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Corn E, Andringa-Seed R, Williams ME, Arroyave-Wessel M, Tarud R, Vezina G, Podolsky RH, Kapse K, Limperopoulos C, Berl MM, Cure C, Mulkey SB. Feasibility and success of a non-sedated brain MRI training protocol in 7-year-old children from rural and semi-rural Colombia. Pediatr Radiol 2024; 54:1513-1522. [PMID: 38970708 DOI: 10.1007/s00247-024-05964-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/20/2024] [Accepted: 05/25/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Brain magnetic resonance imaging (MRI) is a crucial tool for clinical evaluation of the brain and neuroscience research. Obtaining successful non-sedated MRI in children who live in resource-limited settings may be an additional challenge. OBJECTIVE To present a feasibility study of a novel, low-cost MRI training protocol used in a clinical research study in a rural/semi-rural region of Colombia and to examine neurodevelopmental factors associated with successful scans. MATERIALS AND METHODS Fifty-seven typically developing Colombian children underwent a training protocol and non-sedated brain MRI at age 7. Group training utilized a customized booklet, an MRI toy set, and a simple mock scanner. Children attended MRI visits in small groups of two to three. Resting-state functional and structural images were acquired on a 1.5-Tesla scanner with a protocol duration of 30-40 minutes. MRI success was defined as the completion of all sequences and no more than mild motion artifact. Associations between the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Movement Assessment Battery for Children (MABC), Behavioral Rating Inventory of Executive Function (BRIEF), Child Behavior Checklist (CBCL), and Adaptive Behavior Assessment System (ABAS) scores and MRI success were analyzed. RESULTS Mean (SD) age at first MRI attempt was 7.2 (0.2) years (median 7.2 years, interquartile range 7.1-7.3 years). Twenty-six (45.6%) participants were male. Fifty-one (89.5%) children were successful across two attempts; 44 (77.2%) were successful on their first attempt. Six (10.5%) were unsuccessful due to refusal or excessive motion. Age, sex, and scores across all neurodevelopmental assessments (MABC, TVIP, ABAS, BRIEF, CBCL, NIH Toolbox Flanker, NIH Toolbox Pattern Comparison, WPPSI) were not associated with likelihood of MRI success (P=0.18, 0.19, 0.38, 0.92, 0.84, 0.80, 1.00, 0.16, 0.75, 0.86, respectively). CONCLUSION This cohort of children from a rural/semi-rural region of Colombia demonstrated comparable MRI success rates to other published cohorts after completing a low-cost MRI familiarization training protocol suitable for low-resource settings. Achieving non-sedated MRI success in children in low-resource and international settings is important for the continuing diversification of pediatric research studies.
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Affiliation(s)
- Elizabeth Corn
- Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington DC, USA
| | - Regan Andringa-Seed
- Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington DC, USA
| | - Meagan E Williams
- Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington DC, USA
| | | | - Raul Tarud
- Sabbag Radiólogos, Barranquilla, Colombia
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington DC, USA
| | - Robert H Podolsky
- Division of Biostatistics and Study Methodology, Children's National Hospital, Washington DC, USA
| | - Kushal Kapse
- Developing Brain Institute, Children's National Hospital, Washington DC, USA
| | - Catherine Limperopoulos
- Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington DC, USA
- Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington DC, USA
- Developing Brain Institute, Children's National Hospital, Washington DC, USA
- Department of Radiology, The George Washington University School of Medicine and Health Sciences, Washington DC, USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Madison M Berl
- Division of Pediatric Neuropsychology, Children's National Hospital, Washington DC, USA
- Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | | | - Sarah B Mulkey
- Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington DC, USA.
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington DC, USA.
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington DC, USA.
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Abujamea AH, Almosa M, Uzair M, Alabdullatif N, Bashir S. Reduced Cortical Complexity in Children with Developmental Delay in Saudi Arabia. Cureus 2023; 15:e48291. [PMID: 38058330 PMCID: PMC10696479 DOI: 10.7759/cureus.48291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION Developmental delay (DD) is a neurodevelopmental disorder characterized by delays in multiple domains. The investigation of brain structure in DD has been enhanced by advanced neuroimaging techniques that can identify regional surface deformities. Neuroimaging studies have identified structural brain abnormalities in individuals with DD, but research specific to the Saudi Arabian population is limited. In this study, we examine the neuroanatomical abnormalities in the cortical and subcortical regions of Saudi Arabian children with DD. METHOD A T1-weighted, 1-mm-thick MRI was used to acquire structural brain images of 29 children with DD and age-matched healthy controls. RESULTS Analysis of the MRI data revealed significant differences in several cortical and subcortical structures of gray matter (GM) and white matter (WM) in several brain regions of the DD group. Specifically, significant deformities were observed in the caudate nucleus, globus pallidus, frontal gyrus, pars opercularis, pars orbitalis, cingulate gyrus, and subcallosal gyrus. These findings suggest disrupted neurodevelopment in these regions, which may contribute to the cognitive, motor, and behavioral impairments commonly observed in individuals with DD. CONCLUSIONS The present study provides valuable insights into the neuroanatomical differences in Saudi Arabian children with DD. Our results provide evidence for cortical and subcortical abnormalities in DD. Deformities in the observed regions may contribute to cognitive impairment, emotional dysregulation, mood disorders, and language deficits commonly observed in DD. The structural analysis may enable the identification of neuroanatomical biomarkers to facilitate the early diagnosis or progression of DD. These results suggest that lower cortical complexity in DD children due to alterations in networks may play a critical role in early brain development.
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Affiliation(s)
- Abdullah H Abujamea
- Department of Radiology and Medical Imaging, King Saud University Medical City, King Saud University, Riyadh, SAU
| | - Mohammed Almosa
- Department of Radiology and Medical Imaging, King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia, Riyadh, SAU
| | - Mohammad Uzair
- Department of Biological Sciences, Faculty of Basic & Applied Sciences, International Islamic University, Islamabad, PAK
| | | | - Shahid Bashir
- Department of Neuroscience, Neuroscience Center, King Fahad Specialist Hospital, Dammam, SAU
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Forgó B. Challenges and caveats of quantitative susceptibility mapping in infants with neurodevelopmental delay. Eur Radiol 2023; 33:4486-4487. [PMID: 36977853 DOI: 10.1007/s00330-023-09536-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/11/2023] [Accepted: 02/05/2023] [Indexed: 03/30/2023]
Affiliation(s)
- Bianka Forgó
- Department of Radiology and Medical Physics, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan, 70185, Örebro, Sweden.
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Rajvanshi N, Chacham S, Ks A, Semwal P, Nandolia KK, Rohilla J, Saini L, Saxena S, Basu S. Magnetic resonance imaging brain yield in developmental delay: A developing country perspective. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 138:104518. [PMID: 37148576 DOI: 10.1016/j.ridd.2023.104518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 03/26/2023] [Accepted: 04/20/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Developmental delay (DD) is an important neuro-morbidity in children affecting the quality of life. MRI plays a crucial role by delineating the underlying structural, metabolic, and genetic abnormalities. AIM To determine the yield of MRI brain in delineating the various underlying abnormalities and etiological factors in children with DD and to correlate these findings with the clinical presentation. METHODS This cross-sectional study enrolled 50 children with the developmental delay between 6 months to 6 years of age. OUTCOMES AND RESULTS The mean age was 31.32 ± 20.56 months. The sensitivity of MRI was 72%. 81.3% of the children with microcephaly had abnormal MRI. The most common underlying etiology was hypoxic-ischemic encephalopathy (42%), followed by congenital/developmental defects and metabolic diseases (10% each). The most commonly involved region of the cerebral cortex was the occipital lobe (44%) because of the high occurrence of coexisting hypoglycemic brain injury, which is extremely common in developing countries and rare in developed countries, with 80% of them having visual abnormalities. Frontal lobe involvement was significantly more in children with abnormal motor findings and behavioral changes. Cortical grey matter abnormalities were significantly more in children with seizures. CONCLUSION AND IMPLICATIONS It is to be emphasized that children with developmental delays should be evaluated with MRI whenever possible. Apart from hypoxic-ischemic encephalopathy, other etiologies should also be looked for.
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Affiliation(s)
- Nikhil Rajvanshi
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Swathi Chacham
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Aswanth Ks
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Pooja Semwal
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Khanak K Nandolia
- Department of Radio-Diagnosis & Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Jitendra Rohilla
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Lokesh Saini
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan 34200, India.
| | - Sudhir Saxena
- Department of Radio-Diagnosis & Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Sriparna Basu
- Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
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Balcha TE, Woldeyohannes AM, Neknek GA. Brain Magnetic Resonance Imaging Findings in Patients with Developmental Delay in Addis Ababa, Ethiopia. Ethiop J Health Sci 2022; 32:773-780. [PMID: 35950074 PMCID: PMC9341008 DOI: 10.4314/ejhs.v32i4.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background Developmental delay is a major health problem throughout the world causing significant individual disability. Even though physical examination and patient history are the most important and basic evaluations of patients with developmental delay, additional investigations are usually required in supporting or reaching a diagnosis among which is neuroimaging. This study aims to assess brain Magnetic resonance imaging (MRI) patterns in patients presented with developmental delay. Method A retrospective analysis of 164 patients who had undergone brain Magnetic Resonance Imaging (MRI) evaluation for the developmental delay was done. The study was conducted between March to November 2021 G.C at Tikur Anbessa Specialized Hospital (TASH). The patients' clinical history and magnetic resonance imaging reports were reviewed from their medical records. All patients with developmental delay who had brain MRI evaluation at TASH and at one private diagnostic center in Addis Ababa were included in the study. Results A total of 164 patients were included in this study of which 95(57.9%) were male and 69(42.1%) female patients were seen. A total of 120 patients (73.2%) showed abnormal brain MRI studies. Previous neurovascular insults were the most common abnormalities seen in 75(45.7%) patients followed by imaging findings of congenital and developmental abnormalities seen in 20(12.2%) patients. Conclusion Brain MRI is an important input in the evaluation of patients with developmental delay. It can give evidence for the cause of developmental delay, especially in the diagnosis of perinatal/hypoxic-ischemic insults, and congenital and developmental malformations.
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Affiliation(s)
- Tewodros Endale Balcha
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Getachew Assefa Neknek
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Randhawa HS, Bagale S, Umap R, Randhawa J. Brain Magnetic Resonance Imaging-Based Evaluation of Pediatric Patients With Developmental Delay: A Cross-Sectional Study. Cureus 2022; 14:e24051. [PMID: 35573542 PMCID: PMC9095436 DOI: 10.7759/cureus.24051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Developmental delay refers to the insufficient acquisition of age-appropriate developmental milestones. According to World Health Organization, approximately 5% of all children under the age of 14 years display some developmental disability. Aim and objective Our objective was to investigate the prevalence of abnormal magnetic resonance imaging (MRI) brain findings in pediatric patients with non-syndromic developmental delay and to establish the utility of MRI for the same. Material and Method This cross-sectional study prospectively enrolled 60 pediatric patients (three months to 12 years) and data were analyzed using SPSS software. Result Abnormalities on MRI were seen in 80% of cases, with findings indicating perinatal hypoxic insult (36.67%) being the most common, followed by structural abnormalities of the brain (20%). There was no significant difference in the prevalence of abnormal findings when classified by gender or age, or between global developmental delay (GDD) alone and GDD with epilepsy. However, perinatal hypoxic insult was significantly associated with GDD with epilepsy rather than GDD alone (p < 0.01). Conclusion In this study, brain MRI provides a high yield of abnormal findings and helps calculate the relative prevalence of various common etiologies in non-syndromic developmental delay. This study supports several international guidelines that include MRI as the first-line investigation for non-syndromic developmental delay.
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A rare familial rearrangement of chromosomes 9 and 15 associated with intellectual disability: a clinical and molecular study. Mol Cytogenet 2021; 14:47. [PMID: 34607577 PMCID: PMC8489072 DOI: 10.1186/s13039-021-00565-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022] Open
Abstract
Background There are many reports on rearrangements occurring separately in the regions of chromosomes 9p and 15q affected in the case under study. 15q duplication syndrome is caused by the presence of at least one extra maternally derived copy of the Prader–Willi/Angelman critical region. Trisomy 9p is the fourth most frequent chromosome anomaly with a clinically recognizable syndrome often accompanied by intellectual disability. Here we report a new case of a patient with maternally derived unique complex sSMC resulting in partial trisomy of both chromosomes 9 and 15 associated with intellectual disability. Case presentation We characterise a supernumerary derivative chromosome 15: 47,XY,+der(15)t(9;15)(p21.2;q13.2), likely resulting from 3:1 malsegregation during maternal gametogenesis. Chromosomal analysis showed that a phenotypically normal mother is a carrier of balanced translocation t(9;15)(p21.1;q13.2). Her 7-year-old son showed signs of intellectual disability and a number of physical abnormalities including bilateral cryptorchidism and congenital megaureter. The child’s magnetic resonance imaging showed changes in brain volume and in structural and functional connectivity revealing phenotypic changes caused by the presence of the extra chromosome material, whereas the mother’s brain MRI was normal. Sequence analyses of the microdissected der(15) chromosome detected two breakpoint regions: HSA9:25,928,021-26,157,441 (9p21.2 band) and HSA15:30,552,104-30,765,905 (15q13.2 band). The breakpoint region on chromosome HSA9 is poor in genetic features with several areas of high homology with the breakpoint region on chromosome 15. The breakpoint region on HSA15 is located in the area of a large segmental duplication. Conclusions We discuss the case of these phenotypic and brain MRI features in light of reported signatures for 9p partial trisomy and 15 duplication syndromes and analyze how the genomic characteristics of the found breakpoint regions have contributed to the origin of the derivative chromosome. We recommend MRI for all patients with a developmental delay, especially in cases with identified rearrangements, to accumulate more information on brain phenotypes related to chromosomal syndromes. Supplementary Information The online version contains supplementary material available at 10.1186/s13039-021-00565-y.
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Evaluation and Comparison of MRI Findings in Children with Global Developmental Delay and Isolated Neurodevelopmental Delay: A Cross-sectional Study. JOURNAL OF CLINICAL AND BASIC RESEARCH 2021. [DOI: 10.52547/jcbr.5.3.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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9
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Randhawa HS, Randhawa J, Kulkarni A, More A, Jain A. A Very Rare Case of Megalencephalic Leukoencephalopathy With Subcortical Cysts in a Child Born of Non-Consanguineous Marriage in a Non-Predisposed Community. Cureus 2021; 13:e16941. [PMID: 34381660 PMCID: PMC8351400 DOI: 10.7759/cureus.16941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 11/05/2022] Open
Abstract
Megalencephalic leukoencephalopathy (MLC) with subcortical cysts is a very rare white matter disorder characterized predominantly by motor developmental delay and seizures in a child with macrocephaly. Extrapyramidal symptoms, ataxia and mental retardation may also occur. Only a few cases of the disease have been reported worldwide with most of them showing an autosomal recessive pattern of inheritance. In India, most cases have been reported in Agrawal community. Here, we present an interesting case of MLC in a child born in non-Agrawal community to a non-consanguineous marriage. By reporting this case we intend to increase the research horizon and increase the published literature for atypical cases of MLC.
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Affiliation(s)
| | - Jasneet Randhawa
- Department of Resident Medical Services, Fortis Escorts Hospital, Amritsar, IND
| | - Anagha Kulkarni
- Department of Pediatrics, Lokmanya Tilak Municipal General (LTMG) Hospital, Mumbai, IND
| | - Akshay More
- Department of Interventional Radiology, Lokmanya Tilak Municipal General (LTMG) Hospital, Mumbai, IND
| | - Akshay Jain
- Department of Radiology, Government Medical College, Kolhapur, IND
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Alamri A, Aljadhai YI, Alrashed A, Alfheed B, Abdelmoaty R, Alenazi S, Alhashim A, Benini R. Identifying Clinical Clues in Children With Global Developmental Delay / Intellectual Disability With Abnormal Brain Magnetic Resonance Imaging (MRI). J Child Neurol 2021; 36:432-439. [PMID: 33295251 DOI: 10.1177/0883073820977330] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Global developmental delay / intellectual disability are common pediatric conditions. Brain magnetic resonance imaging (MRI), although an important diagnostic tool in the evaluation of these patients, often requires general anesthesia. Recent literature suggests that unnecessary general anesthesia exposure should be avoided in early years because of possible long-term negative neurodevelopmental sequelae. This study sought to identify clinical clues associated with brain MRI abnormalities in children with global developmental delay / intellectual disability in an attempt to provide guidance to physicians on selecting patients who would benefit from an MRI. Retrospective chart review analysis was conducted for patients presenting to a pediatric neurology tertiary care center between 2014 and 2017 for a first clinic evaluation for global developmental delay / intellectual disability. Detailed clinical history and physical examination findings were analyzed and correlated with brain MRI findings. The majority (218/327, 67%) of children referred for evaluation of global developmental delay / intellectual disability underwent complete clinical and radiologic evaluations. Mean age was 37.9 months (±32.5 standard deviation) and 116 were males (53%). Motor deficits were predominant in most subjects (122/218, 56%). Abnormal MRI findings were observed in 153 children (70%), with the most prevalent abnormalities noted within the white matter (104/153, 68%), corpus callosum (77/153, 50%), and the hippocampus (50/153, 33%). Abnormal MRI findings were prevalent in children with predominant motor delay (84, 69%) and cognitive disability (3, 100%) as well as those with visual and hearing impairment (P < .05). The presence of facial dysmorphisms (57/71, P = .02); cranial nerve abnormalities (79/100; P = .007) and abnormal reflexes (16, P = .01) on examination also correlated significantly with increased MRI abnormalities.
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Affiliation(s)
- Abdullah Alamri
- Department of Pediatrics, College of Medicine, 48102Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yaser I Aljadhai
- Department of Neuroimaging and Intervention, Medical Imaging Administration, 37849King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdullah Alrashed
- Department of Neuroimaging and Intervention, Medical Imaging Administration, 37849King Fahad Medical City, Riyadh, Saudi Arabia
| | - Bandar Alfheed
- Department of Neuroimaging and Intervention, Medical Imaging Administration, 37849King Fahad Medical City, Riyadh, Saudi Arabia
| | - Roba Abdelmoaty
- Pediatric Neurology Department, National Neuroscience Institute, 37849King Fahad Medical City, Riyadh, Saudi Arabia
| | - Shoaa Alenazi
- Pediatric Neurology Department, National Neuroscience Institute, 37849King Fahad Medical City, Riyadh, Saudi Arabia
| | - Aqeela Alhashim
- Pediatric Neurology Department, National Neuroscience Institute, 37849King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ruba Benini
- Pediatric Neurology Division, Sidra Medicine, Doha, Qatar
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Jussila MP, Olsén P, Niinimäki J, Suo-Palosaari M. Is Brain MRI Needed in Diagnostic Evaluation of Mild Intellectual Disability? Neuropediatrics 2021; 52:27-33. [PMID: 33111301 DOI: 10.1055/s-0040-1716902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The purpose of our study was to suggest an imaging strategy and guidelines for the selection of the children with mild intellectual disability (ID) for magnetic resonance imaging (MRI), to avoid unnecessary imaging. METHODS The brain MRIs and patient reports of 471 children were reviewed for the imaging findings and ID severity. The correlation between the clinical and brain MRI findings was analyzed in the 305 children with mild ID. RESULTS Thirty-eight (12.5%) of the children with mild ID had significant abnormal brain MRI findings. Thirty-five of these had other neurological symptoms or diseases in addition to ID, which were an indication for brain MRI. In the logistic regression analysis, seizures (in patients without an epilepsy diagnosis), epilepsy, movement disorders, dysmorphia, encephalitis, traumatic brain injury, and abnormal head size were statistically significant symptoms or comorbidities associated with abnormal MRI findings. Only three children (1.0%) with mild ID had a significant MRI finding without any other clinical symptoms or disease. CONCLUSION Routine MRI in children with mild ID without specific neurological symptoms, dysmorphic features, or related diseases is not suggested for revealing an etiology of mild ID. Since children with ID usually need to be sedated for MRI, routine imaging in the diagnostic evaluation of mild ID should be carefully considered. Clinical examination, other symptoms, and related diseases should be carefully assessed to decide the need for MRI.
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Affiliation(s)
- Miro Pekka Jussila
- Department of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics and Technology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Päivi Olsén
- Department of Pediatrics and Adolescence, Oulu University Hospital and PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Department of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics and Technology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Maria Suo-Palosaari
- Department of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics and Technology, Oulu University Hospital and University of Oulu, Oulu, Finland
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Habibullah H, Albaradie R, Bashir S. MRI Evaluation of Global Developmental Delay: A Retrospective Study. DUBAI MEDICAL JOURNAL 2020. [DOI: 10.1159/000506900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction: Global developmental delay (GDD) is defined as a significant delay in one or more developmental domains. Aims and Objectives: To study the prevalence of normal and abnormal magnetic resonance imaging (MRI) in pediatric patients presenting with GDD, and how abnormal MRI helps in the diagnosis of children with GDD. Materials and Methods: This was a retrospective observational study conducted at the King Fahad Specialist Hospital Dammam. MRI of the brain was conducted on 170 patients who were referred by the Pediatric Neurology Department between February 2016 and April 2018. Results: Normal MRI findings were seen in 45.3% and 54.7% had abnormal findings. The ventricles and white matter, mainly the corpus callosum, were the most commonly affected anatomical structures. In 15 (16%) patients, MRI enabled a direct diagnosis, and in 22 (23.6%) MRI suggested a diagnosis which was confirmed by further investigation. Conclusion: The clinical diagnosis of GDD should not be the end point, but rather a springboard for an effective search for causal factors. MRI is the best investigation with a high yield in such patients.
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Murias K, Moir A, Myers KA, Liu I, Wei XC. Systematic review of MRI findings in children with developmental delay or cognitive impairment. Brain Dev 2017; 39:644-655. [PMID: 28457518 DOI: 10.1016/j.braindev.2017.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/02/2017] [Accepted: 04/03/2017] [Indexed: 10/19/2022]
Abstract
AIM To summarize the reported rates of magnetic resonance imaging (MRI) abnormalities in children with isolated global developmental delay (GDD) or intellectual disability (ID). METHOD A literature search was conducted using electronic databases for studies reporting the rate of MRI abnormalities in children with clinically diagnosed ID or GDD and no other neurological signs, symptoms, or previously determined aetiology. All investigations with participants from birth to 18years were considered. Study quality was evaluated using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) critical appraisal checklist items. RESULTS Eighteen cross sectional, and 11 case-controlled studies adhered to inclusion criteria. Reported rates of abnormalities ranged from 0% to 98%. When all subjects with developmental delay from all papers were considered (n=2299) the total percentage found to have abnormalities was 38%. Abnormalities led to an etiological diagnosis for delay in 7.9% of cases. INTERPRETATION Definitions of abnormalities varied widely between studies, and drastically different rates of abnormalities are reported. Currently available evidence is not of sufficient quality to make firm recommendations on the use of neuroimaging in ID or GDD but MRI should be considered for children that do not have a diagnosis after thorough clinical evaluation.
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Affiliation(s)
- Kara Murias
- Neurolab, Departments of Psychology and Clinical Neurosciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; Paediatric Neurology, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada.
| | - Andrea Moir
- Neurolab, Departments of Psychology and Clinical Neurosciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Kenneth Alexis Myers
- Paediatric Neurology, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
| | - Irene Liu
- Neurolab, Departments of Psychology and Clinical Neurosciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Xing-Chang Wei
- Diagnostic Imaging, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
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Ravindran M, Amborium P, Umamaheswari B, Ramani G, Ninan B. Does diffusion restriction changes in magnetic resonance imaging predict neurological outcome in neonatal seizures? J Pediatr Neurosci 2016; 10:326-30. [PMID: 26962336 PMCID: PMC4770642 DOI: 10.4103/1817-1745.174434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Neonatal seizures are a common manifestation of brain dysfunction. Neonatal magnetic resonance imaging (MRI) has rapidly become the study of choice for the evaluation of central nervous systems disorders in newborns. According to a study conducted in Wilhelmina Children's Hospital, University Medical Center Utrecht, diffusion Restriction (DR) changes in the MRI is a good indicator of cell dysfunction (reversible or irreversible) within one week of insult. OBJECTIVES The main aim of this study was to find the association of DR changes in MRI of brain for neonatal seizures with long term neurodevelopment outcome. METHODS This is a retrospective observational study conducted in Sri Ramachandra University. Retrospective data was collected for the time period of January 2010 to December 2011 from medical records department (MRD) for patient data, neonatal intensive care unit and reports from PACS for MRI images and the Karthikeyan child development unit for their developmental follow up reports. RESULTS Comparison of composite score for various domains with DR changes was done with a t-test and comparison of babies with developmental delay and DR changes with Chi-square test. MRI DR changes with developmental outcome in different domains namely cognition, language-receptive/expressive, fine and gross motor was studied. There is no statistical significance among those who have DR changes and with those who do not have DR changes. CONCLUSION Though diffusion restriction changes in MRI may not predict adverse long term neuro developmental outcome, they can be of use with regards to individual etiological profile as in stroke. Larger group study and long term follow up is required to substantiate these findings.
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Affiliation(s)
- Manipriya Ravindran
- Department of Neonatology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
| | - Prakash Amborium
- Department of Neonatology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
| | - B Umamaheswari
- Department of Neonatology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
| | - Gokul Ramani
- Department of Neonatology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
| | - Binu Ninan
- Department of Neonatology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
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Ali AS, Syed NP, Murthy GSN, Nori M, Abkari A, Pooja BK, Venkateswarlu J. Magnetic resonance imaging (MRI) evaluation of developmental delay in pediatric patients. J Clin Diagn Res 2015; 9:TC21-4. [PMID: 25738057 DOI: 10.7860/jcdr/2015/11921.5478] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 12/09/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Developmental delay is defined as significant delay in one or more developmental domains. Magnetic Resonance Imaging (MRI) is the best modality to investigate such patients. Evaluation of a child with developmental delay is important not only because it allows early diagnosis and treatment but also helpful for parental counseling regarding the outcome of their child and to identify any possible risk of recurrence in the siblings. Thus this study was undertaken to evaluate the developmental delay in Indian children which will help the clinicians in providing an estimation of the child's ultimate developmental potential and organize specific treatment requirement and also relieve parental apprehension. AIMS AND OBJECTIVES To study the prevalence of normal and abnormal MRI in pediatric patients presenting with developmental delay and further categorize the abnormal MRI based on its morphological features. MATERIALS AND METHODS It is a prospective, observational & descriptive study of MRI Brain in 81 paediatric patients (46 Males and 35 Females), aged between three months to 12 years; presenting with developmental delay in Deccan College of Medical Sciences, Hyderabad; over a period of three years (Sept 2011 to Sept 2014). MRI brain was done on 1.5T Siemens Magnetom Essenza & 0.35T Magnetom C with appropriate sequences and planes after making the child sleep/sedated/ anesthetized. Various anatomical structures like Ventricles, Corpus callosum, etc were systematically assessed. The MRI findings were divided into various aetiological subgroups. RESULTS Normal MRI findings were seen in 32% cases and 68% had abnormal findings of which the proportion of Traumatic/ Neurovascular Diseases, Congenital & Developmental, Metabolic and Degenerative, neoplastic and non specific were 31%, 17%, 10%, 2.5% and 7.5% respectively. The ventricles and white matter mainly the corpus callosum were the most commonly affected anatomical structures. The diagnostic yield was found to be 68% and higher yield was seen in patients presenting with developmental delay plus. CONCLUSION The clinical diagnosis of developmental delay should not be the end point, but rather a springboard for an effective search for causal factors. MRI is the best investigation with a high yield in such patients.
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Affiliation(s)
- Althaf S Ali
- Assistant Professor, Department of Radiology, Deccan College of Medical Sciences , Hyderabad, Telangana, India
| | - Naziya P Syed
- Assistant Professor, Department of Anatomy, Deccan College of Medical Sciences , Hyderabad, Telangana, India
| | - G S N Murthy
- Professor, Department of Radiology, Deccan College of Medical Sciences , Hyderabad, Telangana, India
| | - Madhavi Nori
- Associate Professor, Department of Radiology, Deccan College of Medical Sciences , Hyderabad, Telangana, India
| | - Anand Abkari
- Professor, Department of Radiology, Deccan College of Medical Sciences , Hyderabad, Telangana, India
| | - B K Pooja
- Senior Resident, Department of Radiology, Deccan College of Medical Sciences , Hyderabad, Telangana, India
| | - J Venkateswarlu
- Professor and Head, Department of Radiology, Deccan College of Medical Sciences , Hyderabad, Telangana, India
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