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Published on: December 5, 2014
Neuroimaging and cerebral palsy in children
M E Msall1, C Limperopoulos, J J Park
1Section of Developmental and Behavioral Pediatrics University of Chicago, Pritzker School of Medicine, JP Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Comer and LaRabida Children's Hospitals, Chicago, IL, USA. mmsall@peds.bsd.uchicago.edu
Insights
Cerebral palsy (CP) is a common childhood motor disability. Neuroimaging aids in diagnosing CP by revealing brain structure, improving understanding of its complexity and impact on children's development.
Area of Science:
- Neurology
- Developmental Pediatrics
- Neuroimaging
Background:
- Cerebral palsy (CP) is a prevalent neurodevelopmental disorder causing motor disabilities in children.
- Current management focuses on interventions to improve quality of life, as curative therapies are unavailable.
- Diagnosis traditionally relies on clinical observations and motor milestone delays.
Purpose of the Study:
- To review the role of neuroimaging in the diagnosis and evaluation of cerebral palsy.
- To explore how brain structure insights inform our understanding of CP and its impact on children's functioning.
- To highlight the evolving role of neuroimaging in appreciating the complexity of CP.
Main Methods:
- Review of major neuroimaging techniques used in cerebral palsy assessment.
- Analysis of how neuroimaging findings correlate with clinical presentation and developmental outcomes.
- Focus on neuroimaging in premature infants and its relation to brain plasticity.
Main Results:
- Neuroimaging provides crucial insights into lesion timing and white matter involvement in CP.
- It enhances the understanding of the diverse motor spectrum associated with CP.
- Emerging knowledge links brain structure to children's functional abilities, particularly in prematurity.
Conclusions:
- Neuroimaging is increasingly recognized as a vital component in the diagnostic process for cerebral palsy.
- Understanding brain structure through imaging offers a deeper appreciation of CP's complexity and impact.
- Continued research into brain plasticity and neuroimaging holds promise for better management and outcomes for children with CP.
Abstract:
Cerebral palsy (CP) is a description of a spectrum of central nervous system (CNS) impairments that affect mobility, communication, intellectual ability, and neurobehavior as a result of developmental brain dysfunction. CP is the most common contributor to motor disability in children with prevalence of about 2-3/1000 live births globally. Presently, no curative therapies or successful methods of prevention on a population level are available for children with one of the cerebral palsy syndromes. Despite these challenges, orthopedic, rehabilitation, neuropharmacological, and other management interventions can help maintain mobility, prevent deformity, and promote quality of life for children with CP. Typically, the diagnosis of CP is based on clinical observations and parent concerns regarding delays in attaining motor milestones (e.g., rolling, sitting, crawling, walking), not on laboratory testing or neuroimaging. However, since 2004 the American Academy of Neurology (AAN) has recommended that neuroimaging of the CNS be part of diagnostic process for cerebral palsy. Although the guideline was initially met with controversy and criticism, neuroimaging has allowed a broader appreciation of timing of lesions, extent of white matter involvement, and the complexity of the motor spectrum of disability. In this article we shall describe the major types of neuroimaging techniques and review their roles in identification and evaluation of children with one of the cerebral palsy syndromes. The authors will focus on the emerging knowledge of how brain structure can inform us about children's functioning, especially among children with prematurity, recognizing that we are only beginning to understand brain plasticity and developmental resiliency.
