INS NYC 2024 Program

Poster	Poster Session 04 Program Schedule 02/15/2024 12:00 pm - 01:15 pm Room: Shubert Complex (Posters 1-60) Poster Session 04: Neuroimaging \| Neurostimulation/Neuromodulation \| Teleneuropsychology/Technology Final Abstract #40 Normative Brain Growth Charts as a Tool for Characterizing Brain Atypicality in Neurodevelopmental Disorders: Methodological Approach and an Example from Fetal Alcohol Spectrum Disorder (FASD) Blake Gimbel, University of Minnesota, Minneapolis, United States Donovan Roediger, University of Minnesota, Minneapolis, United States Abigail Ernst, University of Minnesota, Minneapolis, United States Mary Anthony, University of Minnesota, Minneapolis, United States Kent Tuominen, University of Minnesota, Minneapolis, United States Erik de Water, Great Lakes Neurobehavioral Center, Edina, United States Bryon Mueller, University of Minnesota, Minneapolis, United States Kelvin Lim, University of Minnesota, Minneapolis, United States Jeffrey Wozniak, University of Minnesota, Minneapolis, United States Category: Neuroimaging Keyword 1: neuroimaging: structural Keyword 2: pediatric neuropsychology Keyword 3: fetal alcohol syndrome Objective: Neurodevelopmental conditions are characterized by phenotypic heterogeneity but share overlapping etiological mechanisms and common neurobehavioral endpoints (e.g., impairment in IQ, adaptive skills, executive function). Novel psychometric methods for examining structural brain anomalies may provide new insights into both shared and distinct aspects of atypical brain development across neurodevelopmental conditions. Here, we present an overview of a novel method for quantifying brain volume anomalies using recently published brain “growth charts.” We illustrate the potential value of this approach using data from a sample of youth with fetal alcohol spectrum disorder (FASD), a common neurodevelopmental condition characterized by structural brain anomalies and neurobehavioral impairment. Participants and Methods: Included: 47 children with FASD and 42 controls, ages 8–17 years, from the University of Minnesota FASD Program. Participants completed evaluation of physical anomalies and dysmorphology, cognitive testing (WISC-V/WAIS-IV, DKEFS), caregiver ratings of adaptive (Vineland-III) and emotional/behavioral functioning (CBCL), and an MRI scan (Siemens Prisma 3T). Using recently published lifespan brain charts based on more than 101,000 individuals (Bethlehem et al., 2022; https://brainchart.shinyapps.io/brainchart/#) we calculated individual (per)centile scores for volumes of cortical gray matter (GMV), subcortical gray matter (sGMV), and cortical white matter (WMV). Age- and sex-adjusted normative centile scores were derived for each participant’s brain volumes. Results: Participants with FASD demonstrated significantly lower mean centile scores compared to controls across GMV (Cohen’s d = -0.81), sGMV (d = -0.71), and WMV (d = -1.11). Across all participants, those with brain volumes ≤ 10th centile (any tissue type) demonstrated lower performance on measures of intellectual functioning, adaptive skills, and working memory, and greater caregiver-rated attention problems and total emotional/behavioral problems (effect sizes ranged from 0.32 to 1.31) compared to participants with average volumes (i.e., > 10th centile). Sensitivity and specificity analyses revealed that atypical brain volumes (i.e., ≤ 10th centile) had moderate sensitivity (35%) and high specificity (95%) in differentiating FASD from controls. In contrast, impairment (i.e., ≤ 1.5 SD below mean) in IQ and working memory performance had low sensitivity (19% and 21%, respectively) but high specificity (100% and 98%, respectively) while impairment in adaptive function had high sensitivity (71%) and high specificity (100%). A combination of atypical brain volume in any tissue type and low adaptive function had improved sensitivity (83%) and comparable specificity (95%). Lastly, brain centiles had improved sensitivity and similar specificity compared to measurements of head circumference (sensitivity: 11%, specificity: 100%), commonly used to estimate atypical brain volume in FASD diagnosis. Conclusions: We demonstrate the potential value of leveraging a large normative neuroimaging dataset to characterize whole-brain structural anomalies associated with neurobehavioral functioning in youth with neurodevelopmental disorders (here, illustrated with FASD). Participants with and without FASD who demonstrated atypical brain volumes demonstrated greater impairment across neurobehavioral domains, suggesting these metrics may be useful predictors of important clinical outcomes. In addition, brain centile scores may be more sensitive than some commonly-used assessments in differentiating youth with neurodevelopmental conditions like FASD from controls. Implications for research and clinical practice are discussed.

Poster

02/15/2024
12:00 pm - 01:15 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology

Final Abstract #40

Normative Brain Growth Charts as a Tool for Characterizing Brain Atypicality in Neurodevelopmental Disorders: Methodological Approach and an Example from Fetal Alcohol Spectrum Disorder (FASD)

Blake Gimbel, University of Minnesota, Minneapolis, United States
Donovan Roediger, University of Minnesota, Minneapolis, United States
Abigail Ernst, University of Minnesota, Minneapolis, United States
Mary Anthony, University of Minnesota, Minneapolis, United States
Kent Tuominen, University of Minnesota, Minneapolis, United States
Erik de Water, Great Lakes Neurobehavioral Center, Edina, United States
Bryon Mueller, University of Minnesota, Minneapolis, United States
Kelvin Lim, University of Minnesota, Minneapolis, United States
Jeffrey Wozniak, University of Minnesota, Minneapolis, United States

Category: Neuroimaging

Keyword 1: neuroimaging: structural
Keyword 2: pediatric neuropsychology
Keyword 3: fetal alcohol syndrome

Objective:

Neurodevelopmental conditions are characterized by phenotypic heterogeneity but share overlapping etiological mechanisms and common neurobehavioral endpoints (e.g., impairment in IQ, adaptive skills, executive function). Novel psychometric methods for examining structural brain anomalies may provide new insights into both shared and distinct aspects of atypical brain development across neurodevelopmental conditions. Here, we present an overview of a novel method for quantifying brain volume anomalies using recently published brain “growth charts.” We illustrate the potential value of this approach using data from a sample of youth with fetal alcohol spectrum disorder (FASD), a common neurodevelopmental condition characterized by structural brain anomalies and neurobehavioral impairment.

Participants and Methods:

Included: 47 children with FASD and 42 controls, ages 8–17 years, from the University of Minnesota FASD Program. Participants completed evaluation of physical anomalies and dysmorphology, cognitive testing (WISC-V/WAIS-IV, DKEFS), caregiver ratings of adaptive (Vineland-III) and emotional/behavioral functioning (CBCL), and an MRI scan (Siemens Prisma 3T). Using recently published lifespan brain charts based on more than 101,000 individuals (Bethlehem et al., 2022; https://brainchart.shinyapps.io/brainchart/#) we calculated individual (per)centile scores for volumes of cortical gray matter (GMV), subcortical gray matter (sGMV), and cortical white matter (WMV). Age- and sex-adjusted normative centile scores were derived for each participant’s brain volumes.

Results:

Participants with FASD demonstrated significantly lower mean centile scores compared to controls across GMV (Cohen’s d = -0.81), sGMV (d = -0.71), and WMV (d = -1.11). Across all participants, those with brain volumes ≤ 10th centile (any tissue type) demonstrated lower performance on measures of intellectual functioning, adaptive skills, and working memory, and greater caregiver-rated attention problems and total emotional/behavioral problems (effect sizes ranged from 0.32 to 1.31) compared to participants with average volumes (i.e., > 10th centile). Sensitivity and specificity analyses revealed that atypical brain volumes (i.e., ≤ 10th centile) had moderate sensitivity (35%) and high specificity (95%) in differentiating FASD from controls. In contrast, impairment (i.e., ≤ 1.5 SD below mean) in IQ and working memory performance had low sensitivity (19% and 21%, respectively) but high specificity (100% and 98%, respectively) while impairment in adaptive function had high sensitivity (71%) and high specificity (100%). A combination of atypical brain volume in any tissue type and low adaptive function had improved sensitivity (83%) and comparable specificity (95%). Lastly, brain centiles had improved sensitivity and similar specificity compared to measurements of head circumference (sensitivity: 11%, specificity: 100%), commonly used to estimate atypical brain volume in FASD diagnosis.

Conclusions:

We demonstrate the potential value of leveraging a large normative neuroimaging dataset to characterize whole-brain structural anomalies associated with neurobehavioral functioning in youth with neurodevelopmental disorders (here, illustrated with FASD). Participants with and without FASD who demonstrated atypical brain volumes demonstrated greater impairment across neurobehavioral domains, suggesting these metrics may be useful predictors of important clinical outcomes. In addition, brain centile scores may be more sensitive than some commonly-used assessments in differentiating youth with neurodevelopmental conditions like FASD from controls. Implications for research and clinical practice are discussed.