Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2093-2100 (doi:10.1542/10.1542/peds.2005-1727)

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Abnormal Brain Connectivity in Children After Early Severe Socioemotional Deprivation: A Diffusion Tensor Imaging Study

Thomas J. Eluvathingal, MD^a, Harry T. Chugani, MD^a,b,c, Michael E. Behen, PhD^a,d, Csaba Juhász, MD, PhD^a,b, Otto Muzik, PhD^a,c, Mohsin Maqbool, MD^a, Diane C. Chugani, PhD^a,c and Malek Makki, PhD^a

^a Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan
^b Department of Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan
^c Department of Radiology, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan
^d Department of Psychiatry, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan

OBJECTIVES. We previously reported that children who were subjected to early socioemotional deprivation in Romanian orphanages showed glucose hypometabolism in limbic and paralimbic structures, including the orbital frontal gyrus, infralimbic prefrontal cortex, hippocampus/amygdala, lateral temporal cortex, and the brainstem. The present study used diffusion tensor imaging tractography to examine the integrity of white matter tracts that connect these brain regions.

METHODS. Fractional anisotropy and apparent diffusion coefficient for uncinate fasciculus, stria terminalis, fornix, and cingulum were measured in 7 right-handed children (5 girls and 2 boys; mean age: 9.7 ± 2.6 years) with a history of early severe socioemotional deprivation in Eastern European orphanages and compared with similar measurements in 7 right-handed normal children (4 girls and 3 boys; mean age: 10.7 ± 2.8 years).

RESULTS. Neuropsychological assessment of the orphans verified the relatively mild specific cognitive impairment and impulsivity consistent with previous studies of children who were adopted from Romanian orphanages. Fractional anisotropy values in the left uncinate fasciculus were decreased significantly in the early deprivation group compared with control subjects. Apparent diffusion coefficient values for the early deprivation group tended to be greater than that in control subjects in all of the tracts measured, without reaching statistical significance.

CONCLUSION. Our study demonstrates in children who experienced socioemotional deprivation a structural change in the left uncinate fasciculus that partly may underlie the cognitive, socioemotional, and behavioral difficulties that commonly are observed in these children.

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Key Words: behavior disorders/problems • social-emotional problems • MRI • early childhood • diffusion tensor imaging

Abbreviations: PET—positron emission tomography • fMRI—functional MRI • DTI—diffusion tensor imaging • FA—fractional anisotropy • ADC—apparent diffusion coefficient • CSF—cerebrospinal fluid

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Accepted Nov 29, 2005.

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