Related Experiment Videos
Cortical laminar abnormalities--occurrence and clinical significance
M S van der Knaap1, L S Smit, J J Nauta
1Department of Child Neurology, Free University Hospital, Amsterdam, The Netherlands.
Insights
Cortical laminar abnormalities on MRI are linked to cerebral energy depletion in children. These MRI findings correlate with spasticity risk, especially when white matter damage is absent.
Area of Science:
- Neurology
- Pediatric Radiology
- Neuroimaging
Background:
- Cortical laminar necrosis is a histopathological finding associated with cerebral energy depletion.
- Clinical manifestations include motor deficits, intellectual decline, and epilepsy.
- The study investigates MRI-detected cortical laminar abnormalities as potential indicators of this condition.
Purpose of the Study:
- To evaluate the causes and clinical consequences of cortical laminar abnormalities on MRI in children.
- To find indirect evidence supporting the hypothesis that these abnormalities represent cortical laminar necrosis.
- To explore associations with cerebral energy depletion, white matter damage, and clinical outcomes.
Main Methods:
- A study of 45 children with cortical laminar abnormalities on MRI.
- Comparison with two control groups: 40 children with white matter abnormalities and 53 children with no MRI abnormalities.
- Data collection included medical history, clinical status, and final diagnoses.
Main Results:
- Cortical laminar abnormalities on MRI are strongly associated with a history of cerebral energy depletion (e.g., hypoxia-ischemia).
- These abnormalities occur more frequently in term neonates and older children, unlike white matter damage often seen in premature infants.
- Cortical laminar abnormalities increased spasticity risk in children without white matter damage, but not in those with existing white matter lesions.
Conclusions:
- MRI-detected cortical laminar abnormalities in children are linked to cerebral energy depletion events.
- These abnormalities are associated with an increased risk of spasticity, particularly when white matter damage is not present.
- No association was found between these MRI findings and epilepsy or psychomotor retardation.
Abstract:
Cortical laminar necrosis is a histopathological entity, related to conditions of cerebral energy depletion. Clinical correlates are supposed to be spastic motor deficits, decreased intellectual capacity and epilepsy. A study was performed in 45 children with cortical laminar abnormalities in signal intensity on MRI. The purpose of the study was to evaluate causes and clinical consequences of these cortical abnormalities on MRI in order to find indirect evidence for the hypothesis that they may represent cortical laminar necrosis. In view of the frequently present concomitant white matter damage, two contrast groups were formed: one group of 40 children with periventricular white matter abnormalities, part of them with subcortical extensions of the white matter damage; and another group of 53 children without abnormalities on MRI. Data concerning history, present clinical condition and final diagnosis were collected. The presence of cortical laminar abnormalities on MRI was found to be strongly associated with a history of cerebral energy depletion, especially hypoxia-ischemia, either in the perinatal period or later in life. Whereas white matter abnormalities tended to be more frequent in premature children, cortical laminar abnormalities tended to occur more frequently in term neonates and older children. The presence of cortical laminar abnormalities on MRI was correlated with an increased risk of spasticity in children without concomitant white matter abnormalities. In children with white matter lesions, cortical laminar abnormalities did not contribute to the risk of spasticity, which was already highly increased by the presence of white matter damage. No association was found between cortical abnormalities on MRI and epilepsy or psychomotor retardation.(ABSTRACT TRUNCATED AT 250 WORDS)