Purpose
To test the hypotheses that (hypothesis 1) fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values continue to change in late childhood and adolescence and (hypothesis 2) less mature WM regions have a higher rate of change than white matter (WM) regions that are relatively more mature.
Methods
Eighty-seven healthy children (50 girls; mean age, age range, 4.2 – 17.7 years) underwent 6 direction diffusion tensor imaging on a 3T MR scanner. Three neuroradiologists independently drew regions of interest (ROIs) in 10 WM regions and measured FA and ADC values. To test hypothesis 1, these values were compared with patient age using linear regression analysis (p < 0.05). To test hypothesis 2, we determined whether regions with lower FA and higher ADC in the 4–7 year old group had a higher slope of FA increase and ADC decrease over the entire age range. For this, we used linear regression analysis (p < 0.05) and curve fitting.
Results
Hypothesis 1: Increases of FA with age were noted in all WM regions and were statistically significant in the 6 regions. Decreases of ADC values with age were noted in all brain regions except the genu of corpus callosum. In all other regions except the splenium of corpus callosum, the decreases were statistically significant.
Hypothesis 2: The relationship of FA in the 4–7 year-old subjects and FA increase in the entire population was best described by a linear equation. The rate of age-related FA increase tended to be greater with lower initial FA (r = −0.384, p = 0.271).
The relationship of ADC in the 4–7 year-old subjects and ADC decrease in the entire population was best described by a second order equation. The rate of age-related ADC decrease tended to be greater with higher initial ADC (r = 0.846, p = 0.001). For the ADC values of 100 or less at age 4–7 years, the rate of ADC change with age tended to be decrease as initial ADC increased.
Conclusions
In general, both hypotheses were verified. Overall, FA values continue to increase and ADC values continue to decrease during childhood and adolescence, with the most rapid changes seen in WM regions that were least mature in the first few years of the study period.