Trevarrow Michael P, Dukkipati S Shekar, Baker Sarah E, Wilson Tony W, Kurz Max J
Boys Town National Research Hospital.
Res Sq. 2023 Feb 16:rs.3.rs-2566073. doi: 10.21203/rs.3.rs-2566073/v1.
Persons with cerebral palsy (CP) have impaired mobility that has been attributed to changes in structure and function within the nervous system. The brainstem is a region that plays a critical role in locomotion by connecting the cortex and cerebellum to the spinal cord, yet this region has been largely unstudied in persons with CP. The objective of this investigation was to use high-resolution structural MRI and biomechanical analyses to examine whether the volume of the whole brainstem and its constituent elements are altered in CP, and if these alterations relate to the mobility impairments within this population. We assessed the volume of the pons, midbrain, medulla, and superior cerebellar peduncle (SCP) in a cohort of persons with CP (N = 26; Age = 16.3 ± 1.0 yrs; GMFCS levels I-IV, Females = 12) and a cohort of neurotypical (NT) controls (N = 38; Age = 14.3 ± 0.4 yrs, Females = 14) using structural MR imaging of the brainstem. Outside the scanner, a digital mat was used to quantify the spatiotemporal gait biomechanics of these individuals. Our MRI results revealed that there was a significant decrease in volume of the total brainstem, midbrain, and pons in persons with CP in comparison to the NT controls. Furthermore, we found that the altered volumes were related to reduced gait velocity and step length. These results suggest that there are structural changes in the brainstems of persons with CP that may contribute to the mobility impairments that are ubiquitous within this population.
脑瘫（CP）患者存在行动能力受损的情况，这归因于神经系统结构和功能的变化。脑干是一个在运动中起着关键作用的区域，它将大脑皮层和小脑与脊髓相连，但在脑瘫患者中，这个区域在很大程度上尚未得到研究。本研究的目的是使用高分辨率结构磁共振成像（MRI）和生物力学分析，来检查脑瘫患者的整个脑干及其组成部分的体积是否发生改变，以及这些改变是否与该人群的行动能力受损有关。我们评估了一组脑瘫患者（N = 26；年龄 = 16.3 ± 1.0岁；粗大运动功能分级系统（GMFCS）水平I - IV级，女性 = 12名）和一组神经典型（NT）对照者（N = 38；年龄 = 14.3 ± 0.4岁，女性 = 14名）的脑桥、中脑、延髓和上小脑脚（SCP）的体积，采用脑干的结构磁共振成像。在扫描仪外，使用数字垫来量化这些个体的时空步态生物力学。我们的MRI结果显示，与NT对照者相比，脑瘫患者的整个脑干、中脑和脑桥体积显著减小。此外，我们发现体积改变与步态速度和步长的降低有关。这些结果表明，脑瘫患者的脑干存在结构变化，这可能导致该人群中普遍存在的行动能力受损。
