Release date: 2016-05-26
In patients with spastic cerebral palsy, lower extremity motor dysfunction is a core feature, but its relationship with brain damage is still unclear. It is very complicated to clarify the relationship between pathological gait, lower limb dysfunction and brain damage, including the wide heterogeneity of brain damage, brain development and maturation, and the causes of abnormal gait (eg muscle) Factors related to the state of force and sputum).
In this study, in order to clarify the link between brain damage and gait abnormalities, Meyns et al. from the Department of Rehabilitation and Physical Therapy at the University of Durham, Belgium, used routine MRI and diffusion tensors in children over 3 years old with cerebral palsy. Imaging (DTI), which attempts to quantify the relevant parameters between multiple brain injuries and gait performance, and their findings are published in the online journal of Neurorehabil Neural Repair in January 2016.
The investigators included 50 children with spastic cerebral palsy, 25 of whom were unilaterally involved and 25 were bilaterally involved. The neuroimaging parameters evaluated included volume measurements of the corpus callosum and lateral ventricles, as well as DTI parameters of the corticospinal tract. The researchers used three-dimensional gait analysis and clinical evaluation to evaluate patients with pathological non-filling and major motor dysfunction, including evaluation of muscle strength and tendon status.
In children with bilateral spastic cerebral palsy, the volume of the lateral ventricle, as well as the branching of the frontal lobes, anterior motor, and sensory areas of the corpus callosum, are most closely related to lower extremity dyskinesia and pathological gait. The assessment of corticospinal tracts using DTI suggests additional links to the primary motor zone. In contrast, in children with unilateral spastic cerebral palsy, volume assessment and diffusion assessment are only associated with changes in muscle strength in the lower extremities.
Figure 1 Microscopic and macroscopic lesions of white matter
The results obtained in this study indicate that in children with spastic cerebral palsy, dysfunction caused by multiple brain damage and its effects on the primary motor area can explain the pathological steps of the child to a large extent. The appearance of the state. This study helped us to understand the complex interactions between central nervous system integrity and motor function in children with cerebral palsy.
Future research will also require attention in the following areas, such as a comprehensive assessment of the effects of multifocal lesions (motion and sensation) in the brain on children with bilateral spastic cerebral palsy, and a multicenter study to obtain a more comprehensive and Objective evaluation results.
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