Foetal MRI may help predict neurodevelopmental outcomes in tuberous sclerosis complex

05 Jun 2021

Results of foetal brain magnetic resonance imaging (MRI) are linked to neurodevelopment in children with tuberous sclerosis complex (TSC), a recent study has found.

Researchers retrospectively assessed 41 children with TSC who had undergone foetal MRI and had available 2 years’ worth of follow-up data. Ten brain lobes were given the following scores according to MRI findings: 0 (no subcortical lesions or doubt), 1 (a single small lesion), and 2 (more than one small lesion or at least one large lesion). Participants were also assigned to one of three neurodevelopmental assessment categories (normal, borderline, delayed).

MRI showed (sub)cortical lesions in all but one patient (97.6 percent), and the mean lesion sum score was 4.5. Lesions were most commonly located in the frontal lobe (92.7 percent), followed by the parietal (53.7 percent) and temporal (31.7 percent) lobes.

By the age of 2 years, 59 percent (n=24) of participants had developed epilepsy, while 22 percent (n=9) had drug-resistant epilepsy. The lesion sum score was correlated with neither (odds ratio [OR], 1.00, 95 percent confidence interval [CI], 0.78–1.27; p=0.97 and OR, 1.07, 95 percent CI, 0.81–1.43; p=0.62, respectively).

In contrast, lesion sum scores differed significantly across the three neurodevelopmental categories of cognitive development (one-way analysis of variance p=0.018). Tukey posthoc analysis found that scores were significantly lower among participants who were developing normally as opposed to those with cognitive delays (3.63±2.60 vs 6.20±1.99; p=0.019). No such difference was reported between normal vs borderline (p=0.299) and borderline vs delay (p=0.816).

Motor development likewise correlated with lesion sum scores (p=0.002), such that those with normal development (3.00±2.18) scored lower than counterparts with borderline (5.62±2.47; p=0.007) or delayed (6.00±2.00; p=0.012) development.

“Children with a high cumulative lesion score on foetal MRI have a greater risk of delay in cognitive and motor development,” the researchers said.

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