Volume-Based Morphometry of Brain MR Images in Adolescent Idiopathic Scoliosis and Healthy Control Subjects

BACKGROUND AND PURPOSE: Adolescent idiopathic scoliosis (AIS) is a spinal deformity with unknown cause. Previous studies have suggested that subclinical neurologic abnormalities are associated with AIS. The objective of this prospective study was to characterize systematically neuroanatomic changes in patients with left thoracic AIS vs right thoracic AIS and healthy control subjects by using volume-based morphometry. MATERIALS AND METHODS: Our current study involved 9 girls with left thoracic AIS and 20 girls with right thoracic AIS vs 11 and 17 matched female control subjects, respectively. Voxel-based morphometry (VBM), deformation-based morphometry (DBM), and tensor-based morphometry (TBM) were used to analyze the MR images aligned with a specific brain template of local adolescent girls. The statistical t test was used in VBM and TBM, and the Hotelling T2 test was applied in DBM. RESULTS: Using VBM, we found statistically significant differences (P < .05) in the white matter attenuation of the genu of the corpus callosum and left internal capsule (left thoracic AIS < control subjects). In contrast, no significant differences were observed between patients with right thoracic AIS and control subjects. CONCLUSIONS: White matter attenuation in the corpus callosum and left internal capsule, responsible for interhemispheric communication and conduit of the corticothalamic projectional fibers, respectively, were found to be significantly lower in left thoracic AIS compared with control subjects; however, this was not the case in right thoracic AIS. Confirmation of the findings is required in future research, which needs to evaluate the relationship of white matter abnormality to curve laterality, pathogenesis, and prognosis in patients with AIS, with biologic significance and possible therapeutic correction.

[1]  E. Bleck,et al.  Balance reactions and eye–hand coordination in idiopathic scoliosis , 1986, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[2]  E. Fogarty,et al.  Left thoracic curve patterns and their association with disease. , 1999, Spine.

[3]  Normand Teasdale,et al.  Postural imbalance in non-treated adolescent idiopathic scoliosis at different periods of progression , 2008, European Spine Journal.

[4]  Karl J. Friston,et al.  A unified statistical approach for determining significant signals in images of cerebral activation , 1996, Human brain mapping.

[5]  Hiroshi Yamamoto,et al.  Etiology of Idiopathic Scoliosis , 1984, Clinical orthopaedics and related research.

[6]  Alan C. Evans,et al.  A fully automatic and robust brain MRI tissue classification method , 2003, Medical Image Anal..

[7]  G. Gauchard,et al.  Influence of Different Types of Progressive Idiopathic Scoliosis on Static and Dynamic Postural Control , 2001, Spine.

[8]  Karl J. Friston,et al.  Human Brain Function , 1997 .

[9]  Richard S. J. Frackowiak,et al.  Navigation-related structural change in the hippocampi of taxi drivers. , 2000, Proceedings of the National Academy of Sciences of the United States of America.

[10]  Karl J. Friston,et al.  Identifying Global Anatomical Differences: Deformation-Based Morphometry , 1998, NeuroImage.

[11]  R. Herman,et al.  Idiopathic Scoliosis and the Central Nervous System: A Motor Control Problem: The Harrington Lecture, 1983 Scoliosis Research Society , 1985, Spine.

[12]  R. Thatcher.  Functional neuroimaging : technical foundations , 1994 .

[13]  P. Revell,et al.  Morphometry , 1983 .

[14]  N. Byl,et al.  Complex balance reactions in different sensory conditions: Adolescents with and without idiopathic scoliosis , 1993, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[15]  C. Chang,et al.  The sulcal pattern of the Chinese brain , 1941 .

[16]  R. Castelein,et al.  The Pathogenesis of Adolescent Idiopathic Scoliosis: Review of the Literature , 2008, Spine.

[17]  W. Feller,et al.  The fundamental limit theorems in probability , 1945 .

[18]  P. Dangerfield,et al.  Concepts on the pathogenesis of adolescent idiopathic scoliosis. Bone growth and mass, vertebral column, spinal cord, brain, skull, extra-spinal left-right skeletal length asymmetries, disproportions and molecular pathogenesis. , 2008, Studies in Health Technology and Informatics.

[19]  Armin Curt,et al.  Preoperative radiological and electrophysiological evaluation in 100 adolescent idiopathic scoliosis patients , 2003, European Spine Journal.

[20]  N. Byl,et al.  Postural imbalance and vibratory sensitivity in patients with idiopathic scoliosis: implications for treatment. , 1997, The Journal of orthopaedic and sports physical therapy.

[21]  D. Louis Collins,et al.  Three-dimensional correlative imaging: applica-tions in human brain mapping , 2000 .

[22]  T. Smit,et al.  The pathogenesis of Adolescent Idiopathic Scoliosis , 2007 .

[23]  D. Collins,et al.  Automatic 3D Intersubject Registration of MR Volumetric Data in Standardized Talairach Space , 1994, Journal of computer assisted tomography.

[24]  B. Petruson,et al.  A study of labyrinthine function in patients with adolescent idiopathic scoliosis. I. An electro-nystagmographic study. , 1979, Acta orthopaedica Scandinavica.

[25]  Karl J. Friston,et al.  Voxel-Based Morphometry—The Methods , 2000, NeuroImage.

[26]  Stuart L. Weinstein,et al.  The Pediatric Spine: Principles and Practice , 2001 .

[27]  R. Maenza.  Juvenile and adolescent idiopathic scoliosis: magnetic resonance imaging evaluation and clinical indications , 2003, Journal of pediatric orthopedics. Part B.

[28]  Alan C. Evans,et al.  Structural maturation of neural pathways in children and adolescents: in vivo study. , 1999, Science.

[29]  N. Miller,et al.  Cause and natural history of adolescent idiopathic scoliosis. , 1999, The Orthopedic clinics of North America.

[30]  Stephen M Smith,et al.  Fast robust automated brain extraction , 2002, Human brain mapping.

[31]  J. Dorgan.  The Pediatric Spine; Principles and Practice , 1994 .

[32]  L. Lindström,et al.  Postural Control in Siblings to Scoliosis Patients and Scoliosis Patients , 1988, Spine.

[33]  M. Yekutiel,et al.  Proprioceptive Function in Children With Adolescent Idiopathic Scoliosis , 1981, Spine.

[34]  K. Mazda,et al.  Asymmetric otolith vestibulo-ocular responses in children with idiopathic scoliosis. , 1998, The Journal of pediatrics.

[35]  R. Herman,et al.  IDIOPATHIC SCOLIOSIS AND THE CENTRAL NERVOUS SYSTEM: A MOTOR CONTROL PROBLEM , 1985 .

[36]  Alan C. Evans,et al.  A nonparametric method for automatic correction of intensity nonuniformity in MRI data , 1998, IEEE Transactions on Medical Imaging.

[37]  R G Burwell,et al.  Etiologic theories of idiopathic scoliosis: the breaking of bilateral symmetry in relation to left-right asymmetry of internal organs, right thoracic adolescent idiopathic scoliosis (AIS) and vertebrate evolution. , 2006, Studies in health technology and informatics.

[38]  E. Fogarty,et al.  Equilibrial dysfunction in scoliosis--cause or effect? , 1989, Journal of spinal disorders.

[39]  J. Shellshear.  The Brain of the Aboriginal Australian. A Study in Cerebral Morphology , 1937 .

[40]  H. G. Zadeh,et al.  Absent superficial abdominal reflexes in children with scoliosis. An early indicator of syringomyelia. , 1995, The Journal of bone and joint surgery. British volume.