Fixel-based tractometry unravels the structural-functional coupling of vision in children with unilateral cerebral palsy

Motivation: This study explores the application of fixel-based analysis (FBA) combined with segment-specific tractometry to investigate differences in visual white matter (WM) bundles between children with right- and left-sided unilateral cerebral palsy (uCP). Goal(s): Additionally, we explore associations between WM properties and clinical visual test scores, specifically visual acuity and stereoacuity. Approach: This approach could address challenges posed by crossing fibers, while enabling precise mapping of WM tract segments associated with lesion laterality and with visual outcomes. Results: Findings highlight specific bundle segments relevant to uCP laterality and visual functions, most notably in the occipital corpus callosum (CC), and superior longitudinal fasciculi (SLF). Impact: This study leverages advanced fixel-based tractometry (FBT) to explore segment-specific structural-functional relationships in visual pathways of children with unilateral cerebral palsy, potentially providing insights that could guide future research and improve individualized care for visual impairments in this population.