| 1. |
- Shiran, S. I., et al.
(författare)
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MRI-based radiologic scoring system for extent of brain injury in children with hemiplegia
- 2014
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Ingår i: American Journal of Neuroradiology. - : American Society of Neuroradiology. - 0195-6108 .- 1936-959X. ; 35:12, s. 2388-2396
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE:Brain MR imaging is recommended in children with cerebral palsy. Descriptions of MR imaging findings lack uniformity, due to the absence of a validated quantitative approach. We developed a quantitative scoring method for brain injury based on anatomic MR imaging and examined the reliability and validity in correlation to motor function in children with hemiplegia.MATERIALS AND METHODS:Twenty-seven children with hemiplegia underwent MR imaging (T1, T2-weighted sequences, DTI) and motor assessment (Manual Ability Classification System, Gross Motor Functional Classification System, Assisting Hand Assessment, Jebsen Taylor Test of Hand Function, and Children's Hand Experience Questionnaire). A scoring system devised in our center was applied to all scans. Radiologic score covered 4 domains: number of affected lobes, volume and type of white matter injury, extent of gray matter damage, and major white matter tract injury. Inter- and intrarater reliability was evaluated and the relationship between radiologic score and motor assessments determined.RESULTS:Mean total radiologic score was 11.3 ± 4.5 (range 4 -18). Good inter- (p = 0.909, P < .001) and intrarater (p = 0.926, P =<.001) reliability was demonstrated. Radiologic score correlated significantly with manual ability classification systems (p = 0.708, P < .001), and with motor assessments (assisting hand assessment [p = <0.753, P < .001]; Jebsen Taylor test of hand function [p = 0. 766, P < .001]; children's hand experience questionnaire [p=<0. 716, P < .001]), as well as with DTI parameters.CONCLUSIONS:We present a novel MR imaging- based scoring system that demonstrated high inter- and intrarater reliability and significant associations with manual ability classification systems and motor evaluations. This score provides a standardized radiologic assessment of brain injury extent in hemiplegic patients with predominantly unilateral injury, allowing comparison between groups, and providing an additional tool for counseling families.
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| 2. |
- Zelenin, Pavel V, et al.
(författare)
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Contribution of Different Limb Controllers to Modulation of Motor Cortex Neurons during Locomotion.
- 2011
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Ingår i: The Journal of Neuroscience. - 1529-2401. ; 31:12, s. 49-4636
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Tidskriftsartikel (refereegranskat)abstract
- During locomotion, neurons in motor cortex exhibit profound step-related frequency modulation. The source of this modulation is unclear. The aim of this study was to reveal the contribution of different limb controllers (locomotor mechanisms of individual limbs) to the periodic modulation of motor cortex neurons during locomotion. Experiments were conducted in chronically instrumented cats. The activity of single neurons was recorded during regular quadrupedal locomotion (control), as well as when only one pair of limbs (fore, hind, right, or left) was walking while another pair was standing. Comparison of the modulation patterns in these neurons (their discharge profile with respect to the step cycle) during control and different bipedal locomotor tasks revealed several groups of neurons that receive distinct combinations of inputs from different limb controllers. In the majority (73%) of neurons from the forelimb area of motor cortex, modulation during control was determined exclusively by forelimb controllers (right, left, or both), while in the minority (27%), hindlimb controllers also contributed. By contrast, only in 30% of neurons from the hindlimb area was modulation determined exclusively by hindlimb controllers (right or both), while in 70% of them, the controllers of forelimbs also contributed. We suggest that such organization of inputs allows the motor cortex to contribute to the right-left limbs' coordination within each of the girdles during locomotion, and that it also allows hindlimb neurons to participate in coordination of the movements of the hindlimbs with those of the forelimbs.
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