Heterogeneity of muscle sizes in the lower limbs of children with cerebral palsy

Muscle Nerve. 2016 Jun;53(6):933-45. doi: 10.1002/mus.24972. Epub 2016 Feb 26.


Introduction: Cerebral palsy (CP) is associated with reduced muscle volumes, but previous studies have reported deficits in only a small number of muscles. The extent of volume deficits across lower limb muscles is not known. This study presents an imaging-based assessment of muscle volume and length deficits in 35 lower limb muscles.

Methods: We imaged and segmented 35 muscles in 10 subjects with CP and 8 typically developing (TD) controls using MRI. Muscle volumes were normalized, and Z-scores were computed using TD data. Volume Z-scores and percent deficits in volume, length, and cross-sectional area are reported.

Results: Muscle volumes are 20% lower, on average, for subjects with CP. Volume deficits differ significantly between muscles (12%-43%) and display significant heterogeneity across subjects. Distal muscles, especially the soleus, are commonly and severely small.

Conclusions: Heterogeneity across muscles and across subjects reinforces the subject specificity of CP and the need for individualized treatment planning. Muscle Nerve 53: 933-945, 2016.

Keywords: MRI; cerebral palsy; heterogeneity; lower limb; muscle.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Body Mass Index
  • Cerebral Palsy / diagnostic imaging
  • Cerebral Palsy / pathology*
  • Child
  • Electromyography
  • Female
  • Humans
  • Lower Extremity / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / pathology*