Brain Region Size Differences Associated With Dystonia in People With Cerebral Palsy Born Premature

Keerthana Chintalapati; Toni S Pearson; Keisuke Ueda; Bhooma R Aravamuthan

doi:10.1016/j.pediatrneurol.2023.07.011

Brain Region Size Differences Associated With Dystonia in People With Cerebral Palsy Born Premature

Pediatr Neurol. 2023 Nov:148:8-13. doi: 10.1016/j.pediatrneurol.2023.07.011. Epub 2023 Jul 20.

Authors

Keerthana Chintalapati¹, Toni S Pearson², Keisuke Ueda¹, Bhooma R Aravamuthan³

Affiliations

¹ Division of Pediatric Neurology, Department of Neurology, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri.
² Division of Pediatric Neurology, Department of Neurology, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri; Nationwide Children's Hospital, Columbus, Ohio.
³ Division of Pediatric Neurology, Department of Neurology, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri. Electronic address: aravamuthanb@wustl.edu.

PMID: 37633215
DOI: 10.1016/j.pediatrneurol.2023.07.011

Abstract

Background: Dystonia in cerebral palsy (CP) is classically associated with deep gray matter injury at term gestation, but the patterns of injury associated with dystonia following premature birth are unclear. We examined whether there were brain regional size differences associated with dystonia in people with CP born premature.

Methods: In this retrospective cohort study, we identified subjects with CP born premature (<37 weeks gestational age) seen at a tertiary care CP center between February 1, 2017, to February 1, 2021, who had T1-weighted brain magnetic resonance imaging (MRI) done between ages one and five years available in the clinical record. We measured the following on these brain MRI images per the 2013 Kidokoro criteria: interhemispheric distance, biparietal width, lateral ventricle diameter, transcerebellar diameter, deep gray matter area, and corpus callosum thickness. We then compared the sizes of these structures between those with and without dystonia correcting for gestational age at birth and gross motor functional ability (univariate general linear models).

Results: Fifty-five subjects met the inclusion and exclusion criteria. Interhemispheric distance was significantly greater in those with dystonia, suggesting decreased cortical volume (P = 0.005). There was no significant difference in the other measured structures between those with and without dystonia, including deep gray matter area.

Conclusions: Increased interhemispheric distance, not measures of deep gray matter size, correlate with the presence of dystonia in people with CP born premature.

Keywords: Cerebral palsy; Dystonia; Interhemispheric distance; Magnetic resonance imaging; Prematurity.