The Pyramidal Tract in Congenital Hemiparesis: Relationship between Morphology and Function in Periventricular Lesions

Staudt, Martin; Niemann, Gerhard; Grodd, Wolfgang; Krägeloh-Mann, I.

doi:10.1055/s-2000-9239

Cited by 72 publications

(78 citation statements)

References 13 publications

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“…For example, symmetrical white matter injury close to the ventricle (leg fibers of the pyramidal systems are closest to the ventricles) is likely to be associated with diparesis, and involvement of broader areas of white matter, including areas further from the ventricle subserving arms, is likely to be associated with quadriparesis ( [62], [63], [64]). As a result, children with diparesis have brain lesions that are less likely to be located in white matter association areas that may impair cognition and they have lower rates of microcephaly.…”

Section: Discussionmentioning

confidence: 99%

An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

Kuban

Allred

O’Shea

et al. 2008

The Journal of Pediatrics

105

104

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Objective-To develop an algorithm based on data obtained with a reliable, standardized neurological examination, and report the prevalence of cerebral palsy (CP) subtypes (diparesis, hemiparesis, and quadriparesis) in a cohort of 2-year-old children born before 28 weeks gestation.Study design-We compared children with CP subtypes on extent of handicap and frequency of microcephaly, cognitive impairment, and screening positive for autism.Results-Of the 1056 children evaluated, 11.4% (120) were given an algorithm-based classification of CP. Of these children, 31% had diparesis, 17% had hemiparesis, and 52% had quadriparesis. Children with quadriparesis were 9 times more likely than children with diparesis (76% versus 8%) to be more highly impaired and 5 times more likely than children with diparesis to be microcephalic (43% versus 8%). They were more than twice as likely as children with diparesis to have an MDI score below 70 (75% versus 34%), and had the highest rate of MCHAT positivity (76%) compared with children with diparesis (30%) and children without CP (18%).Conclusion-We developed an algorithm that classifies CP subtypes, which should permit comparison among studies. Extent of gross motor dysfunction and rates of co-morbidities are highest among children with quadriparesis and lowest among children with diparesis.

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Section: Discussionmentioning

confidence: 99%

An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

Kuban

Allred

O’Shea

et al. 2008

The Journal of Pediatrics

105

104

View full text Add to dashboard Cite

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“…10,22 Even at a lower level, that is, in the pons or medulla oblongata, the measure remains biased by other structures, and it is even more difficult to detect the asymmetry on anatomic images. 8 The DTI technique allows us to delineate the corticospinal tract among other structures, and its measurement at the level of the lower pons is particularly easy, because it appears as a well-defined blue area on color-coded DTI maps. 14 At this level, most of the corticopontine fibers stop traveling in a craniocaudal orientation; these fibers are, therefore, excluded from the measure, and a more valid and precise assessment of the corticospinal tract can be obtained, even if the area delineated on colorcoded DTI maps remains contaminated by the corticobulbar fibers.…”

Section: Corticospinal Tract Dysgenesismentioning

confidence: 99%

“…6,7 In most studies, corticospinal tract degeneration has classically been quantified by measuring the cross-sectional area of the cerebral peduncles in the mesencephalon on T1-weighted MRI. [6][7][8] However, such an estimate of the corticospinal area is unavoidably biased, because it includes the substantia nigra and other corticofugal descending pathways. 9,10 A more specific measure of corticospinal tract cross-sectional area can be performed using diffusion tensor imaging (DTI).…”

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confidence: 99%

Corticospinal Dysgenesis and Upper-Limb Deficits in Congenital Hemiplegia: A Diffusion Tensor Imaging Study

et al. 2007

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OBJECTIVES: Precision grasping critically relies on the integrity of the corticospinal tract as evidenced in congenital hemiplegia by the correlation found between corticospinal dysgenesis and hand-movement deficits. Therefore, corticospinal dysgenesis could be used to anticipate upper-limb deficits in young infants with congenital hemiplegia. However, most studies have quantified corticospinal dysgenesis by measuring the cross-sectional area of cerebral peduncles on T1 MRI, a measure biased by other structures present in the peduncles. The purpose of this study was to evaluate the extent to which this may have hampered the conclusions of previous studies. We also aimed to investigate the relationship between upper-limb deficits and a more accurate measure of corticospinal dysgenesis to provide a tool for anticipating upper-limb deficits in infants with congenital hemiplegia. METHODS: To address this issue, we measured corticospinal tract areas in 12 patients with congenital hemipleg... Document type : Article de périodique (Journal article) Référence bibliographiqueBleyenheuft, Yannick ; Grandin, Cécile ; Cosnard, Guy ; Olivier, Etienne ; Thonnard, Jean-Louis. The authors have indicated they have no financial relationships relevant to this article to disclose. Corticospinal dysgenesis and upper-limb deficits in congenital hemiplegia ABSTRACTOBJECTIVES. Precision grasping critically relies on the integrity of the corticospinal tract as evidenced in congenital hemiplegia by the correlation found between corticospinal dysgenesis and hand-movement deficits. Therefore, corticospinal dysgenesis could be used to anticipate upper-limb deficits in young infants with congenital hemiplegia. However, most studies have quantified corticospinal dysgenesis by measuring the cross-sectional area of cerebral peduncles on T1 MRI, a measure biased by other structures present in the peduncles. The purpose of this study was to evaluate the extent to which this may have hampered the conclusions of previous studies. We also aimed to investigate the relationship between upper-limb deficits and a more accurate measure of corticospinal dysgenesis to provide a tool for anticipating upper-limb deficits in infants with congenital hemiplegia.

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“…1,3,[8][9][10] The pathogenesis for their occurrence is not yet fully understood. One potential hypothesis could be the activation of bilateral primary motor cortices due to deficient interhemispheric inhibition caused by the underlying brain lesion.…”

mentioning

confidence: 99%

“…7 Mirror movements have frequently been described in unilateral CP, 3,8,9 mostly in the non-paretic hand, albeit with large variability. 1,3,[8][9][10] The pathogenesis for their occurrence is not yet fully understood. One potential hypothesis could be the activation of bilateral primary motor cortices due to deficient interhemispheric inhibition caused by the underlying brain lesion.…”

mentioning

confidence: 99%

Do mirror movements relate to hand function and timing of the brain lesion in children with unilateral cerebral palsy?

Klingels

Jaspers

Staudt

et al. 2015

Develop Med Child Neuro

121

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AIM This study aimed to systematically map the severity of mirror movements in both hands in a prospective cohort of children with unilateral cerebral palsy, and to explore the relationship with hand function and brain lesion type.METHOD Seventy-eight children were included (41 males, 37 females; age 9y 4mo, SD 3y 1mo, range 5-15y). Mirror movements were scored during three repetitive tasks following Woods and Teuber criteria. Strength, tone, Melbourne Assessment, Jebsen-Taylor test, and Assisting Hand Assessment were evaluated. Lesions were classified into malformations (n=5), periventricular (n=43), cortico-subcortical (n=22), and postnatally acquired lesions (n=8).RESULTS Significantly more mirror movements were observed in the non-paretic versus the paretic hand (p≤0.003). Higher mirror movement scores in the non-paretic hand significantly correlated with lower distal strength and lower scores on unimanual and bimanual assessments (r=0.29-0.41). In the paretic hand, significant differences were found between lesion types (p=0.03). INTERPRETATIONThe occurrence of mirror movements in the non-paretic hand seems related to hand function while mirror movements in the paretic hand seem more related to the lesion timing, whereby children with earlier lesions present with more mirror movements.Children with unilateral cerebral palsy (CP) often experience difficulties in bimanual coordination which affects daily life activities. Apart from spasticity, muscle weakness, and sensory deficits the occurrence of mirror movements has also been suggested as a possible contributing factor that interferes with bimanual performance. 1 Mirror movements are described as 'involuntary movements of one body part that mirror the voluntary movement of the contralateral homologous body part'.2,3 They are mainly observed in the upper limbs, are symmetrical by nature, and their intensity increases with increasing task complexity or fatigue. 4,5 Physiological mirror movements are present in newborn infants, show a steep decrease between 5 years and 8 years of age, and disappear after 10 years of age. 4,6 These mirror movements are most likely to be caused by incomplete maturation of the corpus callosum and concurrent less effective interhemispheric inhibition. Unilateral tasks thereby invoke activation of bilateral motor cortices. [6][7][8] Further maturation of the transcallosal pathways with age ensures increasing inhibition of the motor cortex ipsilateral to the task hand, thus reducing the occurrence of mirror movements. 7Mirror movements have frequently been described in unilateral CP, 3,8,9 mostly in the non-paretic hand, albeit with large variability. 1,3,[8][9][10] The pathogenesis for their occurrence is not yet fully understood. One potential hypothesis could be the activation of bilateral primary motor cortices due to deficient interhemispheric inhibition caused by the underlying brain lesion. 2,6 Conversely, the persistence of ipsilateral corticospinal projections between the non-lesioned motor cortex and the paretic hand has ...

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The Pyramidal Tract in Congenital Hemiparesis: Relationship between Morphology and Function in Periventricular Lesions

Cited by 72 publications

References 13 publications

An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

Corticospinal Dysgenesis and Upper-Limb Deficits in Congenital Hemiplegia: A Diffusion Tensor Imaging Study

Do mirror movements relate to hand function and timing of the brain lesion in children with unilateral cerebral palsy?

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