title: Elevated mean diffusivity in widespread brain regions in congenital central hypoventilation syndrome.
abstract: OBJECTIVE
  To investigate whether mean diffusivity (MD) values are altered in brain areas underlying cardiovascular and respiratory control in congenital central hypoventilation syndrome (CCHS).
  
  
  METHODS
  Conventional and diffusion tensor imaging were performed in 15 CCHS and 30 control subjects, using a 3.0-Tesla MRI unit. Mean diffusivity maps were calculated from diffusion-weighted images, spatially normalized, smoothed, and compared between groups using analysis of covariance at each voxel with age as covariate. Global mean MD values of gray and white matter were determined in individual subjects and compared between groups and with age.
  
  
  RESULTS
  Increased MD values appeared in CCHS over control subjects within multiple areas influencing breathing and cardiovascular control, including the midbrain, pons, and dorsal and ventral medulla. Other altered sites included cerebellar cortex and deep nuclei, basal ganglia, basal forebrain, and temporal and frontal cortices. Global mean MD values for gray and white matter did not differ between groups; however, gray matter MD values significantly increased with age (P < 0.02) in CCHS patients only.
  
  
  CONCLUSIONS
  Increased MD values suggest regional alterations or injury; affected areas include brainstem sites classically associated with autonomic and respiratory control. Other altered regions mediate additional physiological characteristics impaired in CCHS.
authors.affiliation: Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1763, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Paul M
authors.initials: PM
authors.lastname: Macey
authors.forename: Mary A
authors.initials: MA
authors.lastname: Woo
authors.forename: Jeffry R
authors.initials: JR
authors.lastname: Alger
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Harper
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001921:Brain / Q000473:pathology*; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020182:Sleep Apnea, Central / Q000151:congenital* / Q000473:pathology*