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Reduced ventral cingulum integrity and increased behavioral problems in children with isolated optic nerve hypoplasia
Emma A Webb1, Michelle A O'Reilly, Jonathan D Clayden
1Developmental Endocrinology Research Group, Clinical and Molecular Genetics Unit, University College London Institute of Child Health, London, United Kingdom.
Insights
Children with optic nerve hypoplasia often exhibit behavioral problems. Reduced white matter integrity in the ventral cingulum is linked to these behavioral issues, suggesting a need for assessment and further research.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Ophthalmology
Background:
- Optic nerve hypoplasia (ONH) is a congenital condition affecting vision.
- Behavioral problems are frequently observed in children with ONH, but the underlying neural correlates are not fully understood.
- Previous research has not extensively investigated white matter abnormalities in ONH children with minimal visual impairment and normal development.
Purpose of the Study:
- To determine the prevalence of behavioral problems in children with isolated ONH, mild to moderate or no visual impairment, and no developmental delay.
- To identify potential white matter abnormalities associated with behavioral issues in this population.
- To explore the relationship between specific white matter tracts and behavioral scores.
Main Methods:
- Behavioral assessments using the Child Behavior Checklist (CBCL) were conducted on 11 children with isolated ONH.
- Brain diffusion tensor imaging (DTI) was performed on children with ONH to assess white matter integrity.
- Fractional anisotropy (FA) values in the ventral cingulum, corpus callosum, and optic radiations were analyzed using tract-based spatial statistics and correlated with CBCL scores.
Main Results:
- Children with ONH showed significantly higher CBCL scores compared to controls, with 4 exhibiting clinically significant scores.
- Reduced fractional anisotropy (FA) was observed in the ventral cingulum, corpus callosum, and optic radiations of children with ONH.
- Right ventral cingulum FA significantly correlated with total and externalizing behavioral scores on the CBCL.
Conclusions:
- Children with ONH and mild visual impairment warrant behavioral assessment due to a higher prevalence of behavioral problems.
- Reduced structural integrity of the ventral cingulum, indicated by decreased FA, is associated with behavioral scores in ONH.
- The observed reduction in FA within optic radiations in ONH children with minimal visual impairment warrants further investigation into its pathogenesis.
Objectives:
To assess the prevalence of behavioral problems in children with isolated optic nerve hypoplasia, mild to moderate or no visual impairment, and no developmental delay. To identify white matter abnormalities that may provide neural correlates for any behavioral abnormalities identified.
Patients And Methods:
Eleven children with isolated optic nerve hypoplasia (mean age 5.9 years) underwent behavioral assessment and brain diffusion tensor imaging, Twenty four controls with isolated short stature (mean age 6.4 years) underwent MRI, 11 of whom also completed behavioral assessments. Fractional anisotropy images were processed using tract-based spatial statistics. Partial correlation between ventral cingulum, corpus callosum and optic radiation fractional anisotropy, and child behavioral checklist scores (controlled for age at scan and sex) was performed.
Results:
Children with optic nerve hypoplasia had significantly higher scores on the child behavioral checklist (p<0.05) than controls (4 had scores in the clinically significant range). Ventral cingulum, corpus callosum and optic radiation fractional anisotropy were significantly reduced in children with optic nerve hypoplasia. Right ventral cingulum fractional anisotropy correlated with total and externalising child behavioral checklist scores (r = -0.52, p<0.02, r = -0.46, p<0.049 respectively). There were no significant correlations between left ventral cingulum, corpus callosum or optic radiation fractional anisotropy and behavioral scores.
Conclusions:
Our findings suggest that children with optic nerve hypoplasia and mild to moderate or no visual impairment require behavioral assessment to determine the presence of clinically significant behavioral problems. Reduced structural integrity of the ventral cingulum correlated with behavioral scores, suggesting that these white matter abnormalities may be clinically significant. The presence of reduced fractional anisotropy in the optic radiations of children with mild to moderate or no visual impairment raises questions as to the pathogenesis of these changes which will need to be addressed by future studies.
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