MRI Morphometric Study and Correlation with Cognitive Functions in Young Adults Shunted for Congenital Hydrocephalus Related to Spina bifida

Abstract

We studied the morphometric MRI findings and their correlation with cognitive functions in a population of 10 young adults shunted for congenital hydrocephalus related to spina bifida. Morphometric MRI analysis included measurement of the ventricular dilatation index, frontal and occipital parenchymal thickness and the size of the corpus callosum. The neuropsychological status was evaluated, notably to look for a discrepancy between verbal and performance skills, a finding which has previously been described in hydrocephalic children. We also investigated whether there was a correlation between cognitive function and cerebral morphometric indexes. In each case, MRI demonstrated the structural changes associated with the Chiari II malformation. The size of the lateral ventricles varied, ranging from important dilatation to small ventricles. Six patients had only partial development of the corpus callosum. All patients had a normal global IQ. In our population of young adults, we did not observe any discrepancy between verbal and visuospatial performances as has been described in children with hydrocephalus. We found no relationship between cognitive function and ventricle dilatation or parenchymal thickness or between the size of the corpus callosum and callosal transfer.

Parent Ratings of Executive Functioning in Children with Shunted Hydrocephalus

“…Neither group endorsed items suggestive of significant clinical depression on the Children’s Depression Inventory. As expected, based on prior research [16,17] there was a significant difference between IQ scores, with the SH group presenting significantly below their peers. See table 1 for results.…”

Prospective memory in adults with spina bifida

“…Although individuals with more shunt revisions had poorer prospective and immediate episodic memory, the young adults with SBM and fewer revisions in Dennis et al [5] still showed poor memory. Young adults with SBM who have nonfunctioning shunts or non-shunted ventriculomegaly show improved memory after shunt treatment ([21]; although [22] found no relation between memory and magnetic resonance imaging ventricular dilatation, a measure of concurrent hydrocephalus, in a small sample of average-intelligence young adults with hydrocephalus). Thus, some memory deficits may be exacerbated by an increased number of lifetime shunt revisions, a marker for unstable hydrocephalus [5].…”

Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 10: Change in ventricle size as a measurement of effective treatment of hydrocephalus

“…Those papers not used in the analysis were excluded for multiple reasons including the following: reports combining adult and pediatric patient populations without reporting pediatric patients separately; 3,7,[9][10][11]15 a review of other studies; 20 and a technical report. 21 Jain et al 14 reported the effect of valve design on repeated operation, not on effectiveness of treatment.…”