Association of Motor Function and Neuroimaging in Cerebral Palsy: A Cross-sectional Study

Abstract

Introduction: Cerebral Palsy (CP) is one of the most common causes of disability in children. Neuroimaging is useful in determining structural or functional relationships in children with CP. It provides an opportunity to link various CP types to the localisation of the brain maldevelopment or lesion. Aim: To study association of motor function and brain structure on neuroimaging Magnetic Resonance Imaging (MRI) in CP children. Materials and Methods: This cross-sectional observational study was conducted in a tertiary care hospital from August 2015 to December 2016. A total of 50 diagnosed cases of CP were included after satisfying inclusion and exclusion criteria. After detailed history and clinical examination, MRI of brain was advised. All parameters were assessed in terms of Gross Motor Functional Classification System (GMFCS), Manual Ability Classification System (MACS) and MRI Grading. Categorical variables were presented as numbers and percentage and association was checked using Chi-square test or Fischer’sexact test. A p-value of <0.05 was considered statistically significant. Results: Patients with CP in the study ranged from 2-12 years with mean age of 5.43 (±2.58) years. Out of 50 cases, 30 (60%) were in the age group of 2-5 years, 17 (34%) were in the age group of 6-10 years and three (6%) were in the age group of 11-12 years. Out of 50 enrolled cases, maximum cases were having GMFCS level 3 (n=14) and MACS level 2 (n=15). There was significant positive association (p-value <0.05) between GMFCS level and grading of MRI. Similar significant association was observed for analysis of association of MACS level and MRI Grading. Conclusion: The present study highlighted that there was a significant association between extent and type of brain lesion and motor functions (GMFCS and MACS levels). Type and extent of brain lesion helps clinician to understand prognosis of functional motor outcome in CP children.

Keywords

• brain lesion
• gross motor functional classification system
• magnetic resonance imaging
• manual ability classification system