The Application Of VBM, DTI And Resting-state Fmri In Patients With Occult Cerebral Palsy

Purpose: The purpose of this study was to analyze whole-brain grey matter, whitematter and resting state changes in patients with occult spastic diplegic cerebral palsy(SDCP).Materials and methods:16patients with occult SDCP and16age-and sex-matchedhealthy control subjects were collected and the data were acquired on a3T MR system.The motor dysfunction scale was evaluated using the gross motor function classificationsystem (GMFCS). We applied voxel-based morphometry (VBM) and tract-based spatialstatistics (TBSS) analysis to investigate whole brain grey and white matter injury inoccult SDCP. Then the voxel-wise correlation between grey matter volume (GMV),white matter volume (WMV), fractional anisotropy (FA) and GMFCS levels wasperformed.12patients with occult SDCP and14age-and sex-matched healthy control subjectswere collected and the data were acquired using resting state functional magneticresonance imaging. The regional homogeneity(ReHo), amiplitude low frequency(ALFF)and functional connectivity maps(precentral gyrus and thalamus) were analyzed andcompared between the occult SDCP and control groups．Results: By using VBM method, the grey matter volume reduction was revealed in thebilateral basal ganglia regions, thalamus, insula, and left cerebral peduncle, whereas thewhite matter atrophy was found to be located in the posterior part of corpus callosumand right posterior corona radiata in the occult SDCP patients. By using TBSS, reducedfractional anisotropy (FA) values were detected in multiple white matter regions,including white matter tracts in bilateral corticospinal tract，precentral gyrus, postcentralgyrus, paracentral lobule, prefrontal lobe, temporal lobe, internal and external capsule,corpus callosum, cingulum, thalamus, brainstem and cerebellum. Additionally, severalregions of white matter tracts injury were found to be significantly correlated with motor dysfunction.Compared to control groups, occult SDCP groups showed ReHo decreased regionsmainly within the bilateral frontal lobe, parietal lobe, temporal lobe, cerebellum, rightcingulate gyrus and right lenticular nucleus; ReHo increased regions mainly within theleft precuneus, calcarine, fusiform gyrus and right precuneus, no significant differenceswere observed by ALFF.Compared to control groups, occult SDCP groups showed decreased precentral gyrusconnectivity regions mainly within left temporal lobe and bilateral the temporaloccipital lobe, including bilateral fusiform gyrus and lingual gyrus; increased precentralgyrus connectivity regions mainly within the opposite side precentral gyrus, postcentralgyrus, Supplementary motor area and the same side postcentral gyrus. Occult SDCPgroups showed decreased thalamus connectivity regions mainly within the bilateralbasal ganglia, cingulate and prefrontal cortex; increased thalamus connectivity regionsmainly within the bilateral precentral gyrus and the opposite side Cerebellum.Conclusion: Whole-brain grey matter, white matter and resting state change in thepatients with occult SDCP had special distribution which is in line with the pathology ofthe disease.