脑瘫儿童皮层语言网络发育：基于fMRI的横断和纵向跟踪研究

Children with cerebral palsy (CP) are often accompanied by language and speech dysfunction, but the basis of neural network and development is largely unclear. Based on our previous work, this project will test the hypothesis that language impairments in CP may be impaired in varying degrees in the comprehension and generation of language circuit, delayed development, and abnormal integration with other large-scale brain network systems. We therefore will recruit 2 to 7-year-old CP children as well as matched typical development controls, with multimodal magnetic resonance imaging (MRI) parameters (morphology, structure, function and metabolism) and multidimensional language and cognitive neural scale with one-year longitudinal investigation. Firstly, we will locate the significant foci of brain parameters of multimodal MRI in the cortical language network, and then analyze the cortical development trajectory within one year. The characteristic parameters of the above language network alterations are produced by machine learning. The data will predict one-year language circuit developmental trajectory and yield to multimodal imaging bio-markers. This will help to reveal the abnormal cortical development trajectory of children with CP and the neurological mechanism of verbal dysfunction. It is of great scientific and clinical significance for understanding the cortical language development and the language protection of children 's brain surgery.

儿童脑瘫常伴有言语功能障碍，但其神经网络基础及发育尚不清楚。结合我们前期研究，本项目假设脑瘫患儿语言障碍是语言环路理解和生成成分不同程度受损、发育延迟，及其与其它大尺度脑网络系统的整合异常。本项目招募2-7岁脑瘫患儿，联合多模态磁共振指标（形态、结构、功能及代谢）和多维度语言发育认知神经量表以及一年的纵向跟踪。首先定位脑瘫皮层语言网络环路的多模态磁共振脑参数的显著改变位点，然后分析一年内的皮层发育轨迹。随后使用机器学习的方法抽取上述语言环路异常改变的特征参数进行分类，并预测一年后的发展，从而获取潜在的语言环路多模态影像生物学标记。这将有助于揭示脑瘫儿童异常的皮层发育轨迹及其言语功能障碍的神经机制，为理解个体皮层语言发育和儿童颅脑手术语言保护提供依据，具有重要的科学意义和临床指导价值。

儿童脑瘫常伴有语言沟通功能障碍，但其发病机制及神经网络基础尚不清楚。为探讨脑瘫儿童语言沟通功能障碍的语言环路损伤位点及其大尺度脑网络系统的整合异常，我们开展了以下几方面的工作：1）基于脑结构磁共振（MRI）探寻双侧痉挛型脑瘫（BSCP）儿童语言沟通功能障碍相关脑灰质、白质结构改变，结果表明BSCP儿童语言沟通功能障碍与部分脑区形态学及区域内部或之间的纤维束连接结构改变有关，为确定BSCP儿童语言沟通功能障碍潜在生物学标记物提供了初步依据。2）基于扩散张量成像（DTI）采用图论的复杂网络分析方法探讨痉挛型脑瘫（SCP）儿童的大脑白质结构网络拓扑属性及其与认知功能的关系。结果表明痉挛型脑瘫患儿存在认知功能下降及脑网络拓扑属性改变，且部分脑区的节点属性改变与认知功能下降相关，表明SCP儿童大脑对信息的整合和分离方式是不同的。.在原研究计划的基础上，增加了1）基于MRI列线图预测痉挛型脑瘫儿童粗大运动功能研究，寻找基于影像学预测痉挛型脑瘫儿童粗大运动功能的生物学标记。2）基于手节结构MRI的脑瘫儿童手功能评估研究，建立客观、精准地评估CP儿童手功能的模型。.综上，通过本课题的研究，明确了脑瘫儿童语言发育相关的大脑结构和功能的异常，揭示了脑瘫儿童异常的皮层发育轨迹及其言语功能障碍的神经机制，为理解个体语言皮层发育和儿童颅脑手术语言保护提供依据，具有重要的科学意义和临床指导价值。

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