Structural Brain Lesions and Gait Pathology in Children With Spastic Cerebral Palsy

Spastic cerebral palsy (CP), despite the name, is not consistently identifiable by specific brain lesions. CP animal models focus on risk factors for development of CP, yet few reproduce the diagnostic symptoms. Animal models of CP must advance beyond risk factors to etiologies, including both the brain and spinal cord.

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Brain Lesions in Children with Unilateral Spastic Cerebral Palsy

Medical Archives ◽

10.5455/medarh.2017.71.5-11 ◽

2017 ◽

Vol 71 (1) ◽

pp. 5

Author(s):

Feriha HadzagicCatibusic ◽

Edin Avdagic ◽

Smail Zubcevic ◽

Sajra Uzicanin

Keyword(s):

Cerebral Palsy ◽

Brain Lesions ◽

Spastic Cerebral Palsy

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Changes of Structural Brain Network Following Repetitive Transcranial Magnetic Stimulation in Children With Bilateral Spastic Cerebral Palsy: A Diffusion Tensor Imaging Study

Frontiers in Pediatrics ◽

10.3389/fped.2020.617548 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wenxin Zhang ◽

Shang Zhang ◽

Min Zhu ◽

Jian Tang ◽

Xiaoke Zhao ◽

...

Keyword(s):

Cerebral Palsy ◽

Diffusion Tensor ◽

Repetitive Transcranial Magnetic Stimulation ◽

Inferior Frontal Gyrus ◽

Brain Network ◽

Spastic Cerebral Palsy ◽

Cingulate Gyrus ◽

Structural Brain Network ◽

The Right ◽

Structural Brain

Introduction: Bilateral spastic cerebral palsy (BSCP) is the most common subtype of cerebral palsy (CP), which is characterized by various motor and cognitive impairments, as well as emotional instability. However, the neural basis of these problems and how repetitive transcranial magnetic stimulation (rTMS) can make potential impacts on the disrupted structural brain network in BSCP remain unclear. This study was aimed to explore the topological characteristics of the structural brain network in BSCP following the treatment of rTMS.Methods: Fourteen children with BSCP underwent 4 weeks of TMS and 15 matched healthy children (HC) were enrolled. Diffusion tensor imaging (DTI) data were acquired from children with bilateral spastic cerebral palsy before treatment (CP1), children with bilateral spastic cerebral palsy following treatment (CP2) and HC. The graph theory analysis was applied to construct the structural brain network. Then nodal clustering coefficient (Ci) and shortest path length (Li) were measured and compared among groups.Results: Brain regions with significant group differences in Ci were located in the left precental gyrus, middle frontal gyrus, calcarine fissure, cuneus, lingual gyrus, postcentral gyrus, inferior parietal gyri, angular gyrus, precuneus, paracentral lobule and the right inferior frontal gyrus (triangular part), insula, posterior cingulate gyrus, precuneus, paracentral lobule, pallidum. In addition, significant differences were detected in the Li of the left precental gyrus, lingual gyrus, superior occipital gyrus, middle occipital gyrus, superior parietal gyrus, precuneus and the right median cingulate gyrus, posterior cingulate gyrus, hippocampus, putamen, thalamus. Post hoc t-test revealed that the CP2 group exhibited increased Ci in the right inferior frontal gyrus, pallidum and decreased Li in the right putamen, thalamus when compared with the CP1 group.Conclusion: Significant differences of node-level metrics were found in various brain regions of BSCP, which indicated a disruption in structural brain connectivity in BSCP. The alterations of the structural brain network provided a basis for understanding of the pathophysiological mechanisms of motor and cognitive impairments in BSCP. Moreover, the right inferior frontal gyrus, putamen, thalamus could potentially be biomarkers for predicting the efficacy of TMS.

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Genetic Aspects of Pathogenesis of Congenital Spastic Cerebral Paralysis

Acta biomedica scientifica ◽

10.29413/abs.2019-4.3.4 ◽

2019 ◽

Vol 4 (3) ◽

pp. 28-39

Author(s):

A. G. Prityko ◽

N. V. Chebanenko ◽

P. L. Sokolov ◽

V. P. Zykov ◽

O. V. Klimchuk ◽

...

Keyword(s):

Cerebral Palsy ◽

Clinical Picture ◽

Twin Studies ◽

Perinatal Period ◽

Brain Lesions ◽

Spastic Cerebral Palsy ◽

Cerebral Paralysis ◽

Clinically Significant ◽

The Impact

Congenital spastic cerebral palsy (СР) is a large group of non-progressive disorders of the nervous system. The basis of the pathogenesis of these conditions is considered the impact of many factors. The clinical diversity of the disease and the syndromic principle of classification determine the existing uncertainties in the diagnosis of these diseases. The multifactorial nature of the underlying brain lesions is obvious and beyond doubt. The volume of information accumulated to date does not allow one to exclude the role and significance of the direct effect of acute asphyxiation in childbirth on a fetus normally formed during pregnancy, the role of infectious brain lesions, and disorders of neuronal migration. It is impossible to ignore the dependence of the clinical picture of the disease on what stage of ontogenesis the impact of the damaging agent occurs. As one of the pathogenetic factors, the genetic determinism of the phenotype of the clinical picture of a disease is fairly considered. This review focuses on the genetic aspects of the pathogenesis of this pathology. The information on monogenic mechanisms of inheritance is analyzed in detail. Such genetically determined mechanisms of pathogenesis as the inheritance of prerequisites for brain trauma in the perinatal period are considered separately. The new clinically significant variants of chromosomal mutations found in patients with CР are reviewed in detail, the evidence of the influence of genetic factors on the development of cerebral palsy in the absence of a pronounced monogenic cause of the disease, obtained through twin studies, is reviewed. Lit search of polymorphisms markers of predisposition to the development of cerebral palsy genes of the folate cycle, genes of glutamate receptors, the gene of apolipoprotein and of the gene for the transcription factor of oligodendrocytes (OLIG2) in Detail the role of epigenetic effects on the activity of genes coding for mitochondrial proteins.

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