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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment: a
Jin Hyun Kim1, Yong Min Kwon1, Su Min Son1
1Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Daegu, 705-717, Republic of Korea.
Insights
Diffusion tensor imaging (DTI) can assess motor function in children with hemiplegic cerebral palsy. Fiber number (FN) and fractional anisotropy (FA) changes correlate with functional improvement after rehabilitation, with FN showing stronger significance.
Area of Science:
- Neuroimaging
- Rehabilitation Medicine
- Pediatric Neurology
Background:
- Diffusion tensor imaging (DTI) parameters correlate with motor dysfunction severity in pediatric patients.
- DTI shows potential in predicting motor function prognosis for cerebral palsy (CP).
- Limited research exists on DTI parameters reflecting motor outcomes post-rehabilitation in pediatric hemiplegic CP.
Purpose of the Study:
- To investigate the relationship between DTI parameters and motor function outcomes in pediatric hemiplegic cerebral palsy patients after rehabilitation.
- To assess the utility of DTI metrics in evaluating rehabilitation effectiveness.
Main Methods:
- 36 pediatric hemiplegic CP patients underwent DTI before and after rehabilitation.
- Measured fiber number (FN), fractional anisotropy (FA), and apparent diffusion coefficient (ADC) of corticospinal tracts.
- Assessed motor function using the Functional Level of Hemiplegia scale (FxL).
Main Results:
- The affected corticospinal tract showed decreased FN and FA, and increased ADC compared to the less affected tract.
- Changes in FxL positively correlated with changes in FN and FA.
- Correlation between FxL change and FN was stronger than with FA.
Conclusions:
- DTI parameters, specifically FN and FA, can evaluate motor function outcomes in pediatric hemiplegic CP post-rehabilitation.
- Fiber number (FN) demonstrates greater significance than FA in evaluating motor function recovery.
Abstract:
Previous diffusion tensor imaging (DTI) studies regarding pediatric patients with motor dysfunction have confirmed the correlation between DTI parameters of the injured corticospinal tract and the severity of motor dysfunction. There is also evidence that DTI parameters can help predict the prognosis of motor function of patients with cerebral palsy. But few studies are reported on the DTI parameters that can reflect the motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment. In the present study, 36 pediatric patients with hemiplegic cerebral palsy were included. Before and after rehabilitation treatment, DTI was used to measure the fiber number (FN), fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of bilateral corticospinal tracts. Functional Level of Hemiplegia scale (FxL) was used to assess the therapeutic effect of rehabilitative therapy on clinical hemiplegia. Correlation analysis was performed to assess the statistical interrelationship between the change amount of DTI parameters and FxL. DTI findings obtained at the initial and follow-up evaluations demonstrated that more affected corticospinal tract yielded significantly decreased FN and FA values and significantly increased ADC value compared to the less affected corticospinal tract. Correlation analysis results showed that the change amount of FxL was positively correlated to FN and FA values, and the correlation to FN was stronger than the correlation to FA. The results suggest that FN and FA values can be used to evaluate the motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment and FN is of more significance for evaluation.
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