Morphological changes of the cerebral cortex in children with complete growth hormone deficiency: a 3.0 T MRI study

Abstract

Objective To analyze morphological differences in gray matter volume, cortical surface area, and gray matter thickness in children with complete growth hormone deficiency (CGHD) and idiopathic short stature (ISS) using 3.0 T MRI and image post-processing techniques. Methods This is a retrospective cohort study. Patients attending the Shandong Provincial Hospital and who had been diagnosed with CGHD or ISS were recruited from January 2015 to January 2019. Twelve CGHD children ( 8 males and 4 females, 5 to 14 years old, peak growth hormone 10 μg/L) were included in this study. High-resolution, high signal-to-noise ratio three-dimensional T1 weighted MR images were collected at their first visit. The measurements of gray matter volume, cortical surface area and gray matter thickness of the left and right cerebral hemispheres and the total brain were obtained using FreeSurfer software. The significant differences between groups were statistically analyzed. The above measurements at the same region of each group were averaged to obtain the mean values. The mean values at the same region of the two groups were subtracted to obtain the differences. All the values were delineated on the color maps. Results The gray matter volumes of the left and right cerebral hemispheres of CGHD children were(228.50±36.72)cm3 and (229.10±34.95)cm3, respectively; the cortical surface areas of the left and right cerebral hemispheres were (737.02±140.48)cm2 and (738.68±135.26)cm2, respectively; the cortical thickness of the left and right cerebral hemispheres was (2.43±0.09)mm and (2.44±0.09)mm, respectively. The gray matter volumes of the left and right cerebral hemispheres of ISS children were (272.36±34.77)cm3 and (272.54±32.76)cm3, respectively; the cortical surface areas of the left and right cerebral hemispheres were (841.88±141.75)cm2 and (839.98± 135.69)cm2, respectively; the cortical thickness of the left and right cerebral hemispheres was (2.55±0.18)mm and (2.57±0.17)mm, respectively. There were significant differences in the bilateral hemispheric and total gray matter volume(Fleft=17.884, Fright=20.115, Ftotal=19.009), cortical surface area(Fleft=11.105, Fright=11.453, Ftotal=11.337) and gray matter thickness(Fleft=5.907, Fright=6.109, Ftotal=6.066) between CGHD and ISS children (all P values<0.05). The mean distribution map and the difference distribution map showed that the volume of gray matter, cortical surface area and cortical thickness of the two groups were different in many brain regions. Conclusions Compared with ISS children, CGHD children have smaller gray matter volume, cortical surface area, and gray matter thickness, which may be related to their relatively slower development in intelligence, motor performance, or other functions. Key words: Human growth hormone; Complete growth hormone deficiency; Idiopathic short stature; Insulin growth-like factor-1; Brain structure; MRI