title: Brain magnetic resonance imaging of siblings from families with two or more children with learning or intellectual disabilities and need for full-time special education.
abstract: BACKGROUND
  Several factors are involved in determining a child's need for special education (SE). Thus, the value of brain magnetic resonance imaging (MRI) for subjects with learning and intellectual disabilities is uncertain.
  
  
  OBJECTIVE
  To evaluate the usefulness of MRI in the diagnostic process of siblings with learning and intellectual disabilities and need for full-time SE.
  
  
  METHODS
  Altogether, 119 siblings (mean age 11.9 years) from families in which two or more children attended/had previously attended full-time SE underwent prospective brain MRI. SE grouping included three levels, from specific learning disabilities (level 1) to global intellectual disabilities (level 3). Forty-three controls (level 0, mean age 12.0 years) attended mainstream education groups. Signal intensity and structural abnormalities were analyzed, and areas of the cerebrum, posterior fossa, corpus callosum, vermis and brain stem, and diameters of the corpus callosum were measured. In analyses, all area measurements were calculated in proportion to the total inner skull area.
  
  
  RESULTS
  Abnormal finding in MRI was more common for siblings (n=62; 52%) in SE (58% for level 3; 49% for level 2; 35% for level 1) than for controls (n=13; 16%). The siblings showed enlarged supra- (P<0.001) and infratentorial (P=0.015) cerebrospinal fluid (CSF) spaces and mild corpus callosum abnormalities (P=0.003) compared to controls. Siblings in SE had smaller inner skull area than controls (P<0.001). Further, the relative area of the mesencephalon (P=0.027) and the diameter of the body of the corpus callosum (P=0.015) were significantly smaller than in controls. In binary logistic regression analysis, enlarged supratentorial CSF spaces increased the probability of SE (odds ratio 4.2; P=0.023).
  
  
  CONCLUSIONS
  Subjects with learning and intellectual disabilities commonly have more MRI findings than controls. Enlarged supratentorial CSF spaces were a frequent finding in siblings in full-time SE.
authors.affiliation: Child Neurology, HUCH Department of Pediatric and Adolescent Medicine, Helsinki, Finland. minna.mannerkoski@hus.fi
authors.forename: M
authors.initials: M
authors.lastname: Mannerkoski
authors.forename: H
authors.initials: H
authors.lastname: Heiskala
authors.forename: R
authors.initials: R
authors.lastname: Raininko
authors.forename: L
authors.initials: L
authors.lastname: Aberg
authors.forename: S
authors.initials: S
authors.lastname: Sarna
authors.forename: K
authors.initials: K
authors.lastname: Wirtavuori
authors.forename: T
authors.initials: T
authors.lastname: Autti
mesh_terms: D001921:Brain / Q000473:pathology*; D002648:Child; D004519:Education, Special; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000235:genetics / Q000473:pathology* / Q000523:psychology; D007360:Intelligence; D007859:Learning Disabilities / Q000235:genetics / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D035781:Siblings