Background:

Few studies have focused on magnetic resonance imaging (MRI) brain findings associated with functional mobility in cerebral palsy.

Objective:

To determine association between MRI findings and Gross Motor Functional Classification System (GMFCS) levels in cerebral palsy.

Methods:

Prospective-observational study conducted in Pediatric Neurology Clinic at a public teaching hospital, Northern India. First 3 new cases of cerebral palsy were enrolled on particular neuro-clinic day per week for 1 year. Functional mobility was classified according to GMFCS. Association between MRI findings, cerebral palsy type, and GMFCS levels were evaluated using χ² test.

Results:

A total of 138 cases (mean age 2.71 [SD = 1.91] years; male [64.5%]) were enrolled. Reported types of cerebral palsy were as follows: spastic quadriplegia (47.8%), spastic diplegia (28.35%), spastic hemiplegia (11.6%), extrapyramidal (6.5%), and ataxic/hypotonic (5.8%). GMFCS were classified into level 1 (13%), level 2 (7.2%), level 3 (4.3%), level 4 (10.9%), and level 5 (64.5%). Spastic quadriplegia and extrapyramidal cerebral palsy were significantly associated with higher (severe) levels (IV and V), whereas spastic diplegia and hemiplegia were significantly associated with lower (mild) levels (I-III) of GMFCS. MRI features of periventricular white matter injury, deep gray matter injury, basal ganglia and thalamic changes, and superficial gray matter injury were significantly associated with severe levels of GMFCS (V and IV). MRI was normal in 8 children (5 = mild category, 3 = severe category).

Conclusion:

Severe cerebral palsy is most often associated with spastic quadriplegia, extrapyramidal cerebral palsy, superficial gray matter lesions, deep gray matter lesions, and periventricular white matter injury. This information is useful for anticipating and addressing the needs of children with cerebral palsy and for prognostication.

中文翻译：

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与印度北部脑瘫儿童功能活动度严重受限相关的神经放射学特征

背景：

很少有研究关注与脑瘫患者功能活动性相关的磁共振成像 (MRI) 大脑发现。

客观的：

确定 MRI 发现与脑瘫患者粗大运动功能分类系统 (GMFCS) 水平之间的关联。

方法：

在印度北部一家公立教学医院的儿科神经病学诊所进行的前瞻性观察研究。前 3 例新的脑瘫病例在每周特定的神经诊所日登记，为期 1 年。功能移动性根据 GMFCS 进行分类。^使用χ2检验评估 MRI 结果、脑瘫类型和 GMFCS 水平之间的关联。

结果：

共纳入 138 例（平均年龄 2.71 [SD = 1.91] 岁；男性 [64.5%]）。报告的脑瘫类型如下：痉挛性四肢瘫痪（47.8%）、痉挛性双瘫（28.35%）、痉挛性偏瘫（11.6%）、锥体外系（6.5%）和共济失调/低渗性（5.8%）。GMFCS分为1级（13%）、2级（7.2%）、3级（4.3%）、4级（10.9%）和5级（64.5%）。痉挛性四肢瘫痪和锥体外系脑瘫与较高（重度）水平（IV 和 V）显着相关，而痉挛性双瘫和偏瘫与 GMFCS 较低（轻度）水平（I-III）显着相关。脑室周围白质损伤、深部灰质损伤、基底节和丘脑改变以及浅表灰质损伤的 MRI 特征与 GMFCS 的严重水平（V 和 IV）显着相关。

结论：

重度脑瘫最常伴有痉挛性四肢瘫痪、锥体外系脑瘫、浅层灰质病变、深部灰质病变和脑室周围白质损伤。这些信息对于预测和解决脑瘫儿童的需求以及预测非常有用。