Episode 248 (Dr Stina Oftedal)

Brain lesion extent, growth, and body composition in children with cerebral palsy

Stina Oftedal, Simona Fiori, Kristie L Bell, Katherine A Benfer, Leanne Sakzewski, Robert S Ware, Peter S W Davies, Roslyn N Boyd

• PMID: 40745624
• DOI: 10.1111/dmcn.16427

Abstract

Aim: To investigate the relationship between growth, body composition, and the extent of brain lesion measured using structural magnetic resonance imaging (MRI) in children with cerebral palsy (CP).

Method: This prospective population-based cohort study recorded 359 assessments from 124 children with CP aged 18 months to 13 years (38% female, Gross Motor Function Classification System [GMFCS] levels I = 50, II = 24, III = 17, IV = 12, and V = 21). A neurologist assessed the extent of the brain lesion using a validated semi-quantitative scale (global, basal ganglia/brainstem, hemispheric and corpus callosum scores). Height (HTZ), weight (WTZ), and head circumference (HDZ) z-scores were calculated. The Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI) were determined using a deuterium dilution technique, bioelectrical impedance or dual-energy X-ray absorptiometry, and height. Data were analysed using mixed-effects linear regression.

Results: Greater global (β = -0.04, 95% confidence interval [CI] = -0.07 to -0.02), basal ganglia/brainstem (β = -0.06, 95% CI = -0.11 to -0.02), corpus callosum (β = -0.27, 95% CI = -0.27 to -0.12), and hemispheric (β = -0.08, 95% CI = -0.12 to -0.04) scores were associated with lower HTZ. Greater global (β = -0.03,95% CI = -0.06 to -0.01) and corpus callosum (β = -0.23, 95% CI = -0.40 to -0.06) scores were associated with lower WTZ. A greater hemispheric score (β = -0.06, 95% CI = -0.119 to -0.001) was associated with lower HDZ. Semi-quantitative MRI scores were not associated with FMI or FFMI.

Interpretation: Greater extent of the brain lesion was significantly associated with lower HDZ, HTZ, and WTZ but not body composition in children with CP aged 18 months to 13 years.

Keywords: Body composition; Brain imaging; Brain lesion; Cerebral palsy; Growth.