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DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions
Published on: August 26, 2014
White matter microstructural abnormalities in children with spina bifida myelomeningocele and hydrocephalus: a
Khader M Hasan1, Thomas J Eluvathingal, Larry A Kramer
1Department of Diagnostic and Interventional Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada. Khader.M.Hasan@uth.tmc.edu
Insights
Children with spina bifida myelomeningocele (SBM) and hydrocephalus show abnormal white matter development. Diffusion tensor imaging reveals impaired myelination and axonal characteristics in their major brain pathways.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Pediatric Neurology
Background:
- Spina bifida myelomeningocele (SBM) is a complex congenital condition often associated with hydrocephalus.
- Understanding the long-term neurological impact of SBM and shunted hydrocephalus is crucial for affected children.
- White matter abnormalities may underlie cognitive and motor deficits in SBM.
Purpose of the Study:
- To quantify microstructural abnormalities in major white matter association pathways in children with SBM and shunted hydrocephalus.
- To compare diffusion tensor imaging (DTI) metrics between children with SBM and typically developing controls.
- To investigate age-related changes in white matter microstructure in this population.
Main Methods:
- Whole-brain diffusion tensor imaging (DTI) was performed on 38 children with SBM and shunted hydrocephalus and 31 age- and sex-matched controls.
- Diffusion tensor tractography (DTT) was used to delineate and quantify four major association pathways bilaterally.
- Key diffusion metrics including fractional anisotropy (FA) and diffusivities were analyzed.
Main Results:
- Children with SBM did not show the typical age-related decrease in white matter diffusivities seen in controls.
- Significantly elevated transverse and axial diffusivities were observed in most white matter pathways in the SBM group.
- Fractional anisotropy (FA) was significantly lower in most association pathways, with some tracts being untraceable in SBM participants.
Conclusions:
- DTT identified abnormal white matter development in children with SBM, characterized by poor tract visualization and altered diffusion metrics.
- Findings suggest impaired myelination and abnormalities in axonal characteristics and the extra-axonal space.
- The observed diffusion metric differences indicate abnormal white matter development and potential ongoing degeneration with age in children with SBM.
Purpose:
To quantify microstructural abnormalities in the major association pathways of children affected by spina bifida myelomeningocele (SBM) and shunted hydrocephalus using whole-brain diffusion tensor imaging (DTI).
Materials And Methods:
The institutional review board approved this Health Insurance Portability and Accountability Act (HIPAA)-compliant study and written informed consent/assent were obtained prior to the study. The 69 participants included 38 children with SBM and shunted hydrocephalus (age mean +/- SD = 12.30 +/- 2.10 years; 22 boys; 10 left-handed) and 31 age- and sex-matched normally-developing children (11.56 +/- 2.72 years; 15 boys, four left-handed). Diffusion tensor tractography (DTT) was performed to delineate and quantify bilaterally four major association pathways (arcuate, inferior longitudinal, inferior fronto-occipital, and uncinate fasciculi).
Results:
The group with SBM did not exhibit the pattern of age-related decreases in the diffusivities observed in the controls. The transverse and axial diffusivities were significantly elevated in most of the white matter pathways of the participants with SBM. The fractional anisotropy (FA) was significantly lower in most of the association pathways. Many of the association pathways were not traceable in some participants with SBM compared to the controls at the selected FA thresholds.
Conclusion:
DTT revealed diffusion tensor characteristics of abnormal development (nonvisualization/poor visualization of tracts, downward arrow FA, upward arrow diffusivities), impairment in myelination (upward arrow transverse diffusivity) as well as abnormalities in intrinsic axonal characteristics and extraaxonal/extracellular space (upward arrow axial diffusivity) in the association pathways of the SBM children. The differences in the diffusion metrics observed in the children with SBM are suggestive of abnormal white matter development and persistent degeneration with increased age.
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