Ultrasound characterization of medial gastrocnemius tissue composition in children with spastic cerebral palsy

• Published in: Muscle & nerve Vol. 52; no. 3; pp. 397 - 403
• Main Authors: Pitcher, Christian A., Elliott, Catherine M., Panizzolo, Fausto A., Valentine, Jane P., Stannage, Katherine, Reid, Siobhán L.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-09-2015; Wiley Subscription Services, Inc
• Subjects: Acetylcholine Release Inhibitors - therapeutic use; Adolescent; Botulinum Toxins, Type A - therapeutic use; Case-Control Studies; Cerebral palsy; Cerebral Palsy - diagnostic imaging; Cerebral Palsy - drug therapy; Child; Child, Preschool; children; Female; gross motor function; Humans; Male; mean echo intensity; Muscle, Skeletal - diagnostic imaging; quantitative muscle ultrasound; spastic cerebral palsy; Treatment Outcome; Ultrasonic imaging; Ultrasonography; ultrasound; mean echo intensity; spastic cerebral palsy; children; quantitative muscle ultrasound; gross motor function; ultrasound
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.24549

ABSTRACT
Introduction: In this study we aimed to characterize muscle composition of the medial gastrocnemius in children with spastic cerebral palsy (SCP) using quantitative ultrasound. Methods: Forty children with SCP, aged 4–14 years, participated in this study. Children were grouped according to the gross motor function classification system (GMFCS I–V) and compared with a cohort of age‐ and gender‐matched, typically developing children (TD; n = 12). Ultrasound scans were taken of the medial gastrocnemius. Images were then characterized using grayscale statistics to determine mean echo intensity (EI) and the size and number of spatially connected homogeneous regions (i.e., blobs). Results: Significant differences in skeletal muscle composition were found between children with SCP and their TD peers. Children classified as GMFCS III consistently exhibited the highest EI and blob area. Conclusions: This study demonstrates altered tissue composition in children with SCP visualized using ultrasound. Further work is required to determine the pathophysiology contributing to these alterations in SCP. Muscle Nerve 52:397–403, 2015