The effects of hemorrhagic parenchymal infarction on the establishment of sensori-motor structural and functional connectivity in early infancy

Introduction The objective of the study was to characterize alterations of structural and functional connectivity within the developing sensori-motor system in infants with focal perinatal brain injury and at high risk of cerebral palsy. Methods Functional magnetic resonance imaging (fMRI) and diffu...

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Bibliographic Details
Published in:	Neuroradiology 2014-11, Vol.56 (11), p.985-994
Main Authors:	Arichi, T., Counsell, S. J., Allievi, A. G., Chew, A. T., Martinez-Biarge, M., Mondi, V., Tusor, N., Merchant, N., Burdet, E., Cowan, F. M., Edwards, A. D.
Format:	Article
Language:	eng
Subjects:	Brain damage Brain Infarction - complications Brain Infarction - pathology Brain Infarction - physiopathology Case-Control Studies Cerebral Hemorrhage - complications Cerebral Hemorrhage - pathology Cerebral Hemorrhage - physiopathology Cerebral palsy Child development Diffusion Tensor Imaging Hemorrhage Humans Imaging Infant, Newborn Infant, Premature Leukomalacia, Periventricular - complications Leukomalacia, Periventricular - pathology Leukomalacia, Periventricular - physiopathology Magnetic Resonance Imaging Medical imaging Medicine Medicine & Public Health Motor ability Neurology Neuroradiology Neurosciences Neurosurgery Paediatric Neuroradiology Radiology Sensorimotor Cortex - growth & development Sensorimotor Cortex - pathology Sensorimotor Cortex - physiopathology
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Summary:	Introduction The objective of the study was to characterize alterations of structural and functional connectivity within the developing sensori-motor system in infants with focal perinatal brain injury and at high risk of cerebral palsy. Methods Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) data were used to study the developing functional and structural connectivity framework in six infants born prematurely at term equivalent age. This was first characterised in three infants without focal pathology, which was then compared to that derived from three infants with unilateral haemorrhagic parenchymal infarction and a subsequent focal periventricular white matter lesion who developed later haemiparesis. Results Functional responses to passive hand movement were in the contralateral perirolandic cortex, regardless of focal pathology. In infants with unilateral periventricular injury, afferent thalamo-cortical tracts appeared to have developed compensatory trajectories which circumvented areas of damage. In contrast, efferent corticospinal tracts showed marked asymmetry at term equivalent age following focal brain injury. Sensori-motor network analysis suggested that inter-hemispheric functional connectivity is largely preserved despite pathology and that impairment may be associated with adverse neurodevelopmental outcome. Conclusion Following focal perinatal brain injury, altered structural and functional connectivity is already present and can be characterized with MRI at term equivalent age. The results of this small case series suggest that these techniques may provide valuable new information about prognosis and the pathophysiology underlying cerebral palsy.
ISSN:	0028-3940 1432-1920