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Cortical Reorganization following Injury Early in Life
Moran Artzi1, Shelly Irene Shiran2, Maya Weinstein3
1Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239 Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Brain injury in children causes structural changes like reduced white matter and increased cerebrospinal fluid (CSF). Reorganization in the unaffected hemisphere may compensate for deficits, but correlates with motor performance.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatric Neurology
Background:
- The brain's plasticity allows reorganization after injury, particularly in early life.
- Limited understanding exists regarding structural brain reorganization and its effects following perinatal injuries.
Purpose of the Study:
- To investigate structural brain changes in children with hemiplegia compared to typically developing children.
- To analyze differences in brain tissue volume, morphology, perfusion, and integrity.
Main Methods:
- Magnetic Resonance Imaging (MRI) was employed to assess brain structure and function.
- Comparative analysis between children with hemiplegia and a control group of typically developing children.
Main Results:
- Children with hemiplegia showed reduced total cerebral volume, increased cerebrospinal fluid (CSF), and decreased white matter volume.
- Increased cortical thickness was observed in motor and language areas of the hemisphere contralateral to the lesion (CLH).
- Reduced cortical thickness, perfusion, and surface area were noted in limbic areas; increased CSF and CLH cortical thickness correlated with poorer motor function.
Conclusions:
- Brain reorganization, specifically gray matter changes in the CLH, is a response to early-life neuronal deficits after injury.
- While CLH reorganization occurs, it doesn't guarantee improved outcomes and may correlate with motor deficits.
Abstract:
The brain has a remarkable capacity for reorganization following injury, especially during the first years of life. Knowledge of structural reorganization and its consequences following perinatal injury is sparse. Here we studied changes in brain tissue volume, morphology, perfusion, and integrity in children with hemiplegia compared to typically developing children, using MRI. Children with hemiplegia demonstrated reduced total cerebral volume, with increased cerebrospinal fluid (CSF) and reduced total white matter volumes, with no differences in total gray matter volume, compared to typically developing children. An increase in cortical thickness at the hemisphere contralateral to the lesion (CLH) was detected in motor and language areas, which may reflect compensation for the gray matter loss in the lesion area or retention of ipsilateral pathways. In addition, reduced cortical thickness, perfusion, and surface area were detected in limbic areas. Increased CSF volume and precentral cortical thickness and reduced white matter volume were correlated with worse motor performance. Brain reorganization of the gray matter within the CLH, while not necessarily indicating better outcome, is suggested as a response to neuronal deficits following injury early in life.
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