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@ARTICLE{deAlmeidaMarcelino:279443,
author = {de Almeida Marcelino, Ana Luísa and Al-Fatly, Bassam and
Tuncer, Mehmet S and Krägeloh-Mann, Ingeborg and Koy, Anne
and Kühn, Andrea},
title = {{L}esion distribution and network mapping in dyskinetic
cerebral palsy.},
journal = {Brain communications},
volume = {7},
number = {3},
issn = {2632-1297},
address = {[Oxford]},
publisher = {Oxford University Press},
reportid = {DZNE-2025-00774},
pages = {fcaf228},
year = {2025},
abstract = {Dyskinetic cerebral palsy encompasses a group of
predominantly perinatally acquired complex motor disorders
that present with dystonia and/or choreoathetosis and are
frequently associated with brain lesions in neuroimaging.
Recently, lesion network mapping provided a tool to redefine
neurological disorders as circuitopathies. Elucidating the
common networks impacted by lesions in this condition could
pave the way to identify new targets for neuromodulatory
therapeutic approaches. In this study, we aim to assess
lesion distribution in dyskinetic cerebral palsy and
identify a related functional network derived from lesions.
Here, we review the literature of MRI findings in dyskinetic
cerebral palsy and perform literature-based lesion network
mapping. Articles reporting conventional MRI findings
clearly attributable to affected patients were included for
review. Imaging findings and their anatomical distribution
were extracted and quantified according to an established
MRI classification system for cerebral palsy. Reviewed
articles were searched for figures depicting lesions and
these were traced onto a paediatric template. Whole-brain
functional connectivity from lesions causing dyskinetic
cerebral palsy was calculated using a paediatric
resting-state functional MRI connectome. Individual maps
were thresholded and later overlapped to derive a common
network map associated with dyskinetic cerebral palsy.
Results were contrasted with two control datasets for
spatial specificity. Review of 48 selected articles revealed
that grey matter injury predominated $(51\%),$ followed by
white matter injury $(28\%).$ In $16\%$ of cases MRI was
normal. Subcortical lesions affected the thalamus, pallidum
and putamen in $>40\%$ of reported patients, respectively.
Figures available from 23 literature cases were used to
calculate the lesion netwok map of dyskinetic cerebral
palsy. The lesion-derived map revealed functional
connectivity to a wide network including the brainstem,
cerebellum, basal ganglia, cingulate and sensorimotor
cortices. The strongest connectivity was found for the motor
thalamus. This study confirms subcortical grey matter
lesions as the most common MRI finding in dyskinetic
cerebral palsy. The neural network identified with lesion
network mapping includes areas previously implicated in
hyperkinetic disorders and highlights the motor thalamus as
a common network node. These results should be validated and
their therapeutic implications explored in prospective
trials.},
keywords = {dyskinetic cerebral palsy (Other) / lesion network mapping
(Other) / lesion pattern (Other) / neuroimaging (Other)},
cin = {AG Kühn},
ddc = {610},
cid = {I:(DE-2719)5000008},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40574970},
pmc = {pmc:PMC12199781},
doi = {10.1093/braincomms/fcaf228},
url = {https://pub.dzne.de/record/279443},
}