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Published on: January 2, 2012
Microcephaly with Simplified Gyral Pattern in Children: Quantitative Morphometric Assessment on Brain MRI and
Stefanie Chambers1, Mateus A Esmeraldo1, Yanniklas Kravutske1
1From the Department for Biomedical Imaging and Image-guided Therapy (S.C., Y.K., L.H., G.K.), Medical University of Vienna and Department of Radiology (S.C., M.A.E., Y.K., A.F.G., B.P.S.), Stanford University School of Medicine, Stanford, CA, USA.
Background And Purpose:
Microcephaly with simplified gyral pattern (MSGP) represents an often subtle subtype of malformation of cortical development that is commonly accompanied by epilepsy and neurodevelopmental delay. However, whether gyral simpflication scales to reduced brain volume, and if MRI features predict clinical outcome still remains unclear. The aims of this study are therefore to apply a quantitative morphometric approach to distinguish simplified gyral pattern from microcephaly-related effects, and to correlate quantitative MRI-derived features with clinical outcome.
Materials And Methods:
From a single-center cohort of 34 patients with microcephaly and visually confirmed simplified gyral pattern (SGP) (shallow sulci, normal cortical thickness), 18 subjects (mean age 7.1±6.5 years) that fulfilled the eligibility criteria were retrospectively included for final analysis. 26 age- and sex-matched healthy controls were included. Volumetric gray/white-matter volumes (GMV/WMV) and surface-based measures were derived using FreeSurfer. Scaling corrections based on log-log robust regression and cortical folding analyses were subsequently analyzed. Principal component analyses clustered along morphometric phenotypes. ANCOVA, Kendall τ correlations, and logistic regression were applied to evaluated group differences and clinical outcome predictors.
Results:
Compared with healthy controls, patients showed significantly reduced WMV, cortical surface area, local gyrification index (LGI) (all q<0.003), and mildly increased cortical thickness. Allometric modeling indicated that while WMV and LGI scaled proportionally to total brain volume, cortical surface area was disproportionately reduced, suggesting deviation beyond microcephalic scaling. Spectral folding analysis showed loss of specifically macro-scale (primary) folding power. Morphometric clustering separated four subtypes differing in cortical thickness and area, of which the cluster with lowest surface area and LGI exhibited universal developmental delay and included both early deaths. Across the cohort, neurodevelopmental delay correlated negatively with surface area. Logistic regression suggested lower surface area, WMV, and LGI as predictors of adverse clinical outcome (q<0.02).
Conclusion:
The presence of SGP may reflect additional disturbance of primary sulcation and tangential cortical expansion beyond scaling to microcephaly alone. Our results suggest reduced cortical surface area as a key morphometric marker and strong MRI feature predictive of neurodevelopmental delay, underscoring the clinical value of quantitative morphometry for stratifying disease severity in microcephaly with simplified gyral pattern.
Insights
Microcephaly with simplified gyral pattern (MSGP) is linked to reduced brain volume and neurodevelopmental delay. Quantitative MRI analysis reveals decreased cortical surface area as a key predictor of adverse clinical outcomes in MSGP patients.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Quantitative Anatomy
Background:
- Microcephaly with simplified gyral pattern (MSGP) is a subtle cortical malformation often associated with epilepsy and developmental delays.
- The relationship between gyral simplification, brain volume reduction, and MRI-based prediction of clinical outcomes in MSGP remains unclear.
Purpose of the Study:
- To quantitatively differentiate simplified gyral pattern (SGP) effects from microcephaly-related volume changes.
- To correlate quantitative MRI-derived features with clinical outcomes in MSGP.
Main Methods:
- Retrospective analysis of 18 MSGP patients and 26 healthy controls using FreeSurfer for volumetric and surface-based morphometry.
- Allometric scaling corrections and spectral folding analyses were applied.
- Principal component analysis, ANCOVA, Kendall τ, and logistic regression were used to analyze group differences and predict outcomes.
Main Results:
- MSGP patients exhibited reduced white matter volume (WMV), cortical surface area, and local gyrification index (LGI), with mildly increased cortical thickness compared to controls.
- Cortical surface area was disproportionately reduced, indicating effects beyond simple microcephalic scaling.
- Reduced surface area, WMV, and LGI were identified as predictors of adverse clinical outcomes, including developmental delay.
Conclusions:
- Simplified gyral pattern may involve disturbances in cortical expansion beyond microcephaly alone.
- Reduced cortical surface area is a significant morphometric marker and MRI predictor of neurodevelopmental delay in MSGP.
- Quantitative morphometry is valuable for stratifying disease severity in MSGP.
