezing task to quantify similarity between MM activity (MM-similarity) and strength of the MM activity (MM-intensity). We used MRI to evaluate lesion type (periventricular white matter, N=30) cortico-subcortical, N=19), the extent of ipsilesional damage and damage to basal ganglia, thalamus and corpus callosum. The CST wiring pattern (17 CSTcontralateral, 16 CSTipsilateral, 16 CSTbilateral) was assessed with Transcranial Magnetic Stimulation. Data was analyzed with simple and multiple regression analyses.ResultsMM-similarity in the more-affected hand was higher with more damage to the corpus callosum. MM-intensity was higher in children with CSTcontralateral with damage to the basal ganglia and thalamus. In the less-affected hand, MM-similarity was explained by the interaction between lesion type and CST wiring pattern, with higher MM-similarity in children with cortico-subcortical lesions in the CSTcontralateral group. MM-intensity was higher with larger damage to the corpus callosum and unilateral lesions.ConclusionsA complex combination of neurological factors influences MM characteristics and the mechanisms differ between hands.

Brain Lesions as a Predictor of Therapeutic Outcomes of Hand Function in Infants With Unilateral Cerebral Palsy

2018 ◽  
Vol 33 (14) ◽  
pp. 918-924
Author(s):  
Rena Chamudot ◽  
Shula Parush ◽  
Amihai Rigbi ◽  
Varda Gross-Tsur
Keyword(s):  
Cerebral Palsy ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Upper Limb ◽  
Hand Function ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Significant Difference ◽  
Unilateral Cerebral Palsy ◽  
Middle Cerebral Artery Infarct

Aim: The present study aimed to investigate whether the response variability of infants to modified constraint-induced movement therapy and bimanual therapy are associated with different types of brain lesions. Method: Infants with unilateral cerebral palsy (N = 22) ages 8-15 months (mean = 10.95, standard deviation = 2.15 months) were grouped according to having either a periventricular brain lesion or a middle cerebral artery infarct lesion. Improvement in hand function was analyzed based on the mini–Assistive Hand Assessment results. Results: Infants with periventricular brain lesion displayed greater positive response to upper limb treatment compared to those with middle cerebral artery infarct ( P = .02). A significant difference in improvement according to type of treatment was found in the middle cerebral artery infarct group but not in the periventricular brain lesion. Conclusion: The present study showed an association between the type of brain lesion and the efficacy of upper limb treatment in infants. Infants with periventricular brain lesions displayed greater positive responses than those with middle cerebral artery infarct.

scholarly journals Risk factors for hip dislocation in dyskinetic cerebral palsy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Lesion Location ◽  
Hip Displacement ◽  
Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

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