A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor
off Philosophy
Johannesburg, 2015 / Background
Objective volumetric assessment of white matter in children with HIV involves post M
processing, while corpus callosum (CC) thickness measurement on midMsagittal MRI may
represent a rapid surrogate marker.
Aim
To determine whether the thickness of the CC on midMsagittal MRI can be used as a
surrogate marker of brain volume in children with HIV Mrelated brain disease and in
appropriate controls and to determine whether thickness at particular locations
correlates with mental developmental scores and laboratory markers of immunity.
Methods
A retrospective analysis of 33 children with HIV Mrelated neurology(range 7 M 49 months;
median31 months; mean 30 months; 16 boys and 17 girls) and matched controls (range
13 – 48 months; median 34 months; mean 32 months; 6 boys and 5 girls) was performed.
A custom software tool imported sagittal MRI images, divided the midline CC contour into
40 segments and measured the thickness of each segment as well as the length of the CC.
Brain volume (total brain volume (TBV); white matter volume (WMV);grey matter volume
(GMV)) was determined using MATLAB and Statistical Parametric Mapping software.
Overall and segmental CC mean and maximum thickness and CC length were checked for
correlation with brain volume, Griffiths mental development scores(GMDS) and
laboratory parameters.
Results
Griffiths scores in patients were ‘low average’ (mean Griffiths general quotient (GQ) of 84,
range 72 – 101; ‘locomotor’ 84, range 59 – 116; ‘language’ 80; range57 –118).
There was no statistical difference in overall and regional CC thickness, CC length, TBV,
GMV and WMV between patients and controls.
Significant correlation was found in patients for the premotor CC mean with age (p =
0.04). Other significant correlations of CC measurements and laboratory / clinical
parameters were the prefrontal CC max with in adir CD4 (p=0.046)(+vecorrelation); motor
CC max with GQ (p=0.028) (Mve!correlation) and CC length with CD4(p=0.04) (Mve
correlation).
Significant correlations between CC thickness and brain volume were found in patients
and controls for the CC mean and TBV (p=0.049)(+ve correlation);premotor CC mean and
TBV (p=0.039)(+ve correlation); sensory CC mean and TBV (p=0.022)(+ve correlation);
prefrontal CC max and WMV (p=0.019)(+ve correlation); premotor CC mean and WMV
(p=0.019)(+ve correlation and for the premotor CC max and WMV (p=0.023)(+ve
correlation).
Conclusion:
This research met its objectives in demonstrating a statistically significant, albeit weak,
correlation between CC thickness and brain volume in patients and controls, even though
patients were not shown to have significantly diminished brain volumes as compared to
controls.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/19628 |
| Date | January 2015 |
| Creators | Andronikou, Savvas |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf |
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