Abstract

Adolescent idiopathic scoliosis (AIS) is a multifactorial disease affecting approximately 1–4% of teenagers especially girls at the age of 10–16, but its etiopathogenesis remains uncertain. Previous study has revealed that the cortical thickness in AIS patients is different from that in normal controls. Cortical thickness measurements are known to be strongly correlated between regions that are axonally connected. Hence, a hypothesis is proposed to study the possibility to demonstrate abnormal structural network revealed by cortical thickness in AIS patients. The aim of the study is to investigate abnormalities in the organization of the brain cortical network in AIS patients. This study included 42 girls with severe idiopathic scoliosis (14.7±1.3 years old) and 41 age-matched normal controls (NC, 14.6±1.4 years old). The brain cortex was partitioned into 154 cortical regions based on gyral and sulcal structure. The interregional connectivity was measured as the statistical correlations between the regional mean thicknesses across the subjects. We employed the graph theoretic analysis to examine the alteration in interregional correlation, small-world efficiency, hub distribution, and regional nodal characteristics in AIS patients. We demonstrated that the cortical network of AIS patients fully preserved the small-world architecture and organization, and further verified the hemispheric asymmetry of AIS brain. Our results indicated increased central role of temporal and occipital cortex and decreased central role of limbic cortex in AIS patients compared with controls. Furthermore, decreased structural connectivity between hemispheres and increased connectivity in several cortical regions were observed. The findings of the study reveal the pattern of structural network alteration in AIS brain, and would help in understanding the mechanism and etiopathogenesis of AIS.

Highlights

  • Idiopathic scoliosis is a 3-dimensional spinal deformity that occurs most commonly in adolescent girls and affects about 1–4% of school teenagers worldwide

  • Current studies indicate that the etiopathogenesis of Adolescent idiopathic scoliosis (AIS) remains unknown and scientists believe that it is a multifactorial disease which involves intrinsic factors such as the growth of vertebral body, abnormal morphometry of the posterior elements, asymmetrical growth of the neurocentral cartilage etc., and extrinsic factors such as genetic components and chromosomes, extra-spinal left-right asymmetry, body growth and development, imbalance of muscle, dysfunction of the nervous system, somatosensory function, vestibular system, length of spinal cord, abnormal platelets and abnormality in melatonin metabolism [1]

  • We have recently reported the thinning pattern of cerebral cortex in AIS patients

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Summary

Introduction

Idiopathic scoliosis is a 3-dimensional spinal deformity that occurs most commonly in adolescent girls and affects about 1–4% of school teenagers worldwide. Various neuroanatomical studies have been proposed to explore the etiopathogenesis of AIS patients. Structural brain MRI analyses, such as region volume [2], cortical thickness [3], comprehensive morphometry of corpus callosum [4], vestibular morphoanatomy [5], volume-based morphometry [6], have been used to investigate the morphological change in the brains of AIS patients. The findings of cortical thinning pattern lead us to make a hypothesis: is it possible that altered organization pattern of large-scale structural network could be revealed in AIS patients compared with age-matched healthy individuals?

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