Specific White Matter Lesions Related to Motor Dysfunction in Spastic Cerebral Palsy: A Meta-analysis of Diffusion Tensor Imaging Studies

2019 ◽  
Vol 35 (2) ◽  
pp. 146-154 ◽  
Author(s):  
Haoxiang Jiang ◽  
Heng Liu ◽  
Hairong He ◽  
Jian Yang ◽  
Zhe Liu ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Fractional Anisotropy ◽  
Motor Function ◽  
Diffusion Tensor ◽  
Meta Analysis ◽  
White Matter Lesions ◽  
Internal Capsule ◽  
Motor Dysfunction ◽  
Spastic Cerebral Palsy ◽  
Posterior Limb

Background: Assessing motor impairment in spastic cerebral palsy is a key factor in the treatment and rehabilitation of patients. We intend to investigate the correlation between diffusion tensor imaging properties of sensorimotor pathways and motor function in spastic cerebral palsy using meta-analysis, and to determine specific white matter lesions that are closely related to motor dysfunction in spastic cerebral palsy. Methods: We conducted a literature search of PubMed, Embase, Scopus, and Web of Science databases to identify trials published from January 1999 to January 2019 that had evaluated the correlation between fractional anisotropy and motor function scores in spastic cerebral palsy. Correlation coefficient ( r) values were extracted for each study, and the extent of r was quantitatively explored. The r values between fractional anisotropy within different sensorimotor pathways and motor function scores were pooled respectively. Results: Nineteen studies involving 504 children with spastic cerebral palsy, were included. Fractional anisotropy in both sensory and motor pathways significantly correlated with motor function scores. However, compared with the corticospinal tract and thalamic radiation, fractional anisotropy in the posterior limb of the internal capsule correlated more strongly with gross motor function classification system and upper limb motor function ( r = –0.71, 95% confidence interval [CI] –0.80 to –0.60; r = 0.73, 95% CI 0.60-0.82, respectively; P < .05). Conclusions: Fractional anisotropy within the posterior limb of the internal capsule is more closely related to motor dysfunction and can potentially be a biomarker for evaluating the degree of motor impairment in spastic cerebral palsy.

scholarly journals A coordinate-based meta-analysis of white matter alterations in patients with alcohol use disorder

2021 ◽  
Author(s):  
Carolin Spindler ◽  
Louisa Mallien ◽  
Sebastian Trautmann ◽  
Nina Alexander ◽  
Markus Muehlhan
Keyword(s):  
White Matter ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Diffusion Tensor ◽  
Meta Analysis ◽  
Internal Capsule ◽  
Likelihood Estimation ◽  
Posterior Limb ◽  
Reference Space ◽  
The Right

Introduction: Besides the commonly described grey matter (GM) deficits, there is growing evidence of significant white matter (WM) alterations in patients with alcohol use disorder (AUD). WM changes can be assessed using volumetric and diffusive magnetic resonance imaging methods, such as voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). The aim of the present meta-analysis is to investigate the spatial convergence of the reported findings on WM alterations in AUD. Methods: Systematic literature search on PubMed and further databases revealed 18 studies eligible for inclusion, entailing a total of 462 AUD patients and 416 healthy controls (up to January 18, 2021). All studies that had used either VBM or DTI whole-brain analyzing methods and reported results as peak-coordinates in standard reference space were considered for inclusion. We excluded studies using approaches nonconcordant with recent guidelines for neuroimaging meta-analyses and studies investigating patient groups with Korsakoff syndrome or other comorbid substance use disorders (except tobacco). Results: Anatomical Likelihood Estimation (ALE) revealed four significant clusters of convergent macro- and microstructural WM alterations in AUD patients that were assigned to the genu and body of the corpus callosum, anterior and posterior cingulum, fornix, and the right posterior limb of the internal capsule. Discussion: The changes in WM could to some extent explain the deteriorations in motor, cognitive, affective, and perceptual functions seen in AUD. Future studies are needed to clarify how WM alterations vary over the course of the disorder and to what extent they are reversible with prolonged abstinence.

scholarly journals Diffusiontensor MRI tractography in patients with children’s cerebral palsy: assessment of structural lesions of conduction tracts

2019 ◽  
Vol 19 (2) ◽  
pp. 68-74
Author(s):  
Yulia V. Ermolina ◽  
L. S. Namazova-Baranova ◽  
A. M. Mamedyarov ◽  
A. V. Anikin ◽  
O. I. Maslova
Keyword(s):  
Cerebral Palsy ◽  
Corpus Callosum ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Internal Capsule ◽  
Neurological Deficits ◽  
Motor Deficit ◽  
Diffusivity Coefficient ◽  
Posterior Limb ◽  
The Brain

Introduction. The application of diffusion-tensor (DT)-MRI tractography in patients with children S cerebral palsy (CP) allows to establish pathophysiological mechanisms of the development of motor and sensory impairments, to perform a clinical and neuroimaging comparison, as well as to determine correlations between lesions of the conduction tracts and neurological deficits. Aim. For the determination of changes in fractional anisotropy (FA) and mean diffusivity coefficient (MDC), obtained with DT-MRI in the corticospinal and sensory tracts, structures of the corpus callosum in spastic forms of CP. Materials and methods. There were examined 105 children with spastic forms of CP (spastic tetraparesis - 47, spastic diplegia - 38, hemiparetic form - 20) and 50 children without neurological deficit, at the age of 2-18 years. In all CP patients the severity of motor deficit was evaluated according to Gross Motor Function Classification System (GMFCS). DT-MRI was performed in all cases with the use of devices of General Electric (US), under magnetic field strength of 1.5T and 3T, with the calculation of the FA and the MDC in areas of interest - cerebral peduncles the brain stem, the posterior limb of the internal capsule, the genu and splenium of the corpus callosum, posterior thalamic radiation, postcentral gyrus, the thalamus. Results. There was established the distribution of children according to the GMFCS scale: I - 14 (13,4%), II - 19 (18,1%), III - 20 (19%), IV- 10 (9,5%), V- 42 (40%) cases. The severity of motor impairment on the GMFCS scale closely correlated with the values of FA and ADC in cerebral peduncles, posterior limb of the internal capsule, posterior thalamic radiance, genu of the corpus callosum. Conclusion. DT-MRI enables to assess adequately the changes in the white matter of the brain, structural andfunctional state of the motor and sensory conduction tracts, gives a possibility to predict the development of a child with CP.

scholarly journals Quantitative DTI metrics in a canine model of Krabbe disease: comparisons versus age-matched controls across multiple ages

2018 ◽  
Vol 31 (2) ◽  
pp. 168-176 ◽  
Author(s):  
Jonathan Y Li ◽  
Dana M Middleton ◽  
Steven Chen ◽  
Leonard White ◽  
Carley R Corado ◽  
...  
Keyword(s):  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Region Of Interest ◽  
Internal Capsule ◽  
Canine Model ◽  
Krabbe Disease ◽  
Radial Diffusivity ◽  
Centrum Semiovale ◽  
Pelvic Limb ◽  
Normal Controls

Purpose The purpose of this study was to compare quantitative diffusion tensor imaging metrics in dogs affected with a model of Krabbe disease to age-matched normal controls. We hypothesized that fractional anisotropy would be decreased and radial diffusivity would be increased in the Krabbe dogs. Methods We used a highly reproducible region-of-interest interrogation technique to measure fractional anisotropy and radial diffusivity in three different white matter regions within the internal capsule and centrum semiovale in four Krabbe affected brains and three age-matched normal control brains. Results Despite all four Krabbe dogs manifesting pelvic limb paralysis at the time of death, age-dependent differences in DTI metrics were observed. In the 9, 12, and 14 week old Krabbe dogs, FA values unexpectedly increased and RD values decreased. FA values were generally higher and RD values generally lower in both regions of the internal capsule in the Krabbe brains during this period. FA values in the brain from the 16 week old Krabbe dog decreased and were lower than in control brains and RD values increased and were higher than in control brain. Conclusion Our findings suggest that FA and RD in the internal capsule and centrum semiovale are affected differently at different ages, despite disease having progressed to pelvic limb paralysis in all dogs evaluated. In 9, 12, and 14 week old Krabbe dogs, higher FA values and lower RD values are seen in the internal capsule. However, in the 16 week old Krabbe dog, lower FA and higher RD values are seen, consistent with previous observations in Krabbe dogs, as well as observations in human Krabbe patients.

Effect of position on gross motor function and spasticity in spastic cerebral palsy children

2021 ◽  
pp. 1-14
Author(s):  
Wardah Rauf ◽  
Samia Sarmad ◽  
Iqra Khan ◽  
Muhammad Jawad ◽  
Admin
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
System Level ◽  
Spastic Cerebral Palsy ◽  
Sitting Position ◽  
Gross Motor ◽  
Motor Functioning ◽  
Five Dimensions ◽  
Gross Motor Function ◽  
Quasi Experimental

Abstract Objective: To evaluate the effect of positioning on gross motor function and spasticity in spastic quadriplegic cerebral palsy children with Gross Motor Function Classification System level IV and V. Methods: A quasi-experimental study was conducted at two Paediatric Physical Therapy Centres from November 2018 to July 2019. The study was comprised of seventy four children with quadriplegic cerebral palsy aged between 3 to 8 years. Data was obtained and gross motor functional abilities and spasticity were assessed by GMFM-88 and Modified Ashworth Scale respectively. Twenty four-hour positioning in specific seats, night positioning and standing frames for six months. The child was being positioned in 24 hours according to his challenges for the period of six months. Semi reclined positioning was performed to manage aspiration, oral leak and to develop retention. Prone positioning was done to develop righting reactions, functional sitting position was used in the treatment regime to attain better upright position and neutral pelvic standing using standing frames. SPSS 24 was used to analyse the data. Results: Paired t-test reported significant improvement in the test scores in lying position, rolling, sitting position, crawling, kneeling, standing, walking or running. n=59 subjects exhibited improvement in the spasticity before and after interventional procedures, while n=15 showed no improvement as the value of p<0.05. Conclusion: Twenty-Four-hour proper body positioning and postural techniques improved gross motor functioning in all of the five dimensions of functioning. The overall spasticity in quadriplegic cerebral palsy children was also reduced due to appropriate positioning techniques.  Continuous....

Abstract WP366: Quantitative Diffusion Tensor Tractography of the Corticospinal Tract as a Predictive Outcome Parameter in Patients With Intracerebral Hemorrhage

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Bastian Volbers ◽  
Angelika Mennecke ◽  
Nicola Kästle ◽  
Hagen B Huttner ◽  
Stefan Schwab ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Clinical Status ◽  
Internal Capsule ◽  
Favorable Outcome ◽  
Outcome Variable ◽  
Cerebral Peduncle ◽  
Prognostic Impact ◽  
Posterior Limb

Introduction: Intracerebral hemorrhage (ICH) is a devastating disease with poor outcome. Established predictive markers include initial hematoma size, clinical status, intraventricular bleeding and age. However, prognostic assessment is often difficult which additionally burdens patients and caregivers and complicates rehabilitation. Functional outcome especially relies on motor function which is correlated with the integrity of the Corticospinal Tract (CST). Diffusion Tensor (DT) Tractography allows visualization of the CST. However, sufficient data about the prognostic impact of quantitative CST assessment is lacking. Methods: We prospectively enrolled patients with spontaneous supratentorial ICH admitted between 08/2012 und 08/2015. Informed consent and ethical approval was obtained. MRI scan was performed on day 5±1. DT data was normalized to MNI Space and Q-Space diffeomorphic reconstruction was performed using DSI-studio. CST was reconstructed based on quantitative anisotropy (QA) using the CST region (JHU white matter atlas) as seeding region and cerebral peduncle as region of interest (ROI). Fractional Anisotropy (FA) and QA were analyzed in the seeding and ROI region and in the posterior limb of the internal capsule (PLIC). Dichotomized modified Rankin Scale on day 90 (favorable outcome = mRS 0-2) was assessed as primary outcome variable. Results: 33 patients, mean age 70.7 y (standard deviation (SD) 12.9), 12 male, 21 with lobar hemorrhage, mean ICH volume on admission 16.5 (SD 11.3) cm 3 were included. 16 patients had a favorable outcome on day 90 (median mRS 3 (IQR 1-3.5). Mean number of reconstructed CST fiber pathways ipsilateral to ICH was higher in patients with favorable outcome (11343 (SD 8201)) than in patients with unfavorable outcome (4868 (SD 3221), p=0.008). Median QA and FA values in the PLIC ipsilateral to ICH were also higher in patients with favorable outcome (QA: 18.9 (IQR 16.2-23.3) vs. 14.6 (IQR 11.7 - 17.7), p=0.016, FA: 0.49 (IQR 0.45-0.53) vs. 0.41 (IQR 0.38-0.49), p=0.026). Conclusion: Higher FA- and QA-values in the PLIC and higher numbers of CST fiber pathways ipsilateral to ICH seem to be associated with a favorable outcome. DT Imaging may turn out as a useful quantitative predictive marker in the acute phase of ICH.

Abstract TP75: Normal Appearing White Matter Integrity and Motor Impairment Severity in Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Carson Ingo ◽  
Chen Lin ◽  
James Higgins ◽  
Yurany Arevalo ◽  
Shyam Prabhakaran
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Motor Function ◽  
Motor Impairment ◽  
Internal Capsule ◽  
Posterior Limb ◽  
Normal Appearing White Matter ◽  
Stroke Group ◽  
Microstructural Integrity

Introduction: The effect of white matter hyperintensities (WMH) as measured by fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging on functional impairment and recovery after ischemic stroke has been investigated thoroughly. However, there has been growing interest to investigate normal-appearing white matter (NAWM) microstructural integrity following ischemic stroke onset with techniques such as diffusion tensor imaging (DTI). Methods: 52 patients with acute ischemic stroke and 36 without stroke were evaluated with a DTI and FLAIR imaging protocol and clinically assessed for severity of motor impairment using the Motricity Index within 72 hours of suspected symptom onset. Results: There were widespread decreases in fractional anisotropy (FA) and increases in mean diffusivity (MD) and radial diffusivity (RD) for the acute stroke group compared to the non-stroke group. As shown in the abstract figure with the blue voxels, there was a significant positive association between FA and motor function and a significant negative association between MD/RD and motor function. The NAWM regions of interest that were most sensitive to the Motricity Index were the anterior/posterior limb of the internal capsule in the infarcted hemisphere and the splenium of the corpus callosum, external capsule, posterior limb/retrolenticular part of the internal capsule, superior longitudinal fasciculus, and cingulum (hippocampus) of the intra-/contralateral hemisphere. Conclusion: The microstructural integrity of NAWM is a significant parameter to identify neural differences not only between those individuals with and without acute ischemic stroke, but also correlated with severity of acute motor impairment.

Gambaran Peningkatan Fungsi Motorik Kasar Pada Anak Cerebral Palsy Spastik Setelah Pemberian Hippotherapy: Literature Review

2021 ◽  
Vol 1 ◽  
pp. 430-438
Author(s):  
Khusnah Khauliya ◽  
A Abdurrachman
Keyword(s):  
Cerebral Palsy ◽  
Literature Review ◽  
Motor Function ◽  
Google Scholar ◽  
Spastic Cerebral Palsy ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Review Analysis ◽  
Gross Motor Function Measure ◽  
Function Measure

AbstractSpastic Cerebral Palsy is a type of Cerebral Palsy that experiences stiffness or tightness of the muscles. These muscles become stiff because messages to the muscles are conveyed incorrectly by the damaged part of the brain. The presence of spasticity will affect gross motor function disorders in children with cerebral palsy. One of the physiotherapy approaches to improve gross motor function is hippotherapy. This literature review study aims to describe gross motor function in Spastic Cerebral Palsy children after giving hippotherapy from several articles. The selection of articles in this study was a literature review analysis using the PICO method, five articles were obtained for review from several data bases such as PubMed (n=2) and Google Scholar (n=3). The measuring instrument uses GMFM (Gross Motor Function Measure) to measure gross motor function in Spastic Cerebral Palsy children. The results of the literature review analysis in these five articles indicate that hippotherapy can improve gross motor function in Spastic Cerebral Palsy children with an average value before the action of 63.65 and after the action of 66.68. From the results of the literature review of these five articles, it shows that hippotherapy is proven to improve gross motor function in Spastic Cerebral Palsy children before and after giving intervention with hippotherapy modality with an average difference of 3.03. Hippotherapy can be used as a reference material for interventions or research materials or physiotherapy research, especially in pediatric cases.Keywords: GMFM; spastic cerebral palsy; hippotherapy AbstrakCerebral Palsy Spastik merupakan salah satu jenis Cerebral Palsy yang mengalami kekakuan atau keketatan otot-otot. Otot ini menjadi kaku karena pesan pada otot disampaikan secara tidak benar oleh bagian otak yang rusak. Adanya spastisitas akan berpengaruh terhadap gangguan fungsi motorik kasar pada anak Cerebral Palsy. Salah satu pendekatan fisioterapi untuk meningkatkan fungsi motorik kasar adalah hippotherapy. Penelitian literature review ini bertujuan untuk mengetahui gambaran fungsi motorik kasar pada anak Cerebral Palsy Spastik setelah pemberian hippotherapy dari beberapa artikel. Pemilihan artikel pada penelitian ini yaitu analisis literature review dengan metode PICO, didapatkan lima artikel untuk direview dari beberapa data base sepertiPubMed (n=2) dan Google Scholar (n=3). Alat ukur menggunakan GMFM (Gross Motor Function Measure) untuk mengukur fungsi motorik kasar pada anak Cerebral Palsy Spastik. Hasil analisis literature review pada kelima artikel ini menunjukkan bahwa hippotherapy dapat meningkatkan fungsi motorik kasar pada anak Cerebral Palsy Spastik dengan nilai rata-rata sebelum tindakan 63,65 dan sesudah tindakan 66,68. Dari hasil literature review kelima artikel ini menunjukkan bahwa hippotherapy terbukti dapat meningkatkan fungsi motorik kasar pada anak Cerebral Palsy Spastik sebelum dan sesudah pemberian intervensi dengan modalitas hippotherapy dengan hasil selisih rata-rata sebesar 3,03. Hippotherapy dapat digunakan sebagai bahan acuan untuk intervensi maupun bahan riset atau penelitian fisioterapi khususnya pada kasus pediatric.Kata kunci : GMFM;cerebral palsy spastik;hippotherapy

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