Weaker Connectivity of the Cortical Networks Is Linked with the Uncharacteristic Gait in Youth with Cerebral Palsy

Cerebral palsy (CP) is the most prevalent pediatric neurologic impairment and is associated with major mobility deficiencies. This has led to extensive investigations of the sensorimotor network, with far less research focusing on other major networks. The aim of this study was to investigate the functional connectivity (FC) of the main sensory networks (i.e., visual and auditory) and the sensorimotor network, and to link FC to the gait biomechanics of youth with CP. Using resting-state functional magnetic resonance imaging, we first identified the sensorimotor, visual and auditory networks in youth with CP and neurotypical controls. Our analysis revealed reduced FC among the networks in the youth with CP relative to the controls. Notably, the visual network showed lower FC with both the sensorimotor and auditory networks. Furthermore, higher FC between the visual and sensorimotor cortices was associated with larger step length (r = 0.74, p = 0.04) in youth with CP. These results confirm that CP is associated with functional brain abnormalities beyond the sensorimotor network, suggesting abnormal functional integration of the brain's motor and primary sensory systems. The significant association between abnormal visuo-motor FC and gait could indicate a link with visuomotor disorders in this patient population.