Using diffusion tensor imaging to identify corticospinal tract projection patterns in children with unilateral spastic cerebral palsy.
Date
2017-01
Authors
Kuo, Hsing-Ching
Ferre, Claudio L.
Carmel, Jason B.
Gowatsky, Jaimie L.
Stanford, Arielle D.
Rowny, Stefan B.
Lisanby, Sarah H.
Gordon, Andrew M.
Friel, Kathleen M.
Version
Published version
OA Version
Citation
Hsing-Ching Kuo, Claudio L. Ferre, Jason B. Carmel, Jaimie L. Gowatsky, Arielle D. Stanford, Stefan B. Rowny, Sarah H. Lisanby, Andrew M. Gordon, Kathleen M. Friel. 2017. "Using diffusion tensor imaging to identify corticospinal tract projection patterns in children with unilateral spastic cerebral palsy.." Dev Med Child Neurol, Volume 59, Issue 1, pp. 65 - 71. https://doi.org/10.1111/dmcn.13192
Abstract
AIM: To determine whether diffusion tensor imaging (DTI) can be an independent assessment for identifying the corticospinal tract (CST) projecting from the more-affected motor cortex in children with unilateral spastic cerebral palsy (CP). METHOD: Twenty children with unilateral spastic CP participated in this study (16 males, four females; mean age 9y 2mo [standard deviation (SD) 3y 2mo], Manual Ability Classification System [MACS] level I-III). We used DTI tractography to reconstruct the CST projecting from the more-affected motor cortex. We mapped the motor representation of the more-affected hand by stimulating the more- and the less-affected motor cortex measured with single-pulse transcranial magnetic stimulation (TMS). We then verified the presence or absence of the contralateral CST by comparing the TMS map and DTI tractography. Fisher's exact test was used to determine the association between findings of TMS and DTI. RESULTS: DTI tractography successfully identified the CST controlling the more-affected hand (sensitivity=82%, specificity=78%). INTERPRETATION: Contralateral CST projecting from the lesioned motor cortex assessed by DTI is consistent with findings of TMS mapping. Since CST connectivity may be predictive of response to certain upper extremity treatments, DTI-identified CST connectivity may potentially be valuable for determining such connectivity where TMS is unavailable or inadvisable for children with seizures.
Description
License
© 2016 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.