White matter integrity in dyskinetic cerebral palsy : Relationship with intelligence quotient and executive function
Laporta-Hoyos, Olga (Institut de Recerca Sant Joan de Déu)
Pannek, Kerstin (Australian e-Health Research Centre)
Ballester-Plané, Júlia (Institut de Recerca Sant Joan de Déu)
Reid, Lee B. (Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia)
Vázquez, Élida (Hospital Universitari Vall d'Hebron)
Delgado Martínez, Ignacio (Hospital Universitari Vall d'Hebron)
Zubiaurre-Elorza, Leire (Universidad de Deusto. Departamento de Fundamentos y Métodos de la Psicología)
Macaya Ruiz, Alfons (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Póo, Pilar (Hospital Sant Joan de Déu (Barcelona, Catalunya))
Meléndez-Plumed, Mar (Hospital Universitari Vall d'Hebron)
Junqué, Carme (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Boyd, Roslyn (Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia)
Pueyo, Roser (Institut de Recerca Sant Joan de Déu)

Date:	2017
Abstract:	Dyskinetic cerebral palsy (CP) is one of the most disabling motor types of CP and has been classically associated with injury to the basal ganglia and thalamus. Although cognitive dysfunction is common in CP, there is a paucity of published quantitative analyses investigating the relationship between white matter (WM) microstructure and cognition in this CP type. This study aims (1) to compare brain WM microstructure between people with dyskinetic CP and healthy controls, (2) to identify brain regions where WM microstructure is related to intelligence and (3) to identify brain regions where WM microstructure is related to executive function in people with dyskinetic CP and (4) to identify brain regions where the correlations are different between controls and people with CP in IQ and executive functions. Thirty-three participants with dyskinetic CP (mean ± SD age: 24. 42 ± 12. 61, 15 female) were age and sex matched with 33 controls. Participants underwent a comprehensive neuropsychological battery to assess intelligence quotient (IQ) and four executive function domains (attentional control, cognitive flexibility, goal setting and information processing). Diffusion weighted MRI scans were acquired at 3T. Voxel-based whole brain groupwise analyses were used to compare fractional anisotropy (FA) and of the CP group to the matched controls using a general lineal model. Further general linear models were used to identify regions where white matter FA correlated with IQ and each of the executive function domains. White matter FA was significantly reduced in the CP group in all cerebral lobes, predominantly in regions connected with the parietal and to a lesser extent the temporal lobes. There was no significant correlation between IQ or any of the four executive function domains and WM microstructure in the control group. In participants with CP, lower IQ was associated with lower FA in all cerebral lobes, predominantly in locations that also showed reduced FA compared to controls. Attentional control, goal setting and information processing did not correlate with WM microstructure in the CP group. Cognitive flexibility was associated with FA in regions known to contain connections with the frontal lobe (such as the superior longitudinal fasciculus and cingulum) as well as regions not known to contain tracts directly connected with the frontal lobe (such as the posterior corona radiata, posterior thalamic radiation, retrolenticular part of internal capsule, tapetum, body and splenium of corpus callosum). The widespread loss in the integrity of WM tissue is mainly located in the parietal lobe and related to IQ in dyskinetic CP. Unexpectedly, executive functions are only related with WM microstructure in regions containing fronto-cortical and posterior cortico-subcortical pathways, and not being specifically related to the state of fronto-striatal pathways which might be due to brain reorganization. Further studies of this nature may improve our understanding of the neurobiological bases of cognitive impairments after early brain insult.
Grants:	Ministerio de Ciencia e Innovación PSI2011-2438 Ministerio de Economía y Competitividad PSI2016-75979-R
Note:	Altres ajuts: Generalitat de Catalunya (2014SGR98)
Note:	Altres ajuts: MEPSYD/FPU13-06435
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	NeuroImage, Vol. 15 (may 2017) , p. 789-800, ISSN 2213-1582

DOI: 10.1016/j.nicl.2017.05.005
PMID: 28702354

12 p, 1.0 MB

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