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[The relationship between severity of spastic diplegia and laterality of the cerebral function]
1Department of Pediatrics, Kitakyushu City Sogo Ryouiku Center.
Insights
Children with left-handed spastic diplegia (SD) show more severe impairments in intelligence and daily living compared to right-handed SD. Increased severity correlates with upper limb motor difficulties and right-hand spasticity.
Area of Science:
- Neurology
- Developmental Pediatrics
- Neuroscience
Background:
- Spastic diplegia (SD) is a common form of cerebral palsy, often linked to preterm birth.
- Cerebral function laterality and its relationship with clinical severity in SD remain incompletely understood.
Purpose of the Study:
- To investigate the association between clinical severity and cerebral function laterality in children with spastic diplegia.
- To explore potential neuroanatomical correlates of observed clinical patterns.
Main Methods:
- Study included seventeen children with clinical evidence of preterm birth and spastic diplegia.
- Clinical severity was assessed, alongside intelligence and activities of daily living.
- Dichotic listening tests and MRI examinations were performed.
Main Results:
- Left-handed SD patients exhibited more severe impairments in intelligence and daily living compared to right-handed SD patients.
- Increased clinical severity correlated with upper limb motor difficulties and right-hand spasticity.
- Right ear dominance was observed in right-handed SD patients via dichotic listening; MRI revealed periventricular leukomalacia (PVL) in all examined cases with limited correlation to laterality.
Conclusions:
- Clinical severity in spastic diplegia is associated with cerebral function laterality.
- Right-hand spasticity in severe cases may stem from left hemisphere periventricular structure vulnerability.
- Further research is warranted to elucidate the complex interplay between preterm birth, cerebral injury, and functional outcomes in SD.
Abstract:
Seventeen children with clinical evidences of preterm birth and spastic diplegia (SD) were studied about the relationship between clinical severity and laterality of cerebral function. The result showed the patients with the left-handed SD were more serious than those with the right-handed in their intelligence and activity of daily living. As the severity increased, motor difficulty was also observed at upper limbs, and especially spasticity was detected at the right hand. The dichotic listening test showed the right ear dominance only in the patients with the right-handed SD. MRI examination was performed in 10 cases, and periventricular leukomalacia (PVL) was detected in all cases. There was few correlation between PVL and clinical laterality. We speculated that right-hand spasticity which was seen in severe cases was due to the fragility of periventricular structure in the left hemisphere.