Article

Even though lower-limb motor disorders are core features of spastic
cerebral palsy (sCP), the relationship with brain lesions remains unclear.
Unraveling the relation between gait pathology, lower-limb function, and brain
lesions in sCP is complex for several reasons; wide heterogeneity in brain
lesions, ongoing brain maturation, and gait depends on a number of primary motor
functions/deficits (eg, muscle strength, spasticity).
Objective To use a
comprehensive approach combining conventional MRI and diffusion tensor imaging
(DTI) in children with sCP above 3 years old to relate quantitative parameters of
brain lesions in multiple brain areas to gait performance. Methods A total of 50
children with sCP (25 bilateral, 25 unilateral involvement) were enrolled. The
investigated neuroradiological parameters included the following: (1) volumetric
measures of the corpus callosum (CC) and lateral ventricles (LVs), and (2) DTI
parameters of the corticospinal tract (CST). Gait pathology and primary motor
deficits, including muscle strength and spasticity, were evaluated by 3D gait
analysis and clinical examination. Results In bilateral sCP (n = 25), volume of
the LV and the subparts of the CC connecting frontal, (pre)motor, and sensory
areas were most related to lower-limb functioning and gait pathology. DTI
measures of the CST revealed additional relations with the primary motor deficits
(n = 13). In contrast, in unilateral sCP, volumetric (n = 25) and diffusion
measures (n = 14) were only correlated to lower-limb strength. Conclusions These
results indicate that the combined influence of multiple brain lesions and their
impact on the primary motor deficits might explain a large part of the gait pathology in sCP.
CI - (c) The Author(s) 2016.

Langue : ANGLAIS