Published online August 1, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. e442-e448 (doi:10.1542/peds.2006-0637)

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ARTICLE

Brain Developmental Abnormalities in Prader-Willi Syndrome Detected by Diffusion Tensor Imaging

Kenichi Yamada, MD^a, Hitoshi Matsuzawa, MD, PhD^a, Makoto Uchiyama, MD, PhD^b, Ingrid L. Kwee, MD^c and Tsutomu Nakada, MD, PhD^a,c

^a Center for Integrated Human Brain Science, Brain Research Institute
^b Division of Pediatrics, Department of Homeostatic Regulation and Development, Graduate School of Medical and Dental Sciences, University of Niigata, Niigata, Japan
^c Department of Neurology, University of California, Davis, California

OBJECTIVE. The purpose of this work was to detect brain developmental abnormalities in Prader-Willi syndrome by using diffusion tensor imaging based on a high-field MRI system.

METHODS. Eight patients with Prader-Willi syndrome and 8 age- and gender-matched normal control subjects were examined using a high-field (3.0 T) MRI system. Trace value and fractional anisotropy were assessed simultaneously in multiple representative brain regions: the deep gray matter (putamen, caudate head, and dorsomedial thalamus) and the white matter structures (frontal and parietal white matter, posterior limb of internal capsule, and corpus callosum).

RESULTS. In Prader-Willi syndrome patients, trace value was found to be significantly higher in the left frontal white matter and the left dorsomedial thalamus, whereas fractional anisotropy was significantly reduced in the posterior limb of the internal capsule bilaterally, the right frontal white matter, and the splenium of the corpus callosum. The observed diffusivity characteristics indicate developmental abnormalities in these areas, which are highly consistent with the clinical features of Prader-Willi syndrome.

CONCLUSIONS. The study provides the first objective evidence that Prader-Willi syndrome patients indeed have developmental abnormalities in specific areas of the brain, providing a new window toward understanding the pathophysiology of Prader-Willi syndrome.

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Key Words: Prader-Willi syndrome • brain development • diffusion tensor imaging • trace • fractional anisotropy

Abbreviations: PWS—Prader-Willi syndrome • DTI—diffusion tensor imaging • Tr—trace value • FA—fractional anisotropy • ROI—region of interest • PLIC—posterior limb of internal capsule • CC—corpus callosum • 3DAC—three-dimensional anisotropy contrast

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Accepted Apr 14, 2006.

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