Brain magnetic resonance imaging is a predictor of bimanual performance and executive function in children with unilateral cerebral palsy

Alison Crichton, Michael Ditchfield, Stellamay Gwini, Margaret Wallen, Megan Thorley, Jenny Bracken, Adrienne Harvey, Catherine Elliott, Iona Novak, Brian Hoare

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10 Citations (Scopus)


Aim: To examine the association between brain magnetic resonance imaging (MRI) characteristics and executive function and bimanual performance in children with unilateral cerebral palsy (CP). Method: Clinical MRI brain scans were classified as: (1) predominant pathological pattern (normal, white matter injury [WMI]; grey matter injury; focal vascular insults [FVI]; malformations; or miscellaneous); and (2) focal lesions (frontal, basal ganglia, and/or thalamus). Assessments included: (1) bimanual performance; (2) unimanual dexterity; and (3) executive function tasks (information processing, attention control, cognitive flexibility, and goal setting) and behavioural ratings (parent). Results: From 131 recruited children, 60 were ineligible for analysis, leaving 71 children (47 males, 24 females) in the final sample (mean age 9y [SD 2y], 6y–12y 8mo). Brain MRIs were WMI (69%) and FVI (31%); and frontal (59%), thalamic (45%), basal ganglia (37%), and basal ganglia plus thalamic (21%). Bimanual performance was lower in FVI versus WMI (p<0.003), and with frontal (p=0.36), basal ganglia (p=0.032), and thalamic/basal ganglia lesions (p=0.013). Other than information processing, executive function tasks were not associated with predominant pattern. Frontal lesions predicted attention control (p=0.049) and cognitive flexibility (p=0.009) but not goal setting, information processing, or behavioural ratings. Interpretation: Clinical brain MRI predicts cognitive and motor outcomes when focal lesions and predominate lesion patterns are considered.

Original languageEnglish
Pages (from-to)615-624
Number of pages10
JournalDevelopmental Medicine and Child Neurology
Issue number5
Publication statusPublished - 1 May 2020

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