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August 1992

Cerebral White Matter and Cognition in Hydrocephalic Children

Author Affiliations

From the Departments of Pediatrics (Drs Fletcher and Brookshire and Mr Beaver), Pediatric Neurology (Dr Bohan), and Psychiatry and Behavioral Sciences (Dr Brandt), University of Texas Medical School at Houston; Department of Psychology, University of Houston (Dr Francis and Dr Davidson); Southwest Neuropsychiatric Institute and Division of Psychiatry, University of Texas Health Science Center at San Antonio (Dr Thompson); and Division of Neurosurgery, Ohio State University, Columbus (Dr Miner).

Arch Neurol. 1992;49(8):818-824. doi:10.1001/archneur.1992.00530320042010

• Although children with hydrocephalus frequently show poor development of nonverbal cognitive skills relative to verbal skills, little is known about the neuropathologic correlates of these discrepancies. In this study, cerebral whitematter structures and lateral ventricles were measured from the magnetic resonance images of age-matched children with meningomyelocele, meningocele, and aqueductal stenosis and normal subjects. The volume of each lateral ventricle and the cross-sectional area of the corpus callosum and internal capsules were correlated with concurrent measures of verbal and nonverbal cognitive skills. The corpus callosum in the meningomyelocele and aqueductal stenosis groups was smaller. The lateral ventricles were larger, and the internal capsules were smaller, in all patient groups than in normal subjects. There were no differences in the size of the centra semiovale. Although verbal and nonverbal measures correlated positively with the size of the corpus callosum, the correlation was higher for nonverbal measures. Nonverbal measures correlated with the right, but not the left, lateral ventricle and with the area of the right and left internal capsules. Verbal measures correlated with the left, but not right, lateral ventricle and with the left, but not right, internal capsule. These results show a relationship between the corpus callosum and cognitive skills that is also influenced by hydrocephalus-related changes in the lateral ventricles and other cerebral whitematter tracts.

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