title: Abnormal structural connectivity in the brain networks of children with hydrocephalus.
abstract: Increased intracranial pressure and ventriculomegaly in children with hydrocephalus are known to have adverse effects on white matter structure. This study seeks to investigate the impact of hydrocephalus on topological features of brain networks in children. The goal was to investigate structural network connectivity, at both global and regional levels, in the brains in children with hydrocephalus using graph theory analysis and diffusion tensor tractography. Three groups of children were included in the study (29 normally developing controls, 9 preoperative hydrocephalus patients, and 17 postoperative hydrocephalus patients). Graph theory analysis was applied to calculate the global network measures including small-worldness, normalized clustering coefficients, normalized characteristic path length, global efficiency, and modularity. Abnormalities in regional network parameters, including nodal degree, local efficiency, clustering coefficient, and betweenness centrality, were also compared between the two patients groups (separately) and the controls using two tailed t-test at significance level of p < 0.05 (corrected for multiple comparison). Children with hydrocephalus in both the preoperative and postoperative groups were found to have significantly lower small-worldness and lower normalized clustering coefficient than controls. Children with hydrocephalus in the postoperative group were also found to have significantly lower normalized characteristic path length and lower modularity. At regional level, significant group differences (or differences at trend level) in regional network measures were found between hydrocephalus patients and the controls in a series of brain regions including the medial occipital gyrus, medial frontal gyrus, thalamus, cingulate gyrus, lingual gyrus, rectal gyrus, caudate, cuneus, and insular. Our data showed that structural connectivity analysis using graph theory and diffusion tensor tractography is sensitive to detect abnormalities of brain network connectivity associated with hydrocephalus at both global and regional levels, thus providing a new avenue for potential diagnosis and prognosis tool for children with hydrocephalus.
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA ; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Weihong
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA ; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Scott K
authors.initials: SK
authors.lastname: Holland
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Shimony
authors.affiliation: Div. of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA ; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Mekibib
authors.initials: M
authors.lastname: Altaye
authors.affiliation: Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA ; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Francesco T
authors.initials: FT
authors.lastname: Mangano
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: Limbrick
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA ; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Blaise V
authors.initials: BV
authors.lastname: Jones
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Nash
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Akila
authors.initials: A
authors.lastname: Rajagopal
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Simpson
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Dustin
authors.initials: D
authors.lastname: Ragan
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: McKinstry
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology* / Q000601:surgery; D007223:Infant; D008297:Male; D009415:Nerve Net / Q000473:pathology*; D066127:White Matter / Q000473:pathology*
keywords: DTI, diffusion tensor imaging; FA, fractional anisotropy; GM, gray matter; Graph theoretical analysis; HCP, hydrocephalus; Network; Pediatric hydrocephalus; ROI, region of interest; Small-worldness; WM, white matter