Di Hu1, Ningning Zhang1, Huiying Kang1, Xiaolu Tang1, Yanqiu Lv1, Kaining Shi2, and Yun Peng1
1Beijing Children's hospital, Beijing, China, People's Republic of, 2Imaging Systems Clinical Science of Philips Healthcare, Beijing, China, People's Republic of
Synopsis
Our study is the first to evaluate relationship between emotion disorders and cognitive change in microstructure with hemophilia A, suggesting that the assessment of non-Gaussian directional diffusion using DKI provides more sensitive information about tissue microstructural changes than conventional image method and traditional psychological test. Background
Hemophilia A is an X-linked hereditary bleeding disorder caused by deficiency of coagulation factor VIII. Replacement therapy could improve the medical situation but not for patient-perceived well-being and function. Emotional disorders occur frequently in Hemophilia A; however the neural basis remained unclear. Based on prevailing theory that emotion and cognitive demonstrated the same pathological basis and function of brain regions, we chose regions of interests to evaluate relationship between emotion disorders and cognitive change in microstructure with hemophilia A.
1-3Objective
To investigate non-Gaussian water diffusion using diffusional kurtosis imaging(DKI) to assess emotional disorders on brain microstructural changes in frontal, cingulate cortex, hippocampus, insula and amygdala of children with hemophilia A compared to controls combined with clinical data and psychological tests.
Materials and Methods
In this preliminary study, 3D T1-weighted magnetization and DKI images were acquired at 3T from children with hemophilia A(n=22) and controls(n=22). Regression analysis of the frontal, cingulate, hippocampus, insula and amygdala region of interest (ROI) was conducted. Clinical data of children with hemophilia A were collected, included clinical course, disease degree, first time of preventive treatment, age at diagnosis, age of first hemorrhage and frequency of joint bleeding. Results of psychological tests including self-consciousness scale, Wisconsin card sorting test and Canadian hemophilia outcomes-kids life assessment tool (CHO-KLAT) were also collected. Paired t-test was used to analyze the differences of ROI measurements between two groups, and Spearman test was used to analyze the correlation between ROI and psychological test or clinical data.
Results
Fractional anisotropy(FA) in left middle cingulate and right hippocampus; mean diffusion (MD) in frontal lobe, right anterior cingulate and right middle cingulate; axial diffusion(AD) in frontal and axial kurtosis(AK) in left post cingulate showed varying degrees increases in the ROI compared to controls(P < 0.05).MD of frontal lobe and right middle cingulate had a positive correlation with clinical course(P < 0.05). AK of left post cingulate and age of first hemorrhage had a positive correlation (P < 0.05). FA of right hippocampus and social part score of Self-consciousness scale had a positive correlation (p < 0.01).
Conclusion
Our study is the first to evaluate relationship between emotion disorders and cognitive change in microstructure with hemophilia A, suggesting that the assessment of non-Gaussian directional diffusion using DKI provides more sensitive information about tissue microstructural changes than conventional image method and traditional psychological test. DKI may be able to finding abnormal early, permitting possible earlier psychological intervention with treatments for children with hemophilia A. These findings support the prevailing theory that emotion and cognitive demonstrated the same pathological basis and function of brain regions, and they could interacted on each other.
1-3Acknowledgements
We thank Dr. Kaining Shi for his technique support. References
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2.Helpern JA, Adisetiyo V,Falangola MF, et al. Preliminary evidence of altered gray and white matter microstructural development in the frontal lobe of adolescents with attention-deficit hyperactivity disorder:a diffusional kurtosis imaging study.J Magn Reson lmaging,2011,33(1):17-23.
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