Cerebral Magnetic Resonance Imaging of Children With Cerebral Palsy Showed Vulnerabilities Related to Gestational Age
Alexandra Sophie Bencsik1, Guro L Andersen1,2, Jon Skranes1,3
1Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Insights
Cerebral palsy (CP) in children shows distinct MRI findings. White matter injuries are common in preterm infants, while grey matter injuries are more prevalent in term infants, correlating with specific risk factors and clinical features.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder in children.
- Understanding the neuroimaging patterns associated with CP is crucial for diagnosis and management.
- Cerebral magnetic resonance imaging (MRI) provides detailed insights into brain structure.
Purpose of the Study:
- To characterize cerebral MRI findings in a large cohort of children with CP.
- To investigate the associations between MRI findings, perinatal risk factors, and clinical characteristics.
- To identify patterns of brain injury in relation to gestational age, Apgar scores, and CP subtypes.
Main Methods:
- Retrospective analysis of data from 1867 children with CP born between 2000 and 2016.
- Linking registry data with the Medical Birth Registry for comprehensive information.
- Descriptive statistical analysis of MRI findings in 1463 children.
Main Results:
- White matter injuries were the most frequent MRI finding (44.6%), followed by grey matter injuries (28.4%).
- Grey matter injuries correlated positively with gestational age, while white matter injuries were more common in term infants who were small for gestational age (SGA).
- Specific injury patterns were observed in relation to Apgar scores, CP subtypes (spastic vs. dyskinetic), and epilepsy.
Conclusions:
- Cerebral MRI findings in children with CP reveal significant white and grey matter vulnerability.
- Preterm infants with CP predominantly exhibit white matter injuries.
- Term infants with CP show a higher proportion of grey matter injuries, underscoring the distinct pathological processes involved.
Aim:
This study aimed to describe cerebral magnetic resonance imaging (MRI) findings in children with cerebral palsy (CP) and compare them with risk factors and clinical features.
Methods:
Data on 1867 children with CP born in 2000-2016 were retrieved from the Norwegian Quality and Surveillance Registry for CP and linked to the Medical Birth Registry. Descriptive statistics were used.
Results:
MRI scans were performed in 1463 children, that revealed one predominant pathogenic finding: 44.6% white matter injuries, 28.4% grey matter injuries, 13.5% normal, 7.9% maldevelopments and 5.5% miscellaneous. The proportion of grey matter injuries increased as gestational age increased (p < 0.01). However, white matter injuries were more common in children born at term and small for gestational age (SGA) than in those not SGA (p = 0.03). In term-born children, grey matter injuries decreased with increasing 5-min Apgar scores (p < 0.01). Half of the children with spastic CP had white matter injuries, while half of those with dyskinetic CP had grey matter injuries. White matter injuries were the most common, regardless of the Gross Motor Function Classification System level. Children with epilepsy mainly had grey matter injuries.
Conclusion:
This study highlighted the vulnerability of white and grey matter in preterm and term infants with CP, respectively.
