The usefulness of MRI Classification System (MRICS) in a cerebral palsy cohort

Area of Science:

• Neuroimaging
• Pediatric Neurology
• Developmental Pediatrics

Background:

• Cerebral palsy (CP) is a complex developmental disorder affecting movement and posture.
• Understanding the relationship between perinatal factors, clinical characteristics, and brain imaging findings in CP is crucial for diagnosis and management.
• Magnetic resonance imaging (MRI) is a key tool for characterizing brain abnormalities in children with CP.

Purpose of the Study:

• To investigate perinatal and clinical factors associated with specific magnetic resonance imaging (MRI) patterns in children with cerebral palsy (CP).
• To analyze the distribution of MRI patterns using the MRI classification system (MRICS).
• To explore associations between perinatal/clinical characteristics and identified MRI patterns.

Main Methods:

• A population-based cohort study involving 257 children (58.0% male) diagnosed with CP.
• Children were enrolled from a CP database in Southwest Hungary, born between 1990 and 2015, with at least one MRI scan.
• Analysis included the distribution of MRI patterns based on the MRI classification system (MRICS) and associations with perinatal/clinical data.

Main Results:

• Brain maldevelopments were observed in 18.7% of patients, predominantly in those born at term (83.7%).
• White matter injuries were the most frequent abnormality (35.4%), with 69.0% of affected children born preterm (<37 weeks gestation).
• Children with normal MRI or grey matter injuries showed better gross/fine motor and cognitive function; epilepsy prevalence exceeded 60% in all abnormal MRI groups.

Conclusions:

• Cranial MRI findings were conclusive in 86.4% of children with CP.
• The study highlights significant associations between perinatal factors, MRI patterns, and functional outcomes in children with CP.
• Routine cranial MRI is strongly recommended for all children diagnosed with CP to aid in understanding and management.