title: Cognitive functions correlate with diffusion tensor imaging metrics in patients with spina bifida cystica.
abstract: OBJECTIVE
  Spina bifida cystica (SBC) is a group of neurodevelopmental defects caused by improper neural tube closure, which may be responsible for deficits in cognitive functions. The purpose of this study was to examine changes in normal appearing deep gray and white matter brain regions in SBC patients compared with controls through diffusion tensor imaging (DTI) and correlate these changes with neuropsychometric tests.
  
  
  METHODS
  Conventional magnetic resonance imaging and neuropsychometric tests were performed on 13 patients and ten controls. DTI-derived fractional anisotropy (FA) and mean diffusivity (MD) were quantified in different brain regions in controls and patients.
  
  
  RESULTS
  Significantly decreased FA was observed in caudate nuclei, putamen, genu, splenium, and increased FA was found in middle cerebellar peduncle (MCP) in patients compared with controls. We observed significantly increased MD in genu and splenium. However, increased MD was found in fornix of patients compared with controls. Majority of neuropsychological tests were found to be significantly impaired and some of these showed significant correlation with DTI metrics in genu, splenium, and MCP in these patients.
  
  
  CONCLUSIONS
  We conclude that DTI metrics are significantly abnormal in deep gray matter nuclei, genu, splenium, and MCP in SBC patients and may provide microstructural basis for neuropsychological abnormalities in these patients.
authors.affiliation: Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.forename: Arti
authors.initials: A
authors.lastname: Srivastava
authors.forename: Shruti
authors.initials: S
authors.lastname: Agarwal
authors.forename: Sanjay
authors.initials: S
authors.lastname: Behari
authors.forename: Gyanendra K
authors.initials: GK
authors.lastname: Malik
authors.forename: Ram K S
authors.initials: RK
authors.lastname: Rathore
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D001921:Brain / Q000002:abnormalities*; D002648:Child; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016137:Spina Bifida Cystica / Q000150:complications / Q000473:pathology*