Microstructural changes in the spinal cord of adults with cerebral palsy.
Michael P Trevarrow, Sarah E Baker, Tony W Wilson and 1 others
PMID 33719037WHAT IT FOUND
Adults with cerebral palsy showed smaller spinal cord cross-sectional areas and reduced gray matter compared to controls.
These structural differences correlated with poorer hand dexterity scores, suggesting spinal cord microstructure plays a role in upper limb function.
Key findings
01Total spinal cord cross-sectional area was significantly smaller in adults with CP compared to controls.
02Hand dexterity scores (Box and Block Test) were positively correlated with both gray matter and total spinal cord cross-sectional area.
03Magnetization transfer ratio, an indicator of tissue microstructure, was significantly lower in the corticospinal tracts of adults with CP.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study only included adults with spastic bilateral CP, so findings may not apply to children or other CP presentations. The sample size was small (13 participants with CP). MRI measures like fractional anisotropy and magnetization transfer ratio are susceptible to technical artifacts and motion errors. The study is cross-sectional, so it shows association but not causation between spinal structure and dexterity.
Declared interests
The paper states it was supported by the National Institutes of Health (N.I.H., Extramural). No specific conflicts of interest are detailed in the provided text.
The easy way to misread this
Do not assume these spinal cord differences are the sole cause of motor impairment. The study shows an association between spinal structure and hand dexterity in adults, but it does not prove that changing the spinal cord structure would improve function, nor does it address whether these changes are primary or secondary to brain injury.