Precise studies of the brain white matter tracts yield insight into structural and functional differences among children with cerebral palsy.

Cerebral palsy (CP) is the most common motor disability of childhood. Risk factors, causal pathways, clinical manifestations and response to treatments vary widely among children with this broad diagnosis. Conventional brain magnetic resonance imaging (MRI) provides pictures of white and gray brain matter injury in these children. Diffusion tensor imaging (DTI) is a novel technique that allows a more detailed observation of specific brain white matter tracts (WMT). In our research, we identified 26 white matter tracts and established criteria for evaluation of these tracts on a 3 point ordinal scale (normal, abnormal, severely abnormal-absent) in children born preterm with cerebral palsy. Our results indicate variable patterns of brain injury to central sensory and motor pathways in these children. Practical application of this advanced imaging and WMT grading classification within clinical and research situations will help us learn more about inter-individual differences among children with cerebral palsy. Our long-term goal is to use this information to improve the classification of cerebral palsy. We believe that improved diagnostic techniques will contribute to the development and assessment of effective rehabilitative therapies tailored to individual children.

*Nagae LM, Hoon Jr AH, Stashinko E, Lin D, Zhang W, Levey E, Wakana S, Jiang H, Leite CC, Lucato LT, van Zijl PCM., Johnston MV, and Mori S. (2007).American Journal Neuroradiology, 28: 1213-1222.

This work was supported by the United Cerebral Palsy Research and Educational Foundation, the National Institute of Health (NIH) grant R01 AG20012, P41 R15241, the Dana Foundation Clinical Hypothesis Program in Imaging, the National Center for Research Resources (NCRR), and the Johns Hopkins University School of Medicine General Clinical Research Center, Grant #M01-RR00052 from the NCRR/NIH.