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Exploring white matter abnormalities in different subtypes of spastic cerebral palsy using fixel-based analysis

Chih-Chien Tsai1, Chia-Ling Chen2, Chih-Hua Yeh3

  • 1Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan; Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan City, Taiwan.

European Journal of Radiology
|January 21, 2026
PubMed

Insights

Diffusion MRI reveals white matter damage in cerebral palsy (CP) subtypes, particularly in the corpus callosum and corticospinal tract. These findings highlight potential biomarkers for motor impairment severity in CP patients.

Area of Science:

  • Neuroimaging
  • Neurology
  • Biomarkers

Background:

  • Cerebral palsy (CP) is a group of disorders affecting movement and posture, often associated with white matter abnormalities.
  • Diffusion MRI is a powerful tool for assessing white matter integrity in vivo.

Purpose of the Study:

  • To investigate white matter integrity in individuals with CP and its subtypes using diffusion MRI.
  • To identify diffusion MRI-based biomarkers associated with motor impairment in CP.

Main Methods:

  • Diffusion-weighted and T2-weighted MRI scans were acquired from 34 participants with CP and 27 typically developing controls.
  • Fixel-based analysis and Tract-based spatial statistics were employed to analyze white matter microstructure.
  • Clinical assessments included the Gross Motor Function Classification System and Manual Ability Classification System.

Main Results:

  • Significant white matter damage was observed in CP participants compared to controls, affecting the corpus callosum, corticospinal tract, thalamic radiation, and optic radiation.
  • Fixel-based analysis identified additional damage in the genu of the corpus callosum.
  • White matter integrity in the thalamic radiation and corticospinal tract correlated with motor impairment severity.
  • Individuals with diplegia showed distinct patterns of damage compared to those with hemiplegia.

Conclusions:

  • Fixel-based analysis is effective in detecting subtle, subtype-specific white matter alterations in CP.
  • The microstructural and macrostructural integrity of the corticospinal tract and thalamic radiation show promise as imaging biomarkers for CP.
Abstract

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