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Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using 18F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Authors
 Hae-Jeong Park ; Chul Hoon Kim ; Jong Doo Lee ; Chang Il Park ; Maeng-Keun Oh ; So Ra Oh ; Bumhee Park ; Eun Sook Park 
Citation
 Journal of Nuclear Medicine, Vol.54(8) : 1263~1269, 2013 
Journal Title
 Journal of Nuclear Medicine 
ISSN
 0161-5505 
Issue Date
2013
Abstract
γ-aminobutyric acid (GABA)-A receptor-mediated neural transmission is important to promote practice-dependent plasticity after brain injury. This study investigated alterations in GABA-A receptor binding and functional and anatomic connectivity within the motor cortex in children with cerebral palsy (CP). METHODS: We conducted (18)F-fluoroflumazenil PET on children with hemiplegic CP to investigate whether in vivo GABA-A receptor binding is altered in the ipsilateral or contralateral hemisphere of the lesion site. To evaluate changes in the GABA-A receptor subunit after prenatal brain injury, we performed GABA-A receptor immunohistochemistry using rat pups with a diffuse hypoxic ischemic insult. We also performed diffusion tensor MR imaging and resting-state functional MR imaging on the same children with hemiplegic CP to investigate alterations in anatomic and functional connectivity at the motor cortex with increased GABA-A receptor binding. RESULTS: In children with hemiplegic CP, the (18)F-fluoroflumazenil binding potential was increased within the ipsilateral motor cortex. GABA-A receptors with the α1 subunit were highly expressed exclusively within cortical layers III, IV, and VI of the motor cortex in rat pups. The motor cortex with increased GABA-A receptor binding in children with hemiplegic CP had reduced thalamocortical and corticocortical connectivity, which might be linked to increased GABA-A receptor distribution in cortical layers in rats. CONCLUSION: Increased expression of the GABA-A receptor α1 subunit within the ipsilateral motor cortex may be an important adaptive mechanism after prenatal brain injury in children with CP but may be associated with improper functional connectivity after birth and have adverse effects on the development of motor plasticity.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87480
DOI
10.2967/jnumed.112.117358
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Rehabilitation Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Life Science
1. 연구논문 > 1. College of Medicine > Dept. of Nuclear Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Pharmacology
Yonsei Authors
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Link
 http://jnm.snmjournals.org/content/54/8/1263.long
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