The relationship between neuroimaging and motor outcome in children with cerebral palsy: A systematic review - Part A. Structural imaging.
Brain scars alone cannot yet tell us how a child with CP will move.
01Research in Context
What this study did
Franki et al. (2020) hunted for papers that linked brain MRI pictures to how well kids with cerebral palsy move.
They kept only studies that used structural MRI—pictures that show brain scars, missing parts, or extra fluid.
The team wanted to know if the kind of scar on the scan could tell us how bad the gross- or fine-motor problems would be.
What they found
The review found only a weak tie between scar type and gross-motor level.
Fine-motor numbers were too few to trust.
Bottom line: we cannot yet look at an MRI and predict how a child will walk or grab.
How this fits with other research
McGeown et al. (2013) seems to disagree. They showed kids born after 34 weeks with the same white-matter scar moved, talked, and handled objects better than kids born earlier.
The gap is timing: R et al. grouped kids by gestational age, while Inge pooled all ages. When you split by age, the picture gets clearer.
Lima et al. (2020) and Visicato et al. (2015) back Inge up. Both found that small changes in task setup—like chair height or toy size—sway motor scores more than scar type alone.
Pino et al. (2017) add another layer: scar in the front cable of the brain (anterior corpus callosum) links to hidden attention problems, not just leg weakness. Motor tests that skip cognition may miss the full story.
Why it matters
For now, do not write a prognosis based only on an MRI report. Use the GMFCS, the Manual Ability Classification System, and real-world tasks. Track how the child moves at home and school, not just in the gym. Keep watching for new scan rules—once labs agree on one protocol, the pictures may start to talk.
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02At a glance
03Original abstract
BACKGROUND: Conventional Structural Magnetic Resonance Imaging (sMRI) is a mainstay in Cerebral Palsy (CP) diagnosis. AIMS: A systematic literature review was performed with the aim to investigate the relationship between structural brain lesions identified by sMRI and motor outcomes in children with CP. METHODS: Fifty-eight studies were included. The results were analysed in terms of population characteristics, sMRI (classified according to Krägeloh-Mann & Horber, 2007), gross and fine motor function and their interrelation. OUTCOMES: White matter lesions were the most common brain lesion types and were present in 57.8 % of all children with uCP, in 67.0 % of all children with bCP and in 33 % of the group of mixed subtypes. Grey matter lesions were most frequently registered in children with dyskinesia (n = 42.2 %). No structural anomalies visualized by sMRI were reported in 5.7 % of all cases. In all lesion types, an equal distribution over the different gross motor function classification system categories was present. The included studies did not report sufficient information about fine motor function to relate these results to structural imaging. CONCLUSIONS AND IMPLICATIONS: The relationship between brain structure and motor outcome needs to be further elucidated in a representative cohort of children with CP, using a more standardized MRI classification system.
Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103606