Kwon YM, Rose J, Kim AR, Son SM. Corticoreticular tract lesion in children with developmental delay presenting with gait dysfunction and trunk instability. Neural Regeneration Research 2017,Volume 12, Issue 9, Page 1465-1471
歩行時の体幹不安定性および体幹機能障害の程度と網様体脊髄路（Corticoreticular Tract (CRT)）の損傷具合との関係を検証すること．
発達遅延を認める小児患者30名（21 males and 9 females; overall mean corrected age 24.6 ± 3.6 months; range 20–35 months）と年齢をマッチさせた15名の小児．
③グループTD（typically developed children） 正常発達（n=15）
機能的評価はGrowth Motor Function Classification System, Functional Ambulation Category scale, Functional Ambulation Category scaleとした．
The corticoreticular tract (CRT) is known to be involved in walking and postural control. Using diffusion tensor tractography (DTT), we investigated the relationship between the CRT and gait dysfunction, including trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed (TD) children were recruited. Fifteen patients with gait dysfunction (bilateral trunk instability) were included in the group A, and the other 15 patients with gait dysfunction (unilateral trunk instability) were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical manifestations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.