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White matter microstructure and structural network alterations in children with global developmental delay
Xiaona Zhu1, Pu Tian1, Xuerui Lv1
1Department of Radiology, The First Hospital of Jilin University, Changchun, China.
Background:
Global developmental delay (GDD) affects approximately 1-3% of children worldwide. This study investigated alterations in white matter tract integrity and brain network connectivity in children with GDD using diffusion kurtosis imaging (DKI) and graph-theoretical analysis.
Methods:
Thirty-five children with GDD (36-60 months) and 30 age-matched typically developing controls underwent 3.0-T MRI with DKI acquisition. The Griffiths Development Scales-Chinese were used to assess developmental quotients. White matter integrity was evaluated using tract-based spatial statistics (TBSS), and brain network connectivity was analyzed using graph-theoretical methods. The association between imaging metrics and developmental scores was explored.
Results:
Compared with controls, children with GDD showed alterations at both tract and network levels. TBSS revealed widespread reductions in kurtosis metrics within callosal and long association tracts. Consistent with these tract findings, graph-theoretical analysis showed lower nodal efficiency in sensorimotor and frontoparietal-limbic regions, alongside reduced global efficiency, with no nodes showing increases. Partial correlations linked mean kurtosis in the superior longitudinal fasciculus to language, radial kurtosis in the posterior thalamic radiation to eye-hand coordination, and global efficiency to performance.
Conclusion:
GDD is associated with disruptions of white matter microstructure and large-scale network communication, which may contribute to observed developmental impairments.
Impact:
This study combines diffusion kurtosis imaging and graph-theoretical analysis to characterize white matter microstructure and structural network organization in preschool children with global developmental delay (GDD). Children with GDD showed reduced kurtosis metrics in major white matter tracts and lower structural network efficiency compared with clinically screened comparison children. Imaging alterations were associated with domain-specific developmental quotients, including language, eye-hand coordination, and performance. These findings suggest that GDD is associated with multilevel alterations in white matter maturation and network integration, although the results should be interpreted in the context of clinical heterogeneity.
