Zhao Chunfeng, Qiu Xiaofan, Luo Xinyu, Peng Ying, Yin Yu, Nie Lisha, Wang Jinhui, Liu Heng
Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Engineering Research Center of Intelligent Medical Imaging in Guizhou Higher Education Institutions, Zunyi, China.
Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China.
Quant Imaging Med Surg. 2025 Sep 1;15(9):7749-7760. doi: 10.21037/qims-2024-2949. Epub 2025 Aug 19.
Spastic cerebral palsy (SCP) is associated with extensive alterations in regional cortical morphology. However, the specific effects of SCP on the topological organization of morphological brain networks remain largely unknown. This study aimed to investigate these effects and explore their potential correlations with clinical manifestations in SCP children.
Structural magnetic resonance imaging and clinical data were collected from 31 children with SCP and 29 sex- and age-matched children with typical development. Single-subject morphological brain networks were constructed separately based on four different morphological indices [i.e., the cortical thickness (CT), fractal dimension, gyrification index, and sulcus depth], which were further characterized using graph-based network approaches. Permutation tests were used to examine between-group differences in regional morphology, interregional morphological connectivity (MC), and graph-based network properties. For magnetic resonance imaging (MRI)-based features showing significant between-group differences, Spearman partial correlations were used to examine their relationships with the clinical variables in the patients.
Compared with the control group, the SCP group only showed alterations in the CT-based morphological brain networks. Specifically, the SCP group displayed an increased characteristic path length (t=3.909, P=4.0×10), which was negatively correlated with the verbal comprehension index (rho=-0.435, P=0.023), processing speed index (rho=-0.452, P=0.018), and full-scale intelligence quotient (rho=-0.471, P=0.013) of the SCP children, and positively correlated with the Gross Motor Function Classification System (rho=0.399, P=0.039) and Manual Ability Classification System (rho=0.459, P=0.016). Further, the SCP group showed decreased MC for 161 connections. These connections were mainly linked to the right area 25 (a part of the anterior cingulate cortex) at the nodal level and to regions in the default mode network at the subnetwork level. Among these, the MC between the right area 11l, part of the orbital and polar frontal cortex, and the right medial belt complex, part of the early auditory cortex, was positively correlated with the Communication Function Classification System in the SCP children (rho=0.662, P=1.7×10). These results remained unchanged after excluding preterm children from the SCP group.
SCP is associated with abnormal morphological brain network topology, which may contribute to disturbances in motor and cognition in patients.
痉挛性脑瘫（SCP）与区域皮质形态的广泛改变有关。然而，SCP对脑形态网络拓扑组织的具体影响在很大程度上仍不清楚。本研究旨在调查这些影响，并探讨它们与SCP患儿临床表现的潜在相关性。
收集了31例SCP患儿和29例性别与年龄匹配的正常发育儿童的结构磁共振成像和临床数据。基于四种不同的形态学指标[即皮质厚度（CT）、分形维数、脑回指数和脑沟深度]分别构建单受试者脑形态网络，并使用基于图的网络方法进一步对其进行特征分析。采用置换检验来检查组间在区域形态、区域间形态连接性（MC）和基于图的网络属性方面的差异。对于基于磁共振成像（MRI）显示出显著组间差异的特征，使用斯皮尔曼偏相关分析来检查它们与患者临床变量之间的关系。
与对照组相比，SCP组仅在基于CT的脑形态网络中表现出改变。具体而言，SCP组的特征路径长度增加（t=3.909，P=4.0×10），这与SCP患儿的语言理解指数（rho=-0.435，P=0.023）、处理速度指数（rho=-0.452，P=0.018）和全量表智商（rho=-0.471，P=0.013）呈负相关，与粗大运动功能分类系统（rho=0.399，P=0.039）和手动能力分类系统（rho=0.459，P=0.016）呈正相关。此外，SCP组161条连接的MC降低。这些连接在节点水平主要与右侧25区（前扣带回皮质的一部分）相连，在子网水平与默认模式网络中的区域相连。其中，右侧11l区（眶额和极额叶皮质的一部分）与右侧内侧带复合体（早期听觉皮质的一部分）之间的MC与SCP患儿的沟通功能分类系统呈正相关（rho=0.662，P=1.7×10）。在将早产儿从SCP组中排除后，这些结果保持不变。
SCP与脑形态网络拓扑异常有关，这可能导致患者运动和认知障碍。
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