ACKNOWLEDGEMENTS The authors gratefully acknowledge the contributions of Dr Peter van Zijl and our neuroimaging research team, Terri Brawner, Kathleen Kahl, and Carolyn Gillen. Special thanks to the families and children who participated in this study. This study was supported by grants from the Dana Foundation Clinical Hypothesis Program in Imaging, United Cerebral Palsy Research & Educational Foundation, and the Johns Hopkins University School of Medicine General Clinical Research Center, grant no. M01-RR00052 from the National Center of Research Resources/National Institutes of Health, and National Institutes of Health grant RO1 AG20012, P41 R15241.
Sensory and motor deficits in children with cerebral palsy born preterm correlate with diffusion tensor imaging abnormalities in thalamocortical pathways
Article first published online: 31 MAR 2009
© The Authors. Journal compilation © Mac Keith Press 2009
Developmental Medicine & Child Neurology
Volume 51, Issue 9, pages 697–704, September 2009
How to Cite
HOON JR, A. H. , STASHINKO, E. E., NAGAE, L. M., LIN, D. D., KELLER, J., BASTIAN, A., CAMPBELL, M. L., LEVEY, E., MORI, S. and JOHNSTON, M. V. (2009), Sensory and motor deficits in children with cerebral palsy born preterm correlate with diffusion tensor imaging abnormalities in thalamocortical pathways. Developmental Medicine & Child Neurology, 51: 697–704. doi: 10.1111/j.1469-8749.2009.03306.x
- Issue published online: 6 AUG 2009
- Article first published online: 31 MAR 2009
- PUBLICATION DATA Accepted for publication 17th January 2009. Published online 31st March 2009.
Vol. 51, Issue 12, 1004, Article first published online: 2 NOV 2009
Aim Cerebral palsy (CP) is frequently linked to white matter injury in children born preterm. Diffusion tensor imaging (DTI) is a powerful technique providing precise identification of white matter microstructure. We investigated the relationship between DTI-observed thalamocortical (posterior thalamic radiation) injury, motor (corticospinal tract) injury, and sensorimotor function.
Method Twenty-eight children born preterm (16 males, 12 females; mean age 5y 10mo, SD 2y 6mo, range 16mo–13y; mean gestational age at birth 28wks, SD 2.7wks, range 23–34wks) were included in this case–control study. Twenty-one children had spastic diplegia, four had spastic quadriplegia, two had hemiplegia, and one had ataxic/hypotonic CP; 15 of the participants walked independently. Normative comparison data were obtained from 35 healthy age-matched children born at term (19 males, 16 females; mean age 5y 9mo, SD 4y 4mo, range 15mo–15y). Two-dimensional DTI color maps were created to evaluate 26 central white matter tracts, which were graded by a neuroradiologist masked to clinical status. Quantitative measures of touch, proprioception, strength (dynamometer), and spasticity (modified Ashworth scale) were obtained from a subset of participants.
Results All 28 participants with CP had periventricular white-matter injury on magnetic resonance imaging. Using DTI color maps, there was more severe injury in the posterior thalamic radiation pathways than in the descending corticospinal tracts. Posterior thalamic radiation injury correlated with reduced contralateral touch threshold, proprioception, and motor severity, whereas corticospinal tract injury did not correlate with motor or sensory outcome measures.
Interpretation These findings extend previous research demonstrating that CP in preterm children reflects disruption of thalamocortical connections as well as descending corticospinal pathways.