Investigating the underlying pathophysiology of unilateral cerebral palsy: the potential value of using functional connectivity

IntroductionResting-state functional MRI (rs-fMRI) allows investigating interactions between spatially remote brain areas (networks) at rest. Exploring the sensorimotor network in children with unilateral cerebral palsy (uCP) may offer new insights into the underlying pathophysiology of this neurodevelopmental disorder.Patients and methodsRs-fMRI was collected in 26 children with uCP with white matter lesions (mean age: 12y11m (±4y6m), 15 females, 12 left-side affected) and 18 typically developing children (TDC; mean age: 14y5m (±1y7m), 4 females, 3 left-handed). Blood-oxygen-level dependent signal was extracted from eight bilateral sensorimotor regions of interest (ROIs) (primary motor and sensory cortex, secondary sensory cortex, dorsal and ventral premotor cortex, supplementary motor area, thalamus, putamen). Intra- and interhemispheric functional connectivity (FC) between pairs of ROIs was compared between uCP and TDC.ResultsPutamen FC differed between groups: within the dominant/non-lesioned hemisphere, uCP showed higher intrahemispheric FC between putamen and dorsal premotor cortex than TDC (t=-3.40; p(FDR-corrected)=0.01), while cortico-subcortical FC was similar between groups in the non-dominant/lesioned hemisphere. Additionally, interhemispheric FC between bilateral putamen was lower in uCP than TDC (t=3.26; p(FDR-corrected)=0.01).ConclusionCompared to TDC, children with uCP developed stronger cortico-striatal connections within the dominant hemisphere, whereas FC between bilateral putamen was reduced. As there are no direct white matter tracts connecting both putamen, this suggests that cortico-striatal pathways are highly sensitive to developmental disruptions that predominantly affect the non-lesioned hemisphere. Current results are a first step toward a better understanding of the pathophysiology of white matter lesions and potentially help defining new biomarkers of functioning.

Jaar van publicatie:2018