Joke J Geytenbeek1, Kim J Oostrom2, Laurike Harlaar3, Jules G Becher4, Dirk L Knol5, Frederik Barkhof6, Pedro S Pinto7, R Jeroen Vermeulen8. 1. Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; The EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands. Electronic address: J.geytenbeek@vumc.nl. 2. Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Department of Pediatric Psychology, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands. 4. Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; The EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands. 5. The EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands. 6. Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands. 7. Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands; Department of Neuroradiology, Centro Hospitalar do Porto, Portugal. 8. Department of Child Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND AND AIMS: To identify relations between brain abnormalities and spoken language comprehension, MRI characteristics of 80 nonspeaking children with severe CP were examined. METHODS: MRI scans were analysed for patterns of brain abnormalities and scored for specific MRI measures: white matter (WM) areas; size of lateral ventricles, WM abnormality/reduction, cysts, subarachnoid space, corpus callosum thinning and grey matter (GM) areas; cortical GM abnormalities, thalamus, putamen, globus pallidus and nucleus caudatus and cerebellar abnormalities. Language comprehension was assessed with a new validated instrument (C-BiLLT). RESULTS: MRI scans of 35 children were classified as a basal ganglia necrosis (BGN) pattern, with damage to central GM areas; in 60% of these children damage to WM areas was also found. MRI scans of 13 children were classified as periventricular leukomalacia (PVL) with little concomitant damage to central GM areas, 13 as malformations and 19 as miscellaneous. Language comprehension was best in children with BGN, followed by malformations and miscellaneous, and was poorest in PVL. Linear regression modelling per pattern group (malformations excluded), with MRI measures as independent variables, revealed that corpus callosum thinning in BGN and parieto-occipital WM reduction in PVL were the most important explanatory factors for poor language comprehension. No MRI measures explained outcomes in language comprehension in the miscellaneous group. CONCLUSIONS: Comprehension of spoken language differs between MRI patterns of severe CP. In children with BGN and PVL differences in language comprehension performance is attributed to damage in the WM areas. Language comprehension was most affected in children with WM lesions in the subcortical and then periventricular areas, most characteristic for children with PVL.
BACKGROUND AND AIMS: To identify relations between brain abnormalities and spoken language comprehension, MRI characteristics of 80 nonspeaking children with severe CP were examined. METHODS: MRI scans were analysed for patterns of brain abnormalities and scored for specific MRI measures: white matter (WM) areas; size of lateral ventricles, WM abnormality/reduction, cysts, subarachnoid space, corpus callosum thinning and grey matter (GM) areas; cortical GM abnormalities, thalamus, putamen, globus pallidus and nucleus caudatus and cerebellar abnormalities. Language comprehension was assessed with a new validated instrument (C-BiLLT). RESULTS: MRI scans of 35 children were classified as a basal ganglia necrosis (BGN) pattern, with damage to central GM areas; in 60% of these children damage to WM areas was also found. MRI scans of 13 children were classified as periventricular leukomalacia (PVL) with little concomitant damage to central GM areas, 13 as malformations and 19 as miscellaneous. Language comprehension was best in children with BGN, followed by malformations and miscellaneous, and was poorest in PVL. Linear regression modelling per pattern group (malformations excluded), with MRI measures as independent variables, revealed that corpus callosum thinning in BGN and parieto-occipital WM reduction in PVL were the most important explanatory factors for poor language comprehension. No MRI measures explained outcomes in language comprehension in the miscellaneous group. CONCLUSIONS: Comprehension of spoken language differs between MRI patterns of severe CP. In children with BGN and PVL differences in language comprehension performance is attributed to damage in the WM areas. Language comprehension was most affected in children with WM lesions in the subcortical and then periventricular areas, most characteristic for children with PVL.
Authors: Emma Vaillant; Johanna J M Geytenbeek; Elise P Jansma; Kim J Oostrom; R Jeroen Vermeulen; Annemieke I Buizer Journal: Dev Med Child Neurol Date: 2020-08-27 Impact factor: 5.449