Changes of White Matter Diffusion Anisotropy in Response to a 6-Week iPad Application-Based Occupational Therapy Intervention in Children with Surgically Treated Hydrocephalus: A Pilot Study

Weihong Yuan, Karen Harpster, Blaise V. Jones, Joshua S. Shimony, Robert C. McKinstry, Nicole Weckherlin, Stephanie S. Powell, Holly Barnard, Jack Engsberg, Darren S. Kadis, Jonathan Dodd, Mekibib Altaye, David D. Limbrick, Scott K. Holland, Sarah M. Simpson, Sarah Bidwell, Francesco T. Mangano

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective Our aims were (1) to test whether diffusion tensor imaging (DTI) could detect underlying white matter (WM) changes after a 6-week iPad application-based occupational therapy (OT) intervention in children with surgically treated hydrocephalus (HCP); and (2) to explore the association between WM changes and performance outcomes. Methods Five children (age range: 6.05-9.10 years) with surgically treated HCP completed an intensive iPad-based OT intervention targeting common domains of long-term deficits in children with HCP. The intervention included 6 weekly sessions in an OT clinic supplementing home-based program (1 hour/day, 4 days/week). DTI and neuropsychological assessments were performed before and after the intervention. Observation After the therapy, significant increases in fractional anisotropy (FA) and/or decreases in radial diffusivity were found in extensive WM areas. All participants demonstrated an increased perceptual reasoning index (PRI, Wechsler Abbreviated Scale of Intelligence: 2nd edition, PRI gains = 14.20 ± 7.56, p = 0.014). A significant positive correlation was found between PRI increase and the increase of FA in the right posterior limb of the internal capsule and the right external capsule (both p < 0.05). Conclusion This study provides initial evidence of DTI's sensitivity to detect subtle WM changes associated with performance improvements in response to a 6-week OT intervention in children with HCP.

Original languageEnglish
Pages (from-to)336-340
Number of pages5
JournalNeuropediatrics
Volume47
Issue number5
DOIs
StatePublished - Oct 1 2016

Keywords

  • DTI
  • iPad application
  • occupational therapy
  • pediatric hydrocephalus

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