Diffusion Tensor MR Imaging Tractography of the Pyramidal Tracts Correlates with Clinical Motor Function in Children with Congenital Hemiparesis

Glenn, Orit A.; Ludeman, Norna; Berman, Jeffrey; Wu, Yvonne W.; Lu, Yutong; Bartha, Agnes I.; Vigneron, Daniel B.; Chung, Siu-Wah; Ferriero, Donna M.; Barkovich, A. James; Henry, Roland G.

doi:10.3174/ajnr.a0676

Cited by 72 publications

(81 citation statements)

References 23 publications

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“…Elevated radial diffusivity and unchanged axial diffusivity values are seen with increasing white matter maturation in premature newborns with MRI abnormalities compared to those with normal MRI (12). Our findings in premature newborns are also consistent with the lower FA and higher radial diffusivity of the CST observed in children with congenital hemiparesis (20) and in infants with motor dysfunction (21). Changes in radial diffusivity are thought to reflect myelination and pre-myelination events, whereas changes in axial diffusivity are thought to reflect the integrity of the axon and its internal components (22).…”

Section: Discussionsupporting

confidence: 88%

“…Additionally, the widespread nature of most brain injuries precludes the examination of the specific effect of lesion location on CST development. An association between the severity of motor impairment and microstructural changes in the CST have been previously demonstrated in children with congenital hemiparesis (20) and in infants with motor dysfunction (21). Careful follow-up of our cohort, therefore, is required to confirm a similar association between microstructural CST development and motor outcome, and to determine whether systemic illness such as infection leads to subsequent motor deficits through impaired corticospinal tract development, or other motor or sensory pathways (28).…”

Section: Discussionmentioning

confidence: 68%

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Tractography-Based Quantitation of Corticospinal Tract Development in Premature Newborns

Adams

Chau

Poskitt

et al. 2010

The Journal of Pediatrics

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Objective-To evaluate the impact of early brain injury and neonatal illness on corticospinal tract (CST) development in premature newborns serially studied with diffusion tensor tractography (DTT).Study design-Fifty-five premature newborns (median 27.6 weeks PMA) were scanned with MRI early in life and at term-equivalent age. Moderate-severe brain abnormalities (abnormal-MRI) were characterized by moderate-severe white matter injury or ventriculomegaly. DTT was used to measure CST diffusion parameters which reflect microstructural development: fractional anisotropy (FA) and average diffusivity (D av ). The effect of abnormal-MRI and neonatal illness on FA and D av were assessed using multivariate regression for repeated measures adjusting for age at scan.Results-Twenty-one newborns (38%) had abnormal-MRI on either scan. FA increased with age significantly slower in newborns with abnormal-MRI (0.008/week) relative to newborns without these MRI abnormalities (0.011/week) (interaction term P=0.05). D av was higher in newborns with abnormal-MRI (1.5×10 −5 mm 2 /sec; P<0.001) for any given age at scan. In the 23 newborns (42%) with postnatal infection, FA increased more slowly (interaction term P=0.04), even when adjusting for the presence of abnormal-MRI.Conclusions-CST microstructural development is significantly impaired in premature newborns with abnormal-MRI or postnatal infection, with a pattern of diffusion changes suggesting impaired glial cell development.Corresponding Author: Steven P. Miller, MAS MDCM FRCPC, British Columbia Children's Hospital, Department of Pediatrics/ Division of Neurology -University of British Columbia, K3-180, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, CANADA, Telephone: 604-875-2345 ext. 5904/ Facsimile: 604-875-2285.bc.ca. The authors declare no conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Diffusion tensor imaging (DTI) enables in vivo quantification of microstructural development of these white matter pathways by measuring the overall extent (average diffusivity; D av ) and directionality (fractional anisotropy; FA) of water diffusion (2, 3). Previous DTI studies suggest that early brain injury impairs white matter development, even in brain regions that are normal on conventional MRI (4). However, the region of interest (ROI)-based approach used in these studies may not be optimally sensitive to changes in an individual white matter functional pathway. Diffusion tensor tractography (DTT) is a more sophisticated DTI technique for the 3D reconstruction of specific white matter tracts (5), such as the cor...

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 68%

Tractography-Based Quantitation of Corticospinal Tract Development in Premature Newborns

Adams

Chau

Poskitt

et al. 2010

The Journal of Pediatrics

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“…32 This finding is in line with the results of Thomas et al, 35 who showed similar changes close to and distant from the lesion, and with Glenn et al 9 in their study of the CST between the PLIC and the cerebral peduncle. The TRS1 showed a significant increase in MD but no changes in FA, which do not indicate any specific pathologic pattern.…”

Section: Dti Parameter Changes In Cst and Trs1supporting

confidence: 82%

“…8 Studies also have shown parametric changes that suggest secondary (Wallerian) neurodegeneration distant from the primary lesion site, with decreased FA and axial diffusivity (the largest tensor eigenvalue), increases in radial diffusivity (the mean of the 2 smaller tensor eigenvalues), but no changes or only slight increase in MD. 5,9 Moreover, the overall severity of CP, measured by, for example, the Gross Motor Function Classification System, 10 appears to correlate with diffusion parameters in motor 9,[11][12][13] and/or sensory pathways. [14][15][16] In addition, correlations have been shown between diffusion measures in motor and sensory tracts and specific measures of sensory and/or motor functions.…”

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confidence: 99%

Advanced Fiber Tracking in Early Acquired Brain Injury Causing Cerebral Palsy

Lennartsson

Holmström

Eliasson

et al. 2014

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE: Diffusion-weighted MR imaging and fiber tractography can be used to investigate alterations in white matter tracts in patients with early acquired brain lesions and cerebral palsy. Most existing studies have used diffusion tensor tractography, which is limited in areas of complex fiber structures or pathologic processes. We explored a combined normalization and probabilistic fiber-tracking method for more realistic fiber tractography in this patient group.

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“…Of these, 20 studies met strict inclusion criteria. Two further peer-reviewed articles 48,64 that did not occur in the initial search but were known to the authors also met inclusion criteria. Details of the included studies, including limitations, are outlined in Table 2.1.…”

Section: Resultsmentioning

confidence: 99%

Motor, sensory and executive function brain networks in children with unilateral cerebral palsy

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Diffusion Tensor MR Imaging Tractography of the Pyramidal Tracts Correlates with Clinical Motor Function in Children with Congenital Hemiparesis

Cited by 72 publications

References 23 publications

Tractography-Based Quantitation of Corticospinal Tract Development in Premature Newborns

Tractography-Based Quantitation of Corticospinal Tract Development in Premature Newborns

Advanced Fiber Tracking in Early Acquired Brain Injury Causing Cerebral Palsy

Motor, sensory and executive function brain networks in children with unilateral cerebral palsy

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