Selective neuroanatomical alterations in children with growth hormone deficiency: a volumetric MRI analysis using...

To quantitatively evaluate global and regional brain volumes in children with biochemically confirmed growth hormone deficiency (GHD) using standardized volumetric MRI.

This retrospective case-control study included 64 children with isolated GHD (43 boys, 21 girls; mean age, 11.4 ± 3.2 years) and 64 age- and sex-matched healthy controls. High-resolution 3D T1-weighted MRI scans were processed using the volBrain automated segmentation pipeline. Global, cortical, and subcortical volumes were normalized to intracranial cavity volume (ICV). Group differences were analyzed with age-, sex-, and ICV-adjusted models, corrected for multiple comparisons (FDR<0.05).

Children with GHD exhibited significantly smaller gray matter (750.6 ± 92.3 vs. 789.0 ± 88.5 cm³; q=0.002) and total brain (1,204.3 ± 124.9 vs. 1,259.2 ± 118.6 cm³; q=0.003) volumes compared with controls, while white matter volume was preserved. Regionally, hippocampal (q=0.02), thalamic (q=0.03), and caudate (q=0.04) volumes were smaller in GHD. ICV-normalized models showed reduced gray matter and limbic shares, with relatively higher thalamic and white matter proportions. Differences were more pronounced in prepubertal subjects and partially attenuated during puberty.

Pediatric GHD is associated with selective reductions in gray matter-dominant and limbic-striatal regions, with relative preservation of white matter. Quantitative volumetric MRI provides a reproducible biomarker framework for assessing GH-related neurodevelopmental alterations.