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

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.