Background. Variability in hand function among children with unilateral cerebral palsy (UCP) might reflect the type of brain injury and resulting anatomical sequelae. Objective. We used atlas-based analysis of structural images to determine whether children with periventricular (PV) versus middle cerebral artery (MCA) injuries might exhibit unique anatomical characteristics that account for differences in hand function. Methods. Forty children with UCP underwent structural brain imaging using 3-T magnetic resonance imaging. Brain lesions were classified as PV or MCA. A group of 40 typically developing (TD) children served as comparison controls. Whole brains were parcellated into 198 structures (regions of interest) to obtain volume estimates. Dexterity and bimanual hand function were assessed. Unbiased, differential expression analysis was performed to determine volumetric differences between PV and MCA groups. Principal component analysis (PCA) was performed and the top 3 components were extracted to perform regression on hand function. Results. Children with PV had significantly better hand function than children with MCA. Multidimensional scaling analysis of volumetric data revealed separate clustering of children with MCA, PV, and TD children. PCA extracted anatomical components that comprised the 2 types of brain injury. In the MCA group, reductions of volume were concentrated in sensorimotor structures of the injured hemisphere. Models using PCA predicted hand function with greater accuracy than models based on qualitative brain injury type. Conclusions. Our results highlight unique quantitative differences in children with UCP that also predict differences in hand function. The systematic discrimination between groups found in our study reveals future questions about the potential prognostic utility of this approach.

中文翻译：

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单侧脑瘫儿童的解剖和功能特征：基于图谱的分析

背景。单侧脑瘫 (UCP) 儿童手功能的差异可能反映了脑损伤的类型和由此产生的解剖学后遗症。客观的。我们使用基于图谱的结构图像分析来确定脑室周围 (PV) 与大脑中动脉 (MCA) 损伤的儿童是否可能表现出独特的解剖特征，从而解释了手部功能的差异。方法。40 名患有 UCP 的儿童使用 3-T 磁共振成像进行了结构性脑成像。脑损伤被分类为PV或MCA。一组 40 名典型发育 (TD) 儿童作为比较对照。整个大脑被分割成 198 个结构（感兴趣区域）以获得体积估计。评估灵巧性和双手功能。不偏不倚，进行差异表达分析以确定PV和MCA组之间的体积差异。进行主成分分析 (PCA) 并提取前 3 个成分以对手部功能进行回归。结果。PV 患儿的手部功能明显优于 MCA 患儿。体积数据的多维标度分析揭示了 MCA、PV 和 TD 儿童的单独聚类。PCA 提取了包含 2 种脑损伤的解剖成分。在 MCA 组中，体积的减少集中在受伤半球的感觉运动结构中。使用 PCA 的模型比基于定性脑损伤类型的模型更准确地预测手部功能。结论。我们的结果突出了 UCP 儿童独特的数量差异，这也预测了手部功能的差异。在我们的研究中发现的群体之间的系统性歧视揭示了有关这种方法潜在预后效用的未来问题。