Background: Magnetic resonance imaging (MRI) can be used to analyze the location, nature and severity of brain damage in cerebral palsy (CP). Few studies have investigated the contribution of MRI in predicting severity of CP in children. Objective: To analyze the neuroimaging findings and to establish a correlation between motor and cognitive severity and MRI patterns in children with CP Methods: Retrospective study over a period of 10 years [2013-2023], including children with CP. We assessed the functional status using Gross Motor Function Classification System (GMFCS). GMFCS was classified into mild-moderate (level I-III)/ severe (level IV-V) categories. We analyzed neuroimaging patterns and applied the MRI classification system (MRICS) of the Surveillance of Cerebral Palsy in Europe.

Results: We enrolled 217 children. The mean age was 7,9 years. Severe forms were noted in 37% of cases. Cortical maldevelopments (MRICS Class A) were significantly associated with severe forms (p=0,034). Radiological patterns that were associated with motor severity were:Ischemic stroke (p=0,00); bilateral lesions (p=0,00); basal ganglia and thalamic involvement (p=0,002); porencephalic cavity (p=0,007) and brain atrophy (p=0,005). Intellectual disability was significantly associated with bilateral lesions (p=0,026), perirolandic white matter lesions (p=0,013) and lateral ventricle retraction (p=0,02). Severe behavioral disorders were associated with brain atrophy (p=0,028). Calcifications were associated with severe visual and hearing impairment (p=0,002). Conclusions: Although several factors can interfere with the functional and intellectual status of children with CP, we suggest that brain MRI is a reliable biomarker for predicting functional prognosis and thus adapting management.

Meriem Ben Hafsa
Tunisia

Hanene Benrhouma
Tunisia

Thouraya Ben Younes
Tunisia

Maha Jamoussi
Tunisia

Hedia Klaa
Tunisia

Abir Zioudi
Tunisia

Zouhour Miladi
Tunisia

Ichraf Kraoua
Tunisia

Ilhem Ben Youssef Turki
Tunisia