Alterations in Cortical Thickness in Children with Congenital Strabismus and Dissociated Vertical Deviation

Abstract

Introduction: Little is known about the morphometric changes that occur in the cerebral cortex of children with congenital strabismus and Dissociated Vertical Deviation (DVD). Mathematical morphology provides the opportunity to discover alterations in cortical thickness. Objective: Identify and measure differences in cortical thickness in children with congenital strabismus and DVD. Materials and Methods: Twenty-two MRI brain studies were conducted, each comprising 120 sagittal slices of 1 mm. A cohort of 11 healthy children formed the control group, and a cohort of 11 children with congenital strabismus and Dissociated Vertical Deviation, both in Dissociated Esotropia and Dissociated Exotropia formed the case group. Differences in cortical thickness between both groups were compared and identified using the FreeSurfer suite. Subsequently, areas of interest were analyzed using the ImageJ program to determine density, area, size, and pixel quantity in these regions. Study results are presented through tables and figures. Results: Twelve inflated brain projections were obtained from 2640 MRI images. Thickness differences between both groups exhibited three areas with significant morphometric changes: the Left Angular Gyrus, Left Supramarginal Gyrus, and Right Pars Opercularis. Discussion: Children with congenital strabismus and DVD showed changes in cortical thickness that could be identified and measured through Voxel-Based Morphometry (VBM). It is plausible to consider that these changes are related to suppression, aiming to avoid diplopia.