ISSN: 1859 - 2872
Some clinical characteristics, brain MRI findings, and the correlation between pyramidal tract injury and the levels of gross motor function disorder in children with spastic cerebral palsy
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Abstract
Objective: The aim of this study was to describe some of clinical characteristics, brain MRI findings, and evaluate the correlation between the pyramidal tract injury with the levels of gross motor function disorder in children with spastic cerebral palsy. Subject and method: Descriptive cross-sectional study. All children with spastic cerebral palsy ( CP) from 2 to 12 years old at the Rehabilitation Department of National Hospital of Pediatric from 12/2015 to 8/2017 who had eligible inclusion and exclusion criterion were recruited into our study. Participants were evaluated clinical characteristics, Gross motor function classification system (GMFCS) level, the brain conventional MRI findings, and diffusion tensor imaging (DTI) for each pyramidal tract. Result: 44 children with spastic CP met eligibility criteria. The mean age was 4.5 ± 2.1 year, 22 (50.0%) children with spastic quadriplegia, 15 (34.1%) spastic diplegia, and 7 (15.9%) spastic hemiplegia. The distribution of GMFCS levels: 25 (56.8%) level II, 13 (29.8%) level III and 6 (13.6%) level IV. Brain conventional MRI scanner showed that 33 (75%) abnormal findings, within periventricular white-matter damage was the highest finding 27 (61.4%). DTI findings of the pyramidal tract showed that the mean FA values < 0.50. Significant inverse correlation between FN, FA values and GMFCS levels were observed in both right* and left** pyramidal tract (p<0.001). The ADC change of each pyramidal tract was significantly correlated with GMFCS levels change (*r = 0.514, **r = 0.725, p<0.001). Conclusion: The spastic quadriplegia CP was the highest percentage, and caused the most limited self-mobility (GMFCS III - IV). The periventricular white-matter damage was the most common finding. The pyramidal tract injury was significantly correlated with GMFCS levels (p<0.001) in children with spastic cerebral palsy.
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