Yang Jie, Chen Congjie, Chen Ningning, Zheng Helin, Chen Yuxia, Li Xiaoli, Jia Qingxia, Li Tingsong
Department of Rehabilitation, Children's Hospital of Chongqing Medical University (CHCMU), Chongqing, China.
National Clinical Research Center for Child Health and Disorders, Chongqing, China.
Front Pediatr. 2024 Apr 25;12:1382172. doi: 10.3389/fped.2024.1382172. eCollection 2024.
The correlation of clinical characteristics of cerebral palsy (CP) and the magnetic resonance imaging classification system (MRICS) for (CP) is inconsistent. Specifically, the variance in rehabilitation potential across MRICS remains underexplored.
To investigate the clinical characteristics and potential for rehabilitation in children with CP based on MRICS.
Children with CP admitted to the Department of Rehabilitation, Children's Hospital of Chongqing Medical University between 2017 and 2021 were included in the study. Qualified cases underwent a follow-up period of at least one year. The clinical characteristics of CP among different MRICS were analyzed, then the rehabilitation potential was explored by a retrospective cohort study.
Among the 384 initially enrolled children, the male-to-female ratio was 2.3:1, and the median age of diagnosis was 6.5 months (interquartile range: 4-12). The most prevalent MRICS categorization was predominant white matter injury (40.6%), followed by miscellaneous (29.2%) and predominant gray matter injury (15.6%). For the predominant white matter injury and miscellaneous categories, spastic diplegia emerged as the leading subtype of CP, with incidences of 59.6% and 36.6%, respectively, while mixed CP (36.7%) was the most common type in children with predominant gray matter. Notably, 76.4% of children with predominant white matter injury were classified as levels I-III on the gross motor function classification system (GMFCS), indicating significantly less severity than other groups (2= 12.438, = 0.013). No significant difference across MRICS categories was observed for the manual ability classification system (MACS) ( = 8.176, 0.085). Rehabilitation potential regarding fine motor function and adaptability based on Gesell assessment was dependent on MRICS over the follow-up period. Children with normal MRI scans exhibited superior rehabilitation outcomes. Commencing rehabilitation at an earlier stage produced consistent and beneficial results in terms of fine motor function and adaptability across all MRICS categories. Moreover, participants below 2 years of age demonstrated enhanced rehabilitation potential regarding fine motor outcomes and adaptability within the MRICS framework.
MRICS displayed a significant association with clinical characteristics and rehabilitation efficacy in children with CP.
脑性瘫痪（CP）的临床特征与CP的磁共振成像分类系统（MRICS）之间的相关性并不一致。具体而言，MRICS中康复潜力的差异仍未得到充分研究。
基于MRICS研究CP患儿的临床特征和康复潜力。
纳入2017年至2021年期间重庆医科大学附属儿童医院康复科收治的CP患儿。符合条件的病例进行了至少一年的随访。分析不同MRICS中CP的临床特征，然后通过回顾性队列研究探讨康复潜力。
在最初纳入的384名儿童中，男女比例为2.3:1，诊断的中位年龄为6.5个月（四分位间距：4 - 12个月）。最常见的MRICS分类是主要白质损伤（40.6%），其次是其他（29.2%）和主要灰质损伤（15.6%）。对于主要白质损伤和其他类别，痉挛性双瘫是CP的主要亚型，发生率分别为59.6%和36.6%，而混合型CP（36.7%）是主要灰质损伤患儿中最常见的类型。值得注意的是，76.4%的主要白质损伤患儿在粗大运动功能分类系统（GMFCS）中被归类为I - III级，表明其严重程度明显低于其他组（χ² = 12.438，P = 0.013）。在手动能力分类系统（MACS）方面，各MRICS类别之间未观察到显著差异（F = 8.176，P = 0.085）。基于盖塞尔评估的精细运动功能和适应性方面的康复潜力在随访期间取决于MRICS。MRI扫描正常的儿童表现出更好的康复效果。在早期开始康复在所有MRICS类别中，在精细运动功能和适应性方面都产生了一致且有益的结果。此外，2岁以下的参与者在MRICS框架内，在精细运动结果和适应性方面表现出增强的康复潜力。
MRICS与CP患儿的临床特征及康复疗效显著相关。
