Neuroradiological and Neurophysiological Characteristics of Patients With Dyskinetic Cerebral Palsy.
10.5535/arm.2014.38.2.189
- Author:
Byung Hyun PARK
1
;
Sung Hee PARK
;
Jeong Hwan SEO
;
Myoung Hwan KO
;
Gyung Ho CHUNG
Author Information
1. Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea. shpark0130@chonbuk.ac.kr
- Publication Type:Original Article
- Keywords:
Cerebral palsy;
Diffusion tensor imaging;
Motor evoked potentials;
Magnetic resonance imaging
- MeSH:
Basal Ganglia;
Cerebral Palsy*;
Classification;
Deltoid Muscle;
Diffusion;
Diffusion Tensor Imaging;
Dystonia;
Evoked Potentials, Motor;
Extrapyramidal Tracts;
Female;
Hippocampus;
Humans;
Magnetic Resonance Imaging;
Male;
Neuroimaging;
Parahippocampal Gyrus;
Putamen;
Pyramidal Tracts;
Thalamus
- From:Annals of Rehabilitation Medicine
2014;38(2):189-199
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate neuroradiological and neurophysiological characteristics of patients with dyskinetic cerebral palsy (CP), by using magnetic resonance imaging (MRI), voxel-based morphometry (VBM), diffusion tensor tractography (DTT), and motor evoked potential (MEP). METHODS: Twenty-three patients with dyskinetic CP (13 males, 10 females; mean age 34 years, range 16-50 years) were participated in this study. Functional evaluation was assessed by the Gross Motor Functional Classification System (GMFCS) and Barry-Albright Dystonia Scale (BADS). Brain imaging was performed on 3.0 Tesla MRI, and volume change of the grey matter was assessed using VBM. The corticospinal tract (CST) and superior longitudinal fasciculus (SLF) were analyzed by DTT. MEPs were recorded in the first dorsal interossei, the biceps brachii and the deltoid muscles. RESULTS: Mean BADS was 16.4+/-5.0 in ambulatory group (GMFCS levels I, II, and III; n=11) and 21.3+/-3.9 in non-ambulatory group (GMFCS levels IV and V; n=12). Twelve patients showed normal MRI findings, and eleven patients showed abnormal MRI findings (grade I, n=5; grade II, n=2; grade III, n=4). About half of patients with dyskinetic CP showed putamen and thalamus lesions on MRI. Mean BADS was 20.3+/-5.7 in normal MRI group and 17.5+/-4.0 in abnormal MRI group. VBM showed reduced volume of the hippocampus and parahippocampal gyrus. In DTT, no abnormality was observed in CST, but not in SLF. In MEPs, most patients showed normal central motor conduction time. CONCLUSION: These results support that extrapyramidal tract, related with basal ganglia circuitry, may be responsible for the pathophysiology of dyskinetic CP rather than CST abnormality.
