Structural connectivity of the Anterior Cingulate in children with unilateral Cerebral Palsy due to white matter lesions

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Scheck, Simon M.; Pannek, Kerstin; Raffelt, David; Fiori, Simona; Boyd, Roslyn; Rose, Stephen


2015-12-31


Journal Article


NeuroImage: Clinical


9


498-505


In this work we investigate the structural connectivity of the anterior cingulate cortex (ACC) as a potential cause of impaired executive function in children with unilateral cerebral palsy (UCP) due to periventricular white matter lesions. Five brain regions highly connected to the ACC were identified using diffusion MRI fibre tractography: the superior frontal gyrus, medial orbitofrontal cortex, rostral middle frontal gyrus, precuneus and isthmus cingulate. Structural connectivity was assessed in pathways connecting these regions to the ACC using three diffusion MRI derived measures: fractional anisotropy (FA), mean diffusivity (MD) and apparent fibre density (AFD). In a tract-of-interest analysis, we compared these measures between 52 children with UCP and 17 children with typical development. Furthermore we investigated correlations of these measures with executive function as assessed by the Flanker task. The ACC-precuneus tract had significantly different MD (p<0.0001) and AFD (p=0.0072) between groups, with post hoc analysis showing significantly increased MD in the right hemisphere of children with left hemiparesis compared with controls. The ACC-superior frontal gyrus tract had significantly different FA (p=0.0049) and MD (p=0.0031) between groups. AFD in this tract (contralateral to side of hemiparesis; right hemisphere in controls) showed a significant relationship with Flanker task performance (p=0.0045, β=-0.5856), suggesting that reduced connectivity correlates with executive dysfunction. Reduced structural integrity of ACC tracts appears to be important in UCP, in particular the connection to the superior frontal gyrus. Although damage to this area is heterogeneous it may be important in early identification of children with impaired executive function.


Elsevier


Neurology and Neuromuscular Diseases


https://doi.org/10.1016/j.nicl.2015.09.014


EP157983


Journal article - Refereed


English


Scheck, Simon M.; Pannek, Kerstin; Raffelt, David; Fiori, Simona; Boyd, Roslyn; Rose, Stephen. Structural connectivity of the Anterior Cingulate in children with unilateral Cerebral Palsy due to white matter lesions. NeuroImage: Clinical. 2015; 9:498-505. https://doi.org/10.1016/j.nicl.2015.09.014



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