PMID- 25431901
OWN - NLM
STAT- MEDLINE
DCOM- 20150413
LR  - 20181202
IS  - 1933-0715 (Electronic)
IS  - 1933-0707 (Linking)
VI  - 15
IP  - 2
DP  - 2015 Feb
TI  - Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes 
      discriminate neurocognitive outcomes in hydrocephalus.
PG  - 125-32
LID - 10.3171/2014.9.PEDS12427 [doi]
AB  - OBJECT: The evaluation of hydrocephalus remains focused on ventricular size, yet 
      the goal of treatment is to allow for healthy brain development. It is likely 
      that brain volume is more related to cognitive development than is fluid volume 
      in children with hydrocephalus. This study tests this hypothesis by comparing 
      brain and fluid volumes with neurocognitive outcome in pediatric patients with 
      hydrocephalus. METHODS: Warf and colleagues previously acquired CT scans for 
      pediatric patients in Uganda with myelomeningocele, measured frontal-occipital 
      horn ratio (FOHR), and administered the modified Bayley Scales of Infant 
      Development, third edition (BSID-III) to measure neurocognitive outcome that did 
      not correlate with FOHR. In this present study, brain and fluid volumes were 
      measured in 33 of these patients, 26 of whom required surgical treatment for 
      hydrocephalus. Linear discrimination analysis (LDA) was used to test whether 
      age-normalized brain and fluid volumes can discriminate neurocognitive outcome. 
      RESULTS: Hydrocephalic patients show normal to small brain volumes and 
      substantially larger fluid volumes compared with normal values. FOHR correlates 
      highly with fluid volume (r=0.84, p<0.001) and substantially less with brain 
      volume (r=-0.37, p=0.03), while brain and fluid volumes do not correlate with 
      each other (p=0.99). Brain and CSF volumes correlated best with fine motor 
      (p=0.03, p=0.01), cognitive (p=0.05, p=0.09), and expressive communication 
      (p=0.08, p=0.08) scores. A combination of these 3 scores was used as a 
      multivariate measure of neurocognitive outcome. Brain volume alone, unlike fluid 
      volume, could discriminate high from low cognitive outcome (by t-test and ANOVA). 
      It was shown that a combination of age-normalized brain and fluid volumes can 
      discriminate neurocognitive outcome by 2-way LDA (p<0.01) and 3-way LDA (p<0.01). 
      The multivariate LDA demonstrated the contribution of large fluid volume to a 
      decrement in cognition. CONCLUSIONS: Hydrocephalus is treated by normalizing CSF, 
      but normal brain development depends on brain growth. A combination of brain and 
      CSF volumes appears to be significantly more powerful at predicting good versus 
      poor neurocognitive outcomes in patients with hydrocephalus than either volume 
      alone.
FAU - Mandell, Jason G
AU  - Mandell JG
AD  - Center for Neural Engineering, Department of Engineering Science and Mechanics, 
      and 
FAU - Kulkarni, Abhaya V
AU  - Kulkarni AV
FAU - Warf, Benjamin C
AU  - Warf BC
FAU - Schiff, Steven J
AU  - Schiff SJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141128
PL  - United States
TA  - J Neurosurg Pediatr
JT  - Journal of neurosurgery. Pediatrics
JID - 101463759
SB  - IM
MH  - Adolescent
MH  - Brain/diagnostic imaging/*pathology
MH  - *Cerebrospinal Fluid
MH  - Child
MH  - Child, Preschool
MH  - *Cognition
MH  - Cone-Beam Computed Tomography
MH  - Female
MH  - Frontal Lobe/pathology
MH  - Humans
MH  - Hydrocephalus/*pathology/*psychology/surgery
MH  - Infant
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - *Neurosurgical Procedures/methods
MH  - Occipital Lobe/pathology
MH  - Organ Size
MH  - Treatment Outcome
MH  - Uganda
OTO - NOTNLM
OT  - BSID = Bayley Scales of Infant and Toddler Development, third edition
OT  - Bayley Scales of Infant and Toddler Development
OT  - CPC = choroid plexus cauterization
OT  - ETV = endoscopic third ventriculostomy
OT  - FOHR = frontal-occipital horn ratio
OT  - LDA = linear discrimination analysis
OT  - VP = ventriculoperitoneal
OT  - brain volume
OT  - developing country
OT  - hydrocephalus
OT  - myelomeningocele
OT  - outcome assessment
EDAT- 2014/11/29 06:00
MHDA- 2015/04/14 06:00
CRDT- 2014/11/29 06:00
PHST- 2014/11/29 06:00 [entrez]
PHST- 2014/11/29 06:00 [pubmed]
PHST- 2015/04/14 06:00 [medline]
AID - 10.3171/2014.9.PEDS12427 [doi]
PST - ppublish
SO  - J Neurosurg Pediatr. 2015 Feb;15(2):125-32. doi: 10.3171/2014.9.PEDS12427. Epub 
      2014 Nov 28.