Brain Stiffness Relates to Dynamic Balance Reactions in Children With Cerebral Palsy

McIlvain, Grace; Tracy, James B.; Chaze, Charlotte A.; Petersen, Drew A.; Villermaux, Gabrielle M.; Wright, Henry; Miller, Freeman; Crenshaw, Jeremy R.; Johnson, Curtis L.

doi:10.1177/0883073820909274

Cited by 16 publications

(8 citation statements)

References 69 publications

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“…< 35 years or > 65 years), we did not observe any significant correlations between either HCsf or and memory task outcomes in either group, though these subsamples are smaller and less powered to detect such effects, and a future study designed to understand how these structure-function relationships may change across the lifespan is warranted. We note that in recent studies on pediatric participants, MRE structure-function relationships were observed in but not (McIlvain et al, 2020a(McIlvain et al, , 2020b. We also recognize that this study shows weaker evidence of structure-function dissociations than in our prior MRE work that reported a double dissociation in structurefunction relationships of relational memory and fluid intelligence performance with viscoelasticity of the HC and orbitofrontal cortex (Johnson et al, 2018).…”

contrasting

confidence: 57%

Structure–Function Dissociations of Human Hippocampal Subfield Stiffness and Memory Performance

et al. 2022

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Aging and neurodegenerative diseases lead to decline in thinking and memory ability. The subfields of the hippocampus (HCsf) play important roles in memory formation and recall. Imaging techniques sensitive to the underlying HCsf tissue microstructure can reveal unique structure–function associations and their vulnerability in aging and disease. The goal of this study was to use magnetic resonance elastography (MRE), a noninvasive MR imaging-based technique that can quantitatively image the viscoelastic mechanical properties of tissue to determine the associations of HCsf stiffness with different cognitive domains across the lifespan. Eighty-eight adult participants completed the study (age 23–81 years, male/female 36/51), in which we aimed to determine which HCsf regions most strongly correlated with different memory performance outcomes and if viscoelasticity of specific HCsf regions mediated the relationship between age and performance. Our results revealed that both interference cost on a verbal memory task and relational memory task performance were significantly related to cornu ammonis 1–2 (CA1–CA2) stiffness (p= 0.018 andp= 0.011, respectively), with CA1–CA2 stiffness significantly mediating the relationship between age and interference cost performance (p= 0.031). There were also significant associations between delayed free verbal recall performance and stiffness of both the dentate gyrus–cornu ammonis 3 (DG–CA3;p= 0.016) and subiculum (SUB;p= 0.032) regions. This further exemplifies the functional specialization of HCsf in declarative memory and the potential use of MRE measures as clinical biomarkers in assessing brain health in aging and disease.SIGNIFICANCE STATEMENTHippocampal subfields are cytoarchitecturally unique structures involved in distinct aspects of memory processing. Magnetic resonance elastography is a technique that can noninvasively image tissue viscoelastic mechanical properties, potentially serving as sensitive biomarkers of aging and neurodegeneration related to functional outcomes. High-resolutionin vivoimaging has invigorated interest in determining subfield functional specialization and their differential vulnerability in aging and disease. Applying MRE to probe subfield-specific cognitive correlates will indicate that measures of subfield stiffness can determine the integrity of structures supporting specific domains of memory performance. These findings will further validate our high-resolution MRE method and support the potential use of subfield stiffness measures as clinical biomarkers in classifying aging and disease states.

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contrasting

confidence: 57%

Structure–Function Dissociations of Human Hippocampal Subfield Stiffness and Memory Performance

et al. 2022

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“…Previous reports that include data from some or all of these participants focused on the relationships of age, standing sway, and balance reactions in typical development, 18 gait stability in children with and without spastic CP, 19 magnetic resonance elastography to evaluate brain tissue viscoelasticity of the two groups, 20 and the relationship between balance reaction performance and brain viscoelasticity in children with spastic CP. 21 What this paper adds…”

Section: Other Study Aspectsmentioning

confidence: 92%

“…This report focuses on results from balance‐reaction tests, which represent part of a larger, single‐session protocol more broadly assessing balance, gait, and physical activity. Previous reports that include data from some or all of these participants focused on the relationships of age, standing sway, and balance reactions in typical development, gait stability in children with and without spastic CP, magnetic resonance elastography to evaluate brain tissue viscoelasticity of the two groups, and the relationship between balance reaction performance and brain viscoelasticity in children with spastic CP …”

Section: Methodsmentioning

confidence: 99%

Anteroposterior balance reactions in children with spastic cerebral palsy

Crenshaw

Petersen

Conner

et al. 2020

Develop Med Child Neuro

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Aim To compare anterior and posterior standing balance reactions, as measured by single‐stepping thresholds, in children with and without spastic cerebral palsy (CP). Method Seventeen ambulatory children with spastic CP (eight males, nine females) and 28 typically developing children (13 males, 15 females; age range 5–12y, mean [SD] 9y 2mo [2y 3mo]), were included in this cross‐sectional, observational study. Balance reaction skill was quantified as anterior and posterior single‐stepping thresholds, or the treadmill‐induced perturbations that consistently elicited a step in that direction. In order to understand the underlying mechanisms of between‐group differences in stepping thresholds, dynamic stability was quantified using the minimum margin of stability. Ankle muscle activation latency, magnitude, and co‐contraction were assessed with surface electromyography. Results We observed an age and group interaction for anterior thresholds (p=0.001, partial η2=0.24). At older (≈11y; p<0.001, partial η2=0.48), but not younger (≈7y; p=0.33, partial η2=0.02) ages, typically developing children had larger anterior thresholds than those with CP. In response to near‐threshold anterior perturbations, older typically developing children recovered from more instability than their peers with CP (p=0.004, partial η2=0.18). Older children had no between‐group differences in ankle muscle activity. No between‐group differences were observed in posterior thresholds. Interpretation The effects of CP on balance reactions are age‐ and direction‐specific. Older typically developing children are more able or willing to withhold a step when unstable. What this paper adds Children with spastic cerebral palsy have age‐ and direction‐specific balance‐reaction impairments. Lower anterior stepping thresholds were observed in older, but not younger children. Older typically developing children withheld a forward step at higher levels of instability. No between‐group differences were seen in posterior stepping thresholds.

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“… 29 , 34 In later studies by the same group, brain stiffness and cognition were shown to relate in paediatric cerebral palsy and adolescent risk-taking tasks. 38 , 39 Furthermore, a detailed assessment of the relation between hippocampal subfield stiffness and specific aspects of memory was reported. 37 However, less is known about the relationship between mechanical properties and cognitive function in older adults and how this relationship is related to specific pathologies that can be measured by other modalities.…”

Section: Introductionmentioning

confidence: 99%

Associations between vascular health, brain stiffness and global cognitive function

Pavuluri,

Huston,

Ehman

et al. 2024

Brain Communications

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Vascular brain injury results in loss of structural and functional connectivity and leads to cognitive impairment. Its various manifestations, including microinfarcts, microhemorrhages, and white matter hyperintensities (WMH), result in microstructural tissue integrity loss and secondary neurodegeneration. Among these, tissue microstructural alteration is a relatively early event compared to atrophy along the aging and neurodegeneration continuum. Understanding its association with cognition may provide the opportunity to further elucidate the relationship between vascular health and clinical outcomes. Magnetic Resonance Elastography (MRE) offers a non-invasive approach to evaluate tissue mechanical properties, providing a window into the microstructural integrity of the brain. This retrospective study evaluated brain stiffness as a potential biomarker for vascular brain injury and its role in mediating the impact of vascular dysfunction on cognitive impairment. Seventy-five participants from the Mayo Clinic Study of Aging underwent brain imaging using a 3T-MR imager with a spin-echo echo planar imaging sequence for MRE, T1 and T2-weighted pulse sequences. This study evaluated the effects of vascular biomarkers (WMH and cardiometabolic condition score [CMC]) on brain stiffness using voxel-wise analysis. Partial correlation analysis explored associations between brain stiffness, WMH, CMC, and global cognition. Mediation analysis determined the role of stiffness in mediating the relationship between vascular biomarkers and cognitive performance. Statistical significance was set at P values <0.05. Diagnostic accuracy of MRE stiffness for WMH and CMC was evaluated using Receiver Operator Characteristic curves. Voxel-wise linear-regression analysis indicated WMH negatively correlates with brain stiffness, specifically in periventricular regions with high WMH levels. A negative association between cardiovascular risk factors and stiffness was also observed across the brain. No significant patterns of stiffness changes were associated with amyloid-load. Global stiffness (µ) negatively correlated with both WMH and CMC when all other covariables including amyloid load were controlled. The positive correlation between WMH and CMC weakened and became statistically insignificant when controlling for other covariables. Brain stiffness and global cognition were positively correlated, maintaining statistical significance after adjusting for all covariables. These findings suggest mechanical alterations are associated with cognitive dysfunction and vascular brain injury. Brain stiffness significantly mediated the indirect effects of WMH and CMC on global cognition. Local cerebrovascular diseases (assessed by WMH) and systemic vascular risk factors (assessed by CMC) impact brain stiffness with spatially and statistically distinct effects. Global brain stiffness is a significant mediator between vascular disease measures and cognitive function, highlighting the value of MRE-based mechanical assessments in understanding this relationship.

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Brain Stiffness Relates to Dynamic Balance Reactions in Children With Cerebral Palsy

Cited by 16 publications

References 69 publications

Structure–Function Dissociations of Human Hippocampal Subfield Stiffness and Memory Performance

Structure–Function Dissociations of Human Hippocampal Subfield Stiffness and Memory Performance

Anteroposterior balance reactions in children with spastic cerebral palsy

Associations between vascular health, brain stiffness and global cognitive function

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