Exploring communication impairments in children with spastic cerebral palsy through neurovascular coupling: a...

The coupling between cerebral blood flow (CBF) and blood oxygenation level-dependent signals at rest reflects the mechanism of neurovascular coupling (NVC), which holds great potential for the non-invasive assessment of developmental disorders in humans. However, this has not been illustrated in spastic cerebral palsy (SCP). This study aimed to evaluate alterations in NVC in children with SCP and to explore the clinical significance of these NVC changes.

Twenty children with SCP (7.5±2.7) and 22 typically developing controls (TDC) (8.9±2.5) underwent resting-state functional magnetic resonance imaging (rs-fMRI) and arterial spin labeling (ASL) to calculate regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuation (fALFF), and CBF, respectively. Two types of NVC metrics (CBF/ReHo, CBF/fALFF) were compared between SCP and TDC, and the inner association between altered NVC metrics and communication function level in the SCP group was further analyzed.

Compared to TDC, among regional level, SCP showed significantly higher CBF/ReHo coupling in the left fusiform gyrus, right lingual gyrus, bilateral thalamus, left calcarine fissure and surrounding cortex, and left caudate nucleus [P<0.005, Gaussian random field (GRF) correction] and increased CBF/fALFF coupling in the left lingual gyrus, left middle temporal gyrus, right middle occipital gyrus, bilateral caudate nucleus, left angular gyrus, and left median cingulate and paracingulate gyri (P<0.005, GRF correction). Furthermore, increased CBF/fALFF coupling was found in the left middle temporal gyrus (r=-0.560, P=0.010) and left angular gyrus (r=-0.541, P=0.014), and negatively correlated with the communication function level of SCP.

Children with SCP present altered NVC, associated with communication function level. The study provides a new insight into the pathophysiology of SCP and provides potential imaging biomarkers of communication performances in children with SCP.