An Australian population study of factors associated with MRI patterns in cerebral palsy

Authors

  • Susan M Reid,

    Corresponding author
    1. Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Australia
    2. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    • Correspondence to Dr Sue Reid, Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia. E-mail: sue.reid@mcri.edu.au

    Search for more papers by this author
  • Charuta D Dagia,

    1. Department of Medical Imaging, Royal Children's Hospital, Melbourne, Vic., Australia
    Search for more papers by this author
  • Michael R Ditchfield,

    1. Department of Diagnostic Imaging, Monash Children's Hospital, Melbourne, Australia
    Search for more papers by this author
  • John B Carlin,

    1. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    2. Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Australia
    Search for more papers by this author
  • Elaine M Meehan,

    1. Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Australia
    Search for more papers by this author
  • Dinah S Reddihough

    1. Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Australia
    2. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    3. Department of Developmental Medicine, Royal Children's Hospital, Melbourne, Vic., Australia
    Search for more papers by this author

Abstract

Aim

The aim of this study was to describe the distribution of magnetic resonance imaging (MRI) patterns in a large population sample of children with cerebral palsy (CP) and to examine associations between MRI patterns, and antenatal and perinatal variables.

Method

Data were retrieved from the Victorian CP Register for 884 children (527 males, 357 females) born between 1999 and 2006. Postneonatal MRI was classified for 594 children. For 563 children (329 males, 234 females) for whom classification was to a single MRI pattern, the frequency of each variable was compared between patterns and with the population frequency.

Results

White matter injury was the most common MRI pattern (45%), followed by grey matter injury (14%), normal imaging (13%), malformations (10%), focal vascular insults (9%), and miscellaneous patterns (7%). Parity, birth gestation, level of neonatal care, Apgar score, and time to established respiration varied between MRI patterns (p<0.01). Nulliparity was most strongly associated with focal vascular insults, whereas multiparity was associated only with malformations. Grey matter injury was not associated with birth in a tertiary unit, but was strongly associated with severe perinatal compromise. The frequency of neonatal seizures and of nursery admissions was lowest among children with malformations.

Interpretation

As known risk factors for CP are differentially associated with specific MRI patterns, future exploration of causal pathways might be facilitated when performed in pathogenically defined groups.

Ancillary