The relationship between neuroimaging and motor outcome in children with cerebral palsy: A systematic review-Part B diffusion imaging and tractography.
dMRI scans give clearer clues about hand skill potential in one-sided CP than older MRI methods.
01Research in Context
What this study did
Wagels et al. (2020) hunted for papers that linked brain scans to hand skills in kids with cerebral palsy.
They kept only studies that used a special scan called dMRI that maps white-matter cables.
Nineteen studies with 577 children made the cut.
What they found
In kids with one-sided CP, clearer cables in the motor and touch tracts matched better hand use.
For kids with both sides involved, or for non-motor tracts, the data were too thin to trust.
How this fits with other research
Perez et al. (2015) looked at plain MRI pictures and saw only weak links to gross motor scores.
Lisa’s review moves the field forward: dMRI gives sharper, stronger clues for hand function than plain MRI.
Bleyenheuft et al. (2015) showed that after bimanual training, dMRI can spot brain changes.
Lisa’s findings give Yannick’s team a roadmap: check the corticospinal and somatosensory tracts first.
Why it matters
When you plan hand skills training, ask the family if a dMRI report is on file.
Look for phrases like “corticospinal tract integrity” or “somatosensory pathway.”
Good signals in those tracts suggest the child may gain more from intensive upper-limb practice.
If the report is silent on those cables, probe other strengths and set cautious goals.
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Open the child’s latest brain report and circle any mention of corticospinal or somatosensory tracts—use their status to set bold or guarded hand-use targets.
02At a glance
03Original abstract
BACKGROUND: Diffusion magnetic resonance imaging (dMRI) is able to detect, localize and quantify subtle brain white matter abnormalities that may not be visible on conventional structural MRI. Over the past years, a growing number of studies have applied dMRI to investigate structure-function relationships in children with cerebral palsy (CP). AIMS: To provide an overview of the recent literature on dMRI and motor function in children with CP. METHODS: A systematic literature search was conducted in PubMed, Embase, Cochrane Central Register of Controlled trials, Cinahl and Web of Science from 2012 onwards. RESULTS: In total, 577 children with CP in 19 studies were included. Sixteen studies only included unilateral CP, while none included dyskinetic CP. Most studies focused on specific regions/tracts of interest (n = 17) versus two studies that investigated the whole brain. In unilateral and bilateral CP, white matter abnormalities were widespread including non-motor areas. In unilateral CP, consistent relationships were found between white matter integrity of the corticospinal tract and somatosensory pathways (e.g. thalamocortical projections, medial lemniscus) with upper limb sensorimotor function. The role of commissural and associative tracts remains poorly investigated. Also results describing structure-function relationships in bilateral CP are scarce (n = 3). CONCLUSIONS: This review underlines the importance of both the motor and somatosensory tracts for upper limb sensorimotor function in unilateral CP. However, the exact contribution of each tract requires further exploration. In addition, research on the relevance of non-motor pathways is warranted, as well as studies including other types of CP.
Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2019.103569