Anisotropy of transcallosal motor fibres indicates functional impairment in children with periventricular leukomalacia

Authors

  • INGA KOERTE,

    1.  Institute of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
    2.  Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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  • PAULA PELAVIN,

    1.  Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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  • BERIT KIRMESS,

    1.  Pediatric Neurology and Developmental Medicine, Dr von Hauners Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
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  • TERESA FUCHS,

    1.  Pediatric Neurology and Developmental Medicine, Dr von Hauners Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
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  • STEFFEN BERWECK,

    1.  Pediatric Neurology and Developmental Medicine, Dr von Hauners Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
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  • RUEDIGER P LAUBENDER,

    1.  Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University Munich, Germany
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  • INGO BORGGRAEFE,

    1.  Pediatric Neurology and Developmental Medicine, Dr von Hauners Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
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  • SEBASTIAN SCHROEDER,

    1.  Pediatric Neurology and Developmental Medicine, Dr von Hauners Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
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  • ADRIAN DANEK,

    1.  Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
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  • CLAUDIA RUMMENY,

    1.  Institute of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
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  • MAXIMILIAN REISER,

    1.  Institute of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
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  • MAREK KUBICKI,

    1.  Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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  • MARTHA E SHENTON,

    1.  Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
    2.  Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
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  • BIRGIT ERTL-WAGNER,

    1.  Institute of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
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  • FLORIAN HEINEN

    1.  Pediatric Neurology and Developmental Medicine, Dr von Hauners Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
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Dr Inga K Koerte, Institute of Clinical Radiology, Grosshadern Campus, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany. E-mail: inga.koerte@med.lmu.de

Abstract

Aim  In children with bilateral spastic cerebral palsy (CP), periventricular leukomalacia (PVL) is commonly identified on magnetic resonance imaging. We characterized this white matter condition by examining callosal microstructure, interhemispheric inhibitory competence (IIC), and mirror movements.

Method  We examined seven children (age range 11y 9mo–17y 9mo, median age 15y 10mo, four females, three males) with bilateral spastic CP/PVL (Gross Motor Function Classification System level I or II, Manual Ability Classification System level I) and 12 age-matched controls (age range 11y 7mo–17y 1mo, median age 15y 6mo, seven females, five males). Fractional anisotropy of the transcallosal motor fibres (TCMF) and the corticospinal tract (CST) of both sides were calculated. The parameters of IIC (transcranial magnetic stimulation) and mirror movements were measured using a standardized clinical examination and a computer-based hand motor test.

Results  Fractional anisotropy was lower in children with bilateral spastic CP/PVL regarding the TCMF, but not the left or right CST. Resting motor threshold was elevated in children with bilateral spastic CP/PVL whereas measures of IIC tended to be lower. Mirror movements were markedly elevated in bilateral spastic CP/PVL.

Interpretation  This study provides new information on different aspects of motor function in children with bilateral spastic CP/PVL. Decreased fractional anisotropy of TCMF is consistent with impairment of hand motor function in children with bilateral spastic CP/PVL. The previously overlooked microstructure of the TCMF may serve as a potential indicator for hand motor function in patients with bilateral spastic CP/PVL.

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