Objective

The structure–function relation between magnetic resonance imaging (MRI) and visual impairment (VI) in children with cerebral palsy (CP) has not been fully unravelled. The present systematic review aims to summarize the relation between brain lesions on MRI and VI in children and adolescents with CP.

Methods

PubMed, Embase, Web of Science Core Collection, and Cochrane Database were systematically searched according to the PRISMA checklist. A total of 45 articles met the inclusion criteria.

Results

White matter lesions were most frequently associated with VI. Only 25 studies described lesions within specific structures, mainly in the optic radiations. Only four studies reported on the thalamus. 8.4% of children with CP showed no brain abnormalities on MRI. Diffusion-weighted MRI studies showed that decreased structural connectivity in the optic radiations, superior longitudinal fasciculus, posterior limb of the internal capsule, and occipital lobe is associated with more severe VI.

Conclusions

All types of brain lesions lead to visual dysfunctions, arguing for a comprehensive visual assessment in all children with CP. Whereas white matter damage is a well-known contributor, the exact contribution of specific visual structures requires further investigation, to enable early prediction, detection, and intervention.

中文翻译：

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脑瘫儿童和青少年神经影像学与视力障碍的关系：系统评价

客观的

磁共振成像（MRI）与脑瘫（CP）儿童视力障碍（VI）之间的结构-功能关系尚未完全阐明。本系统综述旨在总结 CP 儿童和青少年 MRI 和 VI 脑部病变之间的关系。

方法

根据 PRISMA 检查表系统地检索了 PubMed、Embase、Web of Science 核心合集和 Cochrane 数据库。共有45篇文章符合纳入标准。

结果

白质病变最常与 VI 相关。只有 25 项研究描述了特定结构内的病变，主要是视辐射。只有四项研究报告了丘脑。8.4% 的 CP 儿童MRI 未显示脑部异常。弥散加权 MRI 研究表明，视放射、上纵束、内囊后肢和枕叶的结构连通性下降与更严重的 VI 相关。

结论

所有类型的脑损伤都会导致视觉功能障碍，因此主张对所有脑瘫儿童进行全面的视觉评估。尽管白质损伤是一个众所周知的贡献者，但特定视觉结构的确切贡献需要进一步研究，以实现早期预测、检测和干预。