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Does Contralesional Hand Function After Neonatal Stroke Only Depend on Lesion Characteristics?

Mickael Dinomais1, Lucie Hertz-Pannier2, Samuel Groeschel2

  • 1From the Physical and Rehabilitation Medicine Department (M. Dinomais) and Neurosurgery Department (M. Delion), University Hospital Angers, LUNAM-Angers University, Angers, France; UNIACT-Neurospin, CEA-Saclay, InsermU1129 and Paris-Descartes University, Sorbonne Paris-Cité, Paris, France (L.H.-P); Department of Child Neurology, University Hospital Tübingen, Tübingen, Germany (S.G.); Pediatric Radiology Department, University Hospital Bicêtre (B.H.) and Pediatric Neurology Department, University Hospital Necker (M.K.), Assistance-Publique-Hopitaux de Paris, Paris, France; French Centre for Paediatric Stroke, Saint-Étienne and Paris, France (B.H., M.K., C.R., S.C.); Pediatric PRM Department, University Hospital Saint-Étienne, Saint-Étienne, France (S.C.); Inserm CIC1408 and Inserm University Saint-Étienne U1090 Sainbiose: Equipe dysfonction vasculaire et hémostase, Saint-Étienne, France (S.C.); and Pediatric Neurology Department and Environnement Périnatale et Santé, University Hospital Lille, Lille University, Lille, France (S.N.T.T.). mickael.dinomais@les-capucins-angers.fr.

Stroke
|May 12, 2016
PubMed
Summary

Children with neonatal arterial ischemic stroke show hand deficits linked to remote brain structure atrophy. The cerebellum and thalamus play key roles in manual dexterity recovery.

Keywords:
atrophycerebral palsycerebral peduncledexteritymagnetic resonance imagingmotor systemstroke

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Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Neuroimaging

Background:

  • Neonatal arterial ischemic stroke (NAIS) can impact long-term motor function in children.
  • Understanding the brain basis of motor deficits is crucial for targeted rehabilitation.

Purpose of the Study:

  • To investigate the relationship between contralesional hand performance and structural brain changes in children with NAIS.
  • To identify specific brain regions remote from the infarct that correlate with manual dexterity.

Main Methods:

  • Voxel-based morphometry (VBM) and high-resolution MRI were used.
  • 37 children with NAIS and 37 age-matched controls were analyzed.
  • Manual dexterity was assessed using the box and block test.

Main Results:

  • Significant positive correlations were found between manual dexterity and brain volumes in the mediodorsal thalamus, cerebellar lobule VIIa Crus I, corticospinal tract, internal capsule, cerebral peduncle, and corpus callosum.
  • Children with severe motor deficits showed volume reductions in these areas compared to controls with good dexterity.
  • No negative correlations were observed.

Conclusions:

  • Contralesional hand function after NAIS is associated with atrophy in structurally and functionally connected brain areas distant from the stroke lesion.
  • The cerebellar lobule VIIa Crus I and mediodorsal thalamus are implicated in recovery of manual dexterity.