title: Reduced ventral cingulum integrity and increased behavioral problems in children with isolated optic nerve hypoplasia and mild to moderate or no visual impairment.
abstract: OBJECTIVE
  To assess the prevalence of behavioral problems in children with isolated optic nerve hypoplasia, mild to moderate or no visual impairment, and no developmental delay. To identify white matter abnormalities that may provide neural correlates for any behavioral abnormalities identified.
  
  
  METHODS
  Eleven children with isolated optic nerve hypoplasia (mean age 5.9 years) underwent behavioral assessment and brain diffusion tensor imaging, Twenty four controls with isolated short stature (mean age 6.4 years) underwent MRI, 11 of whom also completed behavioral assessments. Fractional anisotropy images were processed using tract-based spatial statistics. Partial correlation between ventral cingulum, corpus callosum and optic radiation fractional anisotropy, and child behavioral checklist scores (controlled for age at scan and sex) was performed.
  
  
  RESULTS
  Children with optic nerve hypoplasia had significantly higher scores on the child behavioral checklist (p<0.05) than controls (4 had scores in the clinically significant range). Ventral cingulum, corpus callosum and optic radiation fractional anisotropy were significantly reduced in children with optic nerve hypoplasia. Right ventral cingulum fractional anisotropy correlated with total and externalising child behavioral checklist scores (r = -0.52, p<0.02, r = -0.46, p<0.049 respectively). There were no significant correlations between left ventral cingulum, corpus callosum or optic radiation fractional anisotropy and behavioral scores.
  
  
  CONCLUSIONS
  Our findings suggest that children with optic nerve hypoplasia and mild to moderate or no visual impairment require behavioral assessment to determine the presence of clinically significant behavioral problems. Reduced structural integrity of the ventral cingulum correlated with behavioral scores, suggesting that these white matter abnormalities may be clinically significant. The presence of reduced fractional anisotropy in the optic radiations of children with mild to moderate or no visual impairment raises questions as to the pathogenesis of these changes which will need to be addressed by future studies.
authors.affiliation: Developmental Endocrinology Research Group, Clinical and Molecular Genetics Unit, University College London Institute of Child Health, London, United Kingdom.
authors.forename: Emma A
authors.initials: EA
authors.lastname: Webb
authors.forename: Michelle A
authors.initials: MA
authors.lastname: O'Reilly
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Clayden
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Seunarine
authors.forename: Naomi
authors.initials: N
authors.lastname: Dale
authors.forename: Alison
authors.initials: A
authors.lastname: Salt
authors.forename: Chris A
authors.initials: CA
authors.lastname: Clark
authors.forename: Mehul T
authors.initials: MT
authors.lastname: Dattani
mesh_terms: D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications*; D002675:Child, Preschool; D003337:Corpus Callosum / Q000473:pathology; D056324:Diffusion Tensor Imaging; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009900:Optic Nerve / Q000473:pathology*; D014786:Vision Disorders / Q000150:complications* / Q000473:pathology*
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