脑室周围白质软化症合并痉挛型脑瘫患儿脑灰质体积与运动功能的相关性

Correlation Between Grey Matter Volume and Motor Function in Children with Periventricular Leukomalacia and Spastic Cerebral Palsy:A Voxel Based Morphometry Study

目的探讨脑室周围白质软化症(PVL)合并痉挛型脑瘫患儿的灰质体积改变及其与运动功能的相关性。资料与方法回顾性收集2019年4月—2020年12月于遵义医科大学附属医院就诊的30例PVL合并痉挛型脑瘫患儿(研究组)及24名对照组儿童,进行3DT1结构像全脑扫描,并行粗大运动功能分级系统(GMFCS)及手功能分级系统(MACS)对PVL合并痉挛型脑瘫患儿进行运动功能评估。采用体素形态测量学方法比较两组灰质体积的差异,提取差异脑区灰质体积,以年龄作为协变量,与GMFCS及MACS分级进行偏相关分析。结果与对照组比较,研究组双侧(顶叶、丘脑、小脑)、右侧(额叶、壳核)灰质体积下降(P<0.05,FDR校正,t>3.2505);双侧丘脑、右侧小脑半球第6区及左内侧和旁扣带回灰质体积与GMFCS分级呈负相关(r=-0.668、-0.397、-0.414,P均<0.05);双侧丘脑、右侧壳核灰质体积与MACS分级呈负相关(r=-0.557、-0.630,P均<0.01)。结论PVL患儿双侧丘脑、右侧壳核、小脑及左侧扣带回灰质体积变化与运动功能相关,体素形态测量学技术可用于评估PVL患儿脑灰质体积的变化。

Purpose To investigate the altered grey matter volume in children with periventricular leukomalacia(PVL)and spastic cerebral palsy(SCP),and to evaluate the correlation between gray matter volume and motor function.Materials and Methods A total of 30 children with PVL and SCP,and 24 healthy children regarded as the control group in the Affiliated Hospital of Zunyi Medical University from April 2019 to December 2020 were enrolled,and were underwent 3-dimensionality-T1-weighted MR brain images assessment.The gross motor function classification system(GMFCS)and manual ability classification system(MACS)assessments were performed to evaluate the motor function of children with PVL and SCP.Voxel based morphometry was applied to analyze the volume differences between the two groups.The brain regions with significantly different gray matter volume were further extracted,and the correlation between significant regions and GMFCS as well as MACS levels were evaluated,considering age as a covariate.Results Compare with the control group,the gray matter value of the bilateral parietal lobe,thalamus,cerebellum,and right frontal lobe,putamen decreased in the patient group(P<0.05,FDR correct,t>3.2505).The GMFCS in the patient group were negatively correlated with the gray matter values in bilateral thalamus,right cerebellum_6,left median cingulate and paracingulate gyri(r=-0.668,-0.397 and-0.414,all P<0.05).The MACS in the patient group were negatively correlated with the gray matter values in bilateral thalamus and right putamen(r=-0.557 and-0.630,all P<0.01).Conclusion The motor function is associated with altered grey matter volume in parts of bilateral thalamus,right cerebellum,right putamen and left cingulate.Voxel based morphometry could be used to assess the changes of gray matter volume in children with PVL.