Diffusion Tensor Imaging Derived Metrics in the Assessment of White Matter Tracts in Children with Developmental Delay

Background: Neuroimaging is crucial in diagnosing devel-opmental delay, yet some children exhibiting significant cogni-tive or motor deficits may show no abnormalities on standard MRI scans. Diffusion tensor imaging (DTI), however, offers a more detailed evaluation of white matter organization, provid-ing both qualitative and quantitative insights into the integrity of association, commissural, and projection fibers within the brain. Aim of Study: The aim of this study is to evaluate white matter tract microstructural injury in children with develop-mental delay using diffusion tensor metrics and three-dimen-sional tractography. Patients and Methods: This cross-sectional study included 20 patients with developmental delay and 10 controls. Magnetic resonance imaging included T2, T1 3-dimensional magnetiza-tion-prepared rapid acquisition gradient-echo, fluid attenuation inversion recovery, and diffusion tensor imaging. Tractography was performed using Brainance MD software, version v3.5.0 . DTI color maps were analyzed for any color asymmetry. Frac-tional anisotropy, Mean diffusivity values were calculated from 38 regions of interest. Data were analyzed using SPSS software (Mac release 21 versions). Results: Asymmetrical tracts with decreased thickness were seen in 17 patients, partial non-crossing of corticospinal tracts in 4 and decreased color vectarity in 17 patients. Frac-tional anisotropy values were mostly lower in patients than controls (33 regions: 86.8%); this was statistically significant at the bilateral forceps minor and major, bilateral anterior corona radiata, left posterior corona radiata, left cingulate gyrus and corpus callosum genu. Mean diffusivity values were higher in patients in 26 regions (68.4%) and lower in 12 regions (31.6%). Conclusion: Diffusion tensor imaging metrics and color maps can safely detect compromised white matter tracts in chil-dren with developmental delay and assist in early rehabilitation. Important tracts to be evaluated include bilateral forceps minor and major, bilateral anterior corona radiata, left posterior coro-na radiata, left cingulate gyrus and genu of the corpus callosum.