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

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.