PONE-D-24-17895White matter lesions and DTI metrics related to various types of dysfunction in cerebral palsy: A meta-analysis and systematic reviewPLOS ONE

Dear Dr. Jiang,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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We look forward to receiving your revised manuscript.

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Christos Papadelis, Ph.D.

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The meta-analysis and review manuscript by Jiang et al. assesses the correlation between various types of disfunction and DTI metrics in cerebral palsy. The manuscript is well written and it is technically sound. There are only a few minor modifications required:

1. There are some instances that the full version of the abbreviations are not mentioned in the text or table (e.g., GPS, ADC, etc.). In addition, there are some discrepancies in the abbreviations and the metric names. For instance, AFD is the abbreviation for 'apparent fiber density'; whereas it is noted as axial diffusivity in the text. You can confirm it with the reference (ref. 20). I suggest adding a table explaining the abbreviations for scales, pathways and DTI metrics and proofreading all the shortened forms in the text and table.

2. There are several typos in table 1. For example:

- 'country' in the first row is not spelled correctly

- non-English font in DTI metrics

- countries 'Spanish', 'Indian', and 'Iranian' should change to 'Spain', 'India', and 'Iran'.

3. There are studies in the field from established research groups which are not cited in the manuscript. For example, the DTI studies of Papadelis group have been omitted from this review paper.  

Reviewer #2: The article has some novelty and positive results. Overall the methodology is sound and the conclusions are supported by the results. However, the details of this paper should be improved. See below for some comments in the different sections of the paper:

1.Abstract：The relatively r values,95% CIs and I² value should be given in main results. The parts of results section seems a little simple.

2.Introduction：

（1）Consider more about the primary and secondary objective of this systematic review and emphasize it.

（2）When mentioned DTI indexes and metric analysis,all the recommended names and clinical significance in the following paper should be involved,for example ADC is missed.

3.Methods：

（1）The search term strategy was not comprehensive (cerebral palsy was used only in cerebral palsy, and no other free words were used).Please improve your search strategy.

（2）Bias was not assessed.Please provide a funnel plot for publication bias in Appendix.

（3）A fixed-effect model should be taken when I2 < 50%，it is not mentioned in this article.

4.Results：

（1）Please list the NOS evaluation score form of all studies.

（2）Upper limb motor function disorder：After pooling 3 studies[9, 10, 22], the FA in CST correlated with MA2 (r =-0.43,95% confidence interval [CI] –1.33 to 0.46) and was markedly heterogeneous （I2=95.1%，P=0.000）. The 95% confidence interval [CI] contains 0,so it's not correlated between FA in CST and MA2.

（3）Upper limb motor function disorder：After pooling 8 studies[9, 22-28], the FA in CST correlated with Assisting Hand Assessment（AHA） (r =0.46,95% confidence interval [CI] 0.32 to 0.60) and was markedly heterogeneous （I2=14.5%，P=0.317）. I2＜50%，P＞0.05，it is not markedly heterogeneous.

5.Discussion：No comments.

6.Overall:General writing quality should be ameliorated.

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Reviewer #1: No

Reviewer #2: No

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PONE-D-24-17895R1White matter lesions and DTI metrics related to various types of dysfunction in cerebral palsy: A meta-analysis and systematic reviewPLOS ONE

Dear Dr. Jiang,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Nov 02 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Maryam Bemanalizadeh

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: Thanks for your specific revision.Now there is still a little minor details should be revised:

（1）A minor error exists in part“Literature Search”：After removing 391 duplicate articles, the remaining 940（not 930） articles were screened.

（2）Table 1：Adjust the form to three-wire watch and add the corresponding NOS score in the last column.

（3）After adding the corresponding NOS score to table 1，table S2（the NOS Evaluation Score Form of All Studies）and table S1（Abbreviation）in appendix can choosed to be deleted,else there are too many tables.（or you can discuss it with editor eventually）

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

White matter lesions and DTI metrics related to various types of dysfunction in cerebral palsy: A meta-analysis and systematic review

PONE-D-24-17895R2

Dear Dr. Jiang,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Maryam Bemanalizadeh

Academic Editor

PLOS ONE