title: Volumetric changes in cerebellar regions in adolescent idiopathic scoliosis compared with healthy controls.
abstract: BACKGROUND
  Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformation that affects adolescents, especially girls. The etiopathogenesis of this disease remains uncertain, and studies have been carried out to understand its cause and related organs. Previous studies suggest that AIS is probably related to the cerebellum dysfunction, which could also be related to the abnormality in morphology of the cerebellum.
  
  
  OBJECTIVE
  The purpose of the study is to investigate the relationship between AIS and the volume and morphology of cerebellum.
  
  
  METHODS
  The study design of the cerebellum segmentation and volume quantification involved the following four steps: whole-brain normalization, cerebellum isolation, mapping with the statistical cerebellum template, and cerebellum regional volume correction.
  
  
  METHODS
  In particular, high-resolution T1-weighted magnetic resonance images of 50 AIS patients with the right-thoracic curves (ie, Cobb angle ≥20°) and 40 age-matched normal controls were acquired. The exclusion criteria included history of head injury, back injury, severe headache, weakness or numbness in any limbs, urinary incontinence, nocturnal enuresis, and any space-occupying lesion found on magnetic resonance (MR) images.
  
  
  METHODS
  The AIS subjects were all with moderate-to-severe curves (ie, Cobb angle ≥20°) (9 moderate and 41 severe; mean Cobb angle 48.7°, range 20°-90°).
  
  
  METHODS
  The cerebellum was parcellated to 28 regions by mapping with a well-recognized probabilistic MR cerebellum atlas. Student t test of each cerebellar region and the correction for multiple comparisons were performed.
  
  
  RESULTS
  The volumes of four regions, namely right VIIIa, right VIIIb, left X, and right X, were significantly increased by approximately 7.43% to 8.25% in the AIS compared with the control group. Statistically, the results suggested that the cerebellar volume in AIS patients was larger compared with normal controls in the cerebellum regions of prepyramidal-prebiventer and intrabiventer fissures, intrabiventer and secondary fissures, and floccular-nodular (X)-posterolateral fissure to the inferior hemispheric margin.
  
  
  CONCLUSIONS
  The functions of the affected regions involve motor control, somatosensory, working memory, language, and response to visual stimulation. We conclude that the volume difference could be compensatory consequences in the central nervous system because of the persistent effort in AIS patients to maintain the body balance given the asymmetric spine.
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, 30-32 Ngan Shing St, Shatin, NT, Hong Kong SAR, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Shi
authors.forename: Defeng
authors.initials: D
authors.lastname: Wang
authors.forename: Steve C N
authors.initials: SC
authors.lastname: Hui
authors.forename: Michael C F
authors.initials: MC
authors.lastname: Tong
authors.forename: Jack C Y
authors.initials: JC
authors.lastname: Cheng
authors.forename: Winnie C W
authors.initials: WC
authors.lastname: Chu
mesh_terms: D000293:Adolescent; D002531:Cerebellum / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D012600:Scoliosis / Q000209:etiology* / Q000473:pathology*
keywords: Adolescent idiopathic scoliosis; Cerebellum; Vestibular system