The Relationship Between Structure of the Corticoreticular Tract and Walking Capacity in Children With Cerebral Palsy Publisher



Azizi S^{1, 2} ; Moradi Birgani P¹ ; Ashtiyani M³ ; Irani A⁴ ; Shahrokhi A⁵ ; Meydanloo K⁶ ; Mirbagheri MM^{1, 7} Show Affiliations
Source: Journal of Biomedical Physics and Engineering Published:2024

Abstract

Background: Disruption in the descending pathways may lead to gait impairments in Cerebral Palsy (CP) children. Though, the mechanisms behind walking problems have not been completely understood. Objective: We aimed to define the relationship between the structure of the cortico-reticular tract (CRT) and walking capacity in children with CP. Material and Methods: This is a retrospective, observational, and cross-section-al study. Twenty-six children with CP between 4 to 15 years old participated. Also, we used existed data of healthy children aged 4 to 15 years old. CRT structure was character-ized using diffusion tensor imaging (DTI). The DTI parameters extracted to quantify CRT structure included: fractional anisotropy (FA), mean (MD), axial (AD), and radial (RD) diffusivity. Balance and walking capacity was evaluated using popular clinical measures, including the Berg balance scale (BBS), Timed-Up-and-Go (TUG; balance and mobil-ity), six-minute walk test (6 MWT; gait endurance), and 10-meter walk Test (10 MWT; gait speed). Results: There are significant differences between MD, AD, and RD in CP and healthy groups. Brain injury leads to various patterns of the CRT structure in children with CP. In the CP group with abnormal CRT patterns, DTI parameters of the more affected CRT are significantly correlated with walking balance, speed, and endurance measures. Conclusion: Considering the high inter-subject variability, the variability of CRT patterns is vital for determining the nature of changes in CRT structure, their relationship with gait impairment, and understanding the underlying mechanisms of movement disorders. This information is also important for the development or prescription of an effective rehabilitation target for individualizing treatment. © 2024, Shiraz University of Medical Sciences. All rights reserved.