Regional Brain Tissue Composition in Children With Hydrocephalus

Fletcher, Jack Μ.; McCauley, Stephen R.; Brandt, Michael E.; Bohan, Timothy P.; Kramer, Larry A.; Francis, D.; Thorstad, Kelly; Brookshire, Bonnie L.

doi:10.1001/archneur.1996.00550060093022

Cited by 74 publications

(45 citation statements)

References 17 publications

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“…There were no differences between children with or without MMC, which indicates that the visuo-motor tests (Trail Making Test and Tower of London Test) also reflect deficits in planning and speed and not deficits in motor functions in children with MMC. Deficits in visual and visuo-spatial functions can be partly explained by the thinning of the posterior cortex, which is often found as a secondary CNS insult in children with hydrocephalus (Dennis et al, 1981, Fletcher et al, 1996. In spite of the fact that children with hydrocephalus have fluent spontaneous language in everyday life, they had difficulty performing the word-finding task in this study.…”

Section: The Impact Of Hydrocephalus On Cognition and Neuropsychologimentioning

confidence: 64%

“…The few existing studies of executive function in children with hydrocephalus generally illustrate single, or just a few, aspects. Fletcher et al (1996) reported poorer results on planning tasks performed by children with hydrocephalus, but they were not discussed in terms of executive dysfunction, but as a result of a generalised spatial problem-solving deficit due to the loss of white matter. Anderson et al (2002) identified significant symptoms of executive dysfunction in children with hydrocephalus in both auditive-verbal and visuo-per-ceptual tests.…”

Section: Memorymentioning

confidence: 99%

“…Non-verbal deficits are explained as being related to the loss of white matter in the posterior regions of the brain and also to the abnormalities of the corpus callosum that are frequently found (Fletcher et al, 1992;Fletcher et al, 1996;Hannay, 2000). The loss of periventricular white matter also causes visual perception problems as in children born preterm with periventricular leukomalacia (PVL) (Jacobson et al, 1996) and in children with congenital hemiplegia (Carlsson et al, 1994).…”

Section: Non-verbal Functionsmentioning

confidence: 99%

“…There are few studies focusing directly on attentional processes in children with hydrocephalus. Fletcher et al (1996) showed that children with hydrocephalus solved fewer problems on tests of focused attention and selective attention. They argued, however, that the results possibly did not reflect poorer frontal lobe control but difficulty sustaining attention and greater distractibility, i.e.…”

Section: Behaviour and Attentionmentioning

confidence: 99%

“…In spite of the fact that children with hydrocephalus have fluent spontaneous language in everyday life, they had difficulty performing the word-finding task in this study. Fletcher et al (1992Fletcher et al ( , 1996 have shown that the motor and spatial deficits displayed by children with early hydrocephalus are strongly related to the integrity of the corpus callosum.…”

Section: The Impact Of Hydrocephalus On Cognition and Neuropsychologimentioning

confidence: 99%

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Behavioural problems and autism in children with hydrocephalus

Lindquist

Carlsson

Persson

et al. 2006

Eur Child Adolesc Psychiatry

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Aims: The main objective of this thesis was to explore the cognitive and behavioural consequences of hydrocephalus in children born at term and preterm, with or without myelomeningocele (MMC) and with or without concomitant neurological impairments, such as cerebral palsy (CP), epilepsy or learning disabilities. Material and methods:From a population-based cohort of all 107 children with hydrocephalus born in [1989][1990][1991][1992][1993] 73 of the surviving children were assessed with intelligence tests and most of them also using behavioural and autism rating scales. Thirty-six of 47 (77%) children with an IQ of ≥ 70 and eight children with MMC but no hydrocephalus were assessed with a neuropsychological test battery (NIMES) and compared with age-and gender-matched controls. Results:One-third of the children were normally gifted (IQ > 85), another 30% had a low-average IQ of 70-84 and 37% had learning disabilities (IQ < 70). An IQ of < 70 was found in 42% of children without MMC and in 29% of those with MMC. Children born preterm had a lower IQ than those born at term. Children with CP and/or epilepsy had significantly lower IQ scores than those without these impairments. Parents rated 67% and teachers 39% of the children as having behavioural problems. Learning disabilities increased the risk significantly. Almost all the children with CP and/or epilepsy had behavioural problems. Learning disabilities, CP and epilepsy significantly increased the risk of autistic symptoms, which were present in 13 %, in 4 % of those with MMC and in 20 % of those without MMC. Children with hydrocephalus both with and without MMC and with an IQ of > 70 performed significantly less well than controls on learning, memory and executive functions but not on registration skills. There were no differences between children with hydrocephalus in combination with MMC and those without MMC, whereas children with MMC but no hydrocephalus and normal intelligence performed as well as controls on all the neuropsychological functions. Conclusions:The majority of children with hydrocephalus had learning disabilities or a low-average IQ, as well as behavioural problems, and some had autistic symptoms. Despite average or slightly below average intelligence, children with hydrocephalus had major difficulties with learning and memory and with executive functions, regardless of the aetiology of the hydrocephalus. Only MMC did not appear to influence cognitive and neuropsychological outcome as much as the brain lesion causing or caused by the hydrocephalus.

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Section: The Impact Of Hydrocephalus On Cognition and Neuropsychologimentioning

confidence: 64%

Section: Memorymentioning

confidence: 99%

Section: Non-verbal Functionsmentioning

confidence: 99%

Section: Behaviour and Attentionmentioning

confidence: 99%

Section: The Impact Of Hydrocephalus On Cognition and Neuropsychologimentioning

confidence: 99%

See 3 more Smart Citations

Behavioural problems and autism in children with hydrocephalus

Lindquist

Carlsson

Persson

et al. 2006

Eur Child Adolesc Psychiatry

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White matter microstructural abnormalities in children with spina bifida myelomeningocele and hydrocephalus: A diffusion tensor tractography study of the association pathways

Hasan

Eluvathingal

Kramer

et al. 2008

Magnetic Resonance Imaging

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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 Ϯ SD ϭ 12.30 Ϯ 2.10 years; 22 boys; 10 left-handed) and 31 age-and sex-matched normally-developing children (11.56 Ϯ 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 frontooccipital, 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, 2 FA, 1 diffusivities), impairment in myelination (1 transverse diffusivity) as well as abnormalities in intrinsic axonal characteristics and extraaxonal/extracellular space (1 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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Fully automated measurement of intracranial CSF and brain parenchyma volumes in pediatric hydrocephalus by segmentation of clinical MRI studies

et al. 2023

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BackgroundBrain parenchyma (BP) and intracranial cerebrospinal fluid (iCSF) volumes measured by fully automated segmentation of clinical brain MRI studies may be useful for the diagnosis and follow‐up of pediatric hydrocephalus. However, previously published segmentation techniques either rely on dedicated sequences, not routinely used in clinical practice, or on spatial normalization, which has limited accuracy when severe brain distortions, such as in hydrocephalic patients, are present.PurposeWe developed a fully automated method to measure BP and iCSF volumes from clinical brain MRI studies of pediatric hydrocephalus patients, exploiting the complementary information contained in T2‐ and T1‐weighted images commonly used in clinical practice.MethodsThe proposed procedure, following skull‐stripping of the combined volumes, performed using a multiparametric method to obtain a reliable definition of the inner skull profile, maximizes the CSF‐to‐parenchyma contrast by dividing the T2w‐ by the T1w‐ volume after full‐scale dynamic rescaling, thus allowing separation of iCSF and BP through a simple thresholding routine.ResultsValidation against manual tracing on 23 studies (four controls and 19 hydrocephalic patients) showed excellent concordance (ICC > 0.98) and spatial overlap (Dice coefficients ranging from 77.2% for iCSF to 96.8% for intracranial volume). Accuracy was comparable to the intra‐operator reproducibility of manual segmentation, as measured in 14 studies processed twice by the same experienced neuroradiologist. Results of the application of the algorithm to a dataset of 63 controls and 57 hydrocephalic patients (19 with parenchymal damage), measuring volumes’ changes with normal development and in hydrocephalic patients, are also reported for demonstration purposes.ConclusionsThe proposed approach allows fully automated segmentation of BP and iCSF in clinical studies, also in severely distorted brains, enabling to assess age‐ and disease‐related changes in intracranial tissue volume with an accuracy comparable to expert manual segmentation.

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Regional Brain Tissue Composition in Children With Hydrocephalus

Abstract: Regional variations in brain tissue composition in children with shunted hydrocephalus correlate with a variety of cognitive and visuomotor functions.

Cited by 74 publications

References 17 publications

Behavioural problems and autism in children with hydrocephalus

Behavioural problems and autism in children with hydrocephalus

White matter microstructural abnormalities in children with spina bifida myelomeningocele and hydrocephalus: A diffusion tensor tractography study of the association pathways

Fully automated measurement of intracranial CSF and brain parenchyma volumes in pediatric hydrocephalus by segmentation of clinical MRI studies

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