Brain magnetic resonance imaging is a predictor of bimanual performance and executive function in children with unilateral cerebral palsy

Journal article


Crichton, Alison, Ditchfield, Michael, Gwini, Stellamay, Wallen, Margaret, Thorley, Megan, Bracken, Jenny, Harvey, Adrienne, Elliott, Catherine, Novak, Iona and Hoare, Brian. (2020) Brain magnetic resonance imaging is a predictor of bimanual performance and executive function in children with unilateral cerebral palsy. Developmental Medicine and Child Neurology. 62(5), pp. 615 - 624. https://doi.org/10.1111/dmcn.14462
AuthorsCrichton, Alison, Ditchfield, Michael, Gwini, Stellamay, Wallen, Margaret, Thorley, Megan, Bracken, Jenny, Harvey, Adrienne, Elliott, Catherine, Novak, Iona and Hoare, Brian
Abstract

Aim To examine the association between brain magnetic resonance imaging (MRI) characteristics and executive function and bimanual performance in children with unilateral cerebral palsy (CP). Method Clinical MRI brain scans were classified as: (1) predominant pathological pattern (normal, white matter injury [WMI]; grey matter injury; focal vascular insults [FVI]; malformations; or miscellaneous); and (2) focal lesions (frontal, basal ganglia, and/or thalamus). Assessments included: (1) bimanual performance; (2) unimanual dexterity; and (3) executive function tasks (information processing, attention control, cognitive flexibility, and goal setting) and behavioural ratings (parent). Results From 131 recruited children, 60 were ineligible for analysis, leaving 71 children (47 males, 24 females) in the final sample (mean age 9y [SD 2y], 6y–12y 8mo). Brain MRIs were WMI (69%) and FVI (31%); and frontal (59%), thalamic (45%), basal ganglia (37%), and basal ganglia plus thalamic (21%). Bimanual performance was lower in FVI versus WMI (p<0.003), and with frontal (p=0.36), basal ganglia (p=0.032), and thalamic/basal ganglia lesions (p=0.013). Other than information processing, executive function tasks were not associated with predominant pattern. Frontal lesions predicted attention control (p=0.049) and cognitive flexibility (p=0.009) but not goal setting, information processing, or behavioural ratings. Interpretation Clinical brain MRI predicts cognitive and motor outcomes when focal lesions and predominate lesion patterns are considered. What this paper adds Early brain magnetic resonance imaging (MRI) predicts bimanual performance and cognitive outcomes. Brain MRI may identify children requiring targeted interventions. Basal ganglia with/without thalamic lesions predicted bimanual performance. Frontal lesions were associated with attention control and cognitive flexibility. Brain MRI predominant patterns predicted motor, not cognitive outcomes, other than information processing.

Year2020
JournalDevelopmental Medicine and Child Neurology
Journal citation62 (5), pp. 615 - 624
PublisherBlackwell Publishing Ltd
ISSN0012-1622
Digital Object Identifier (DOI)https://doi.org/10.1111/dmcn.14462
Scopus EID2-s2.0-85078662656
Page range615 - 624
Research GroupSchool of Allied Health
Place of publicationUnited Kingdom
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