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 K 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

*Corresponding author for this work

Research output: Contribution to journalArticle

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 (US)
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

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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