title: Longitudinal changes in diffusion properties in white matter pathways of children with tuberous sclerosis complex.
abstract: BACKGROUND
  Abnormal white matter development in patients with tuberous sclerosis complex, a multisystem hamartomatous disorder caused by aberrant neural proliferation and axonal maturation, may be associated with poorer neurocognitive outcomes. The purpose of this study is to identify predictors of longitudinal changes in diffusion properties of white matter tracts in patients with tuberous sclerosis complex.
  
  
  METHODS
  Diffusion magnetic resonance imaging was carried out in 17 subjects with tuberous sclerosis complex (mean age, 7.2 ± 4.4 years) with at least two magnetic resonance imaging scans (mean number of days between scans, 419.4 ± 105.4). There were 10 males; 5 of 17 had autism spectrum disorder and 10 of 17 had epilepsy. Regions of interest were placed to delineate the internal capsule/corona radiata, cingulum, and corpus callosum. The outcomes were mean change in apparent diffusion coefficient and fractional anisotropy. Data were analyzed using Pearson's correlation and multiple linear regression analyses.
  
  
  RESULTS
  Gender was a significant predictor of mean change in apparent diffusion coefficient in the left internal capsule, right and left cingulum bundles, and corpus callosum and a significant predictor of mean change in fractional anisotropy in the corpus callosum. Epilepsy was a significant predictor of mean change in apparent diffusion coefficient in the left internal capsule. Autism spectrum disorder was not predictive of diffusion changes in any of the studied pathways.
  
  
  CONCLUSIONS
  Clinical variables, including gender and epilepsy, have an effect on the development of white matter pathways. These variables should be taken into consideration when counseling tuberous sclerosis complex patients and in future imaging studies in this population.
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Baumer
authors.affiliation: Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jae W
authors.initials: JW
authors.lastname: Song
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Mitchell
authors.affiliation: Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Rudolph
authors.initials: R
authors.lastname: Pienaar
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sahin
authors.affiliation: Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: P Ellen
authors.initials: PE
authors.lastname: Grant
authors.affiliation: Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: emi.takahashioki@childrens.harvard.edu.
authors.forename: Emi
authors.initials: E
authors.lastname: Takahashi
mesh_terms: D000293:Adolescent; D016880:Anisotropy; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology / Q000502:physiology*; D014402:Tuberous Sclerosis / Q000473:pathology / Q000503:physiopathology*; D066127:White Matter / Q000473:pathology / Q000503:physiopathology*
keywords: development; diffusion imaging; epilepsy; gender; human; tractography; tuberous sclerosis complex; white matter
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