全面性发育迟缓患儿大脑白质纤维束微结构异常的扩散峰度成像研究OA北大核心CSTPCD

Objective: Diffusion kurtosis imaging (DKI) was employed to evaluate microstructural changes in the white matter fiber tracts of the brain in children with global developmental delay (GDD). Materials and Methods: This prospective study included 37 children with GDD in the experimental group and 32 age- and gender-matched healthy children in the control group. All participants underwent DKI sequence scanning, and diffusion tensor and kurtosis tensor parameters were obtained following post-processing. The parameters were compared between the two groups using tract-based spatial statistics (TBSS). Spearman correlation analysis was conducted between the parameter values within the fiber bundles showing significant intergroup differences and the neurodevelopmental scores of children with GDD. Results: Compared to the control group, the mean diffusivity (MD) of the right corticospinal tract and right anterior thalamic radiation were significantly increased in the GDD group (all P<0.05); the radial diffusivity (RD) of the bilateral anterior thalamic radiation, bilateral corticospinal tract, and right superior longitudinal fasciculus were also significantly increased (all P<0.05). Additionally, the radial kurtosis (RK) in the GDD group was significantly decreased (all P<0.05), including the bilateral anterior thalamic radiations, bilateral corticospinal tracts, bilateral inferior fronto-occipital fasciculi, bilateral superior longitudinal fasciculi, bilateral inferior longitudinal fasciculi, forceps minor, left uncinate fasciculus, and right cingulum. Correlation analysis revealed that the average RK values of the left inferior longitudinal fasciculus and left uncinate fasciculus were positively correlated with adaptive behavior scores (r=0.349, 0.486, respectively; all P<0.05); the average RK value of the left uncinate fasciculus was positively correlated with fine motor and personal-social behavior scores (r=0.365, 0.590, respectively; all P<0.05). Conclusions: The DKI technique can detect abnormalities in the microstructure of the white matter fiber bundles in children with GDD, providing useful insights into the potential pathophysiological mechanisms of GDD.