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Neuroimaging Strategies Addressing Challenges in Using fMRI for the Children with Cerebral Palsy

Journal of Behavioral and Brain Science 2018年第5期8卷 306-318页

作者： Juniper J. Lee-Park Harshawardhan Deshpande Jonathan Lisinski Stephen LaConte sharon ramey Stephanie DeLuca Virginia Tech Carilion School of Medicine Roanoke VA USA Virginia Polytechnic Institute and State University Blacksburg VA USA Emergency Medicine Virginia Tech Carilion School of Medicine Roanoke VA USA Neuromotor Research Clinic Virginia Tech Carilion Research Institute Roanoke VA USA Department of Pediatrics Virginia Tech Carilion School of Medicine Roanoke VA USA Psychology Virginia Polytechnic Institute and State University Blacksburg VA USA Department of Rehabilitation Health and Wellness Jefferson College of Health Sciences Roanoke VA USA

Aim: This study sought to develop a process and methodology that could be a useful clinical and research tool for successfully completing functional magnetic resonance imaging (fMRI) scanning in children with Cerebral Palsy. Method: Six children with CP (mean age of 8.83 years;five with spastic hemiplegia, one with spastic quadriplegia) and three children with typical development (mean age of 9.33 years) completed an fMRI scanning protocol that used real-time motion feedback as a means of minimizing head and trunk motion. Anatomical, resting-state, and motor-task scans were sequentially obtained from each subject. Precentral “hand-knob” regions were identified on the anatomical scan and served as seed regions to reveal the functional connectivity of each subject’s brain as associated with hand movement. Results: Real-time motion feedback aided children in successful completion of resting state scans. Functional connectivity and brain activity mapping were obtained based on anatomical landmarks, and laterality indices were developed based on the obtained functional-connectivity map to specify a dominant side of brain activity that was matched to a clinical profile, despite anatomical variations that occur with Cerebral Palsy. Interpretation: Real-time motion feedback and the development of laterality indices can improve the clinical and research utility of fMRI scanning. What this paper adds: 1) Presents a real-time imaging protocol for fMRI to help children complete scanning;2) Presents an fMRI methodology to obtain laterality indices in the presence of abnormal anatomy;3) Provides findings of LI that match clinical diagnosis.

关键词： fMRI Cerebral Palsy Real-Time Motion Feedback Functional-Connectivity Resting State

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