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

## TL;DR

This study found that more severe brain lesions in children with cerebral palsy are linked to lower height, weight, and head size, but not to body fat or muscle composition.

## Contribution

The study is the first to link brain lesion extent measured by MRI with growth and body composition in children with cerebral palsy.

## Key findings

- Greater brain lesion extent was associated with lower height, weight, and head circumference z-scores.
- No significant associations were found between brain lesion extent and fat mass or fat-free mass indices.
- The corpus callosum and hemispheric scores showed the strongest associations with growth measures.

## Abstract

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).

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.

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.

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.