Neuropediatrics 2020; 51(02): 113-119
DOI: 10.1055/s-0039-3402007
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Origin of the Cerebral Palsies: Contribution of Population-Based Neuroimaging Data

Veronka Horber
1  Department of Paediatric Neurology, University Children's Hospital, Tübingen, Germany
,
Elodie Sellier
2  CNRS, Grenoble INP, CHU Grenoble Alpes, Univ. Grenoble Alpes, TIMC-IMAG, Grenoble, France
,
Karen Horridge
3  Department of Paediatrics, Sunderland Royal Hospital, Sunderland, United Kingdom
,
Gija Rackauskaite
4  Child and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
,
Guro L. Andersen
5  Vestfold Hospital Trust, Cerebral Palsy Registry of Norway, Tønsberg, Norway
,
Daniel Virella
6  Neonatology Intensive Care Unit/Research Centre, Lisbon, Central Lisbon Hospital, Portugal
,
Els Ortibus
7  Department of Development and Regeneration, KULeuven and University Hospitals Leuven, Belgium
,
Ivana Dakovic
8  Department of Neuropediatrics, Children's Hospital Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia
,
Owen Hensey
9  Central Remedial Clinic, Clontarf, Dublin, Ireland
,
Anja Radsel
10  Community Health Centre Medvode, Paediatric Medical Office, Slovenia
,
Antigone Papavasiliou
11  Department of Paediatric Neurology, IASO Children's Hospital, Athens, Greece
,
Javier Cruz De la
12  Research Institute (i + 12), SAMID, University Hospital “12 Octubre,” Madrid, Spain
,
Catherine Arnaud
13  UMR Inserm U1027, team SPHERE University Toulouse III Paul Sabatier, Toulouse, France
14  Clinical Epidemiology Unit, Toulouse University Hospital, Toulouse, France
,
Ingeborg Krägeloh-Mann
1  Department of Paediatric Neurology, University Children's Hospital, Tübingen, Germany
,
15  Department of Pediatrics, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden
› Author Affiliations
Further Information

Publication History

20 August 2019

11 November 2019

Publication Date:
02 March 2020 (online)

Abstract

Background Surveillance of cerebral palsy in Europe (SCPE) presents the first population-based results on neuroimaging findings in children with cerebral palsy (CP) using a magnetic resonance imaging classification system (MRICS).

Method MRIs of children with CP born between 1999 and 2009 from 18 European countries were analyzed. MRICS identifies patterns of brain pathology according to timing during brain development which was analyzed with respect to CP subtypes and gestational age.

Results MRIs or written reports from 3,818 children were available. The main clinical characteristics were similar to the 5,415 without such data. Most frequent was predominant white matter injury (49%), followed by predominant gray matter injury (21%). Maldevelopments were found in 11% of cases. Miscellaneous findings were present in 8.5% and normal findings in 10.6%. MRI patterns of children with unilateral spastic, bilateral spastic, and dyskinetic CP were mainly lesional (77, 71, and 59%, respectively), whereas children with ataxic CP had more maldevelopments, miscellaneous, and normal findings (25, 21, and 32%, respectively). In children born preterm, predominant white matter injury was most prevalent (80% in children born <32 weeks of gestation).

Conclusion Analysis of MRI in the European CP database identified CP as a mainly lesional condition on a large population basis, maldevelopments were relatively uncommon. An exception was ataxic CP. Children born preterm mostly presented with a lesion typical for their gestational age (GA) at birth. The decreasing prevalence of CP in this group suggests that progress in perinatal and neonatal medicine may lead to a reduction of these lesions.