TY - JOUR
T1 - Early prediction of unilateral cerebral palsy in infants at risk
T2 - MRI versus the hand assessment for infants
AU - Wagenaar, Nienke
AU - Verhage, Cornelia H
AU - de Vries, Linda S
AU - van Gasselt, Bram P L
AU - Koopman-Esseboom, Corine
AU - Leemans, Alexander
AU - Groenendaal, Floris
AU - Benders, Manon J N L
AU - van der Aa, Niek E
N1 - Funding Information:
We thank Robin van Aggele for his help with cerebral peduncle measurements. N.W. was supported by the Netherlands Organisation for Health Research and Development (ZonMW), the Netherlands (TAS Research Grant 11600200). C.H.V. was supported by the Phelps Foundation. The research of A.L. is supported by VIDI Grant 639.072.411 from the Netherlands Organisation for Scientific Research (NWO). This study received no specific financial support.
Publisher Copyright:
© 2019, International Pediatric Research Foundation, Inc.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/4
Y1 - 2020/4
N2 - Background: Neonates with unilateral perinatal brain injury (UPBI) are at risk for developing unilateral spastic cerebral palsy (USCP). This study compares several predictors for USCP later in life. Methods: Twenty-one preterm and 24 term born infants with UPBI were included, with an MRI scan including diffusion tensor imaging (DTI) performed at term equivalent age or around 3 months after birth, respectively. T2-weighted images and DTI-based tractography were used to measure the surface area, diameter, and fractional anisotropy (FA) of both corticospinal tracts (CSTs). The hand assessment for infants (HAI) was performed before 5, between 5 and 8 and between 8 and 12 months of (corrected) age. Asymmetry indices were derived from all techniques and related to USCP at ≥2 years of age. Results: MRI measures and HAI scores were significantly lower for the affected compared to the unaffected side. Before 5 months of age, FA asymmetry on DTI yielded the highest area under the curve compared to conventional MRI and HAI. Conclusions: Prediction of USCP after UPBI is reliable using asymmetry of the CST on MRI, as well as clinical hand assessment. Before 5 months of age, DTI tractography provides strongest predictive information, while HAI specifically aids to prognosis of USCP at later age points.
AB - Background: Neonates with unilateral perinatal brain injury (UPBI) are at risk for developing unilateral spastic cerebral palsy (USCP). This study compares several predictors for USCP later in life. Methods: Twenty-one preterm and 24 term born infants with UPBI were included, with an MRI scan including diffusion tensor imaging (DTI) performed at term equivalent age or around 3 months after birth, respectively. T2-weighted images and DTI-based tractography were used to measure the surface area, diameter, and fractional anisotropy (FA) of both corticospinal tracts (CSTs). The hand assessment for infants (HAI) was performed before 5, between 5 and 8 and between 8 and 12 months of (corrected) age. Asymmetry indices were derived from all techniques and related to USCP at ≥2 years of age. Results: MRI measures and HAI scores were significantly lower for the affected compared to the unaffected side. Before 5 months of age, FA asymmetry on DTI yielded the highest area under the curve compared to conventional MRI and HAI. Conclusions: Prediction of USCP after UPBI is reliable using asymmetry of the CST on MRI, as well as clinical hand assessment. Before 5 months of age, DTI tractography provides strongest predictive information, while HAI specifically aids to prognosis of USCP at later age points.
UR - https://www.scopus.com/pages/publications/85075399037
U2 - 10.1038/s41390-019-0664-5
DO - 10.1038/s41390-019-0664-5
M3 - Article
C2 - 31722367
SN - 0031-3998
VL - 87
SP - 932
EP - 939
JO - Pediatric Research
JF - Pediatric Research
IS - 5
ER -