{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:09:11Z","timestamp":1784956151214,"version":"3.55.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>No previous reports exist that have evaluated the relationships of white matter (WM) integrity with the number of shunt revisions, ventricular volume after shunting, and cognition in medically stable children who have spina bifida and hydrocephalus (SBH). The authors hypothesized that enlarged ventricles and a greater number of shunt revisions decrease WM integrity in children.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>In total, 80 children (mean age 13.7 years) who had SBH underwent MRI and IQ testing. Probabilistic diffusion tractography was performed to determine mean diffusion tensor imaging (DTI) metrics along the frontal and parietal tectocortical pathways. The DTI metrics were evaluated for significant correlation with a composite IQ measure and with the total number of shunt revisions and the total lateral ventricular volume obtained through semiautomated parcellation of T1-weighted MRI scans.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>An enlargement in total lateral ventricle volume and an increase in the number of shunt revisions were both associated with higher fractional anisotropy (FA) and with lower radial diffusivity (RD) along both frontal and parietal tectocortical pathways. Children who had not undergone a shunt revision had on average a greater lateral ventricle volume and higher FA and lower RD along frontal and parietal pathways than those who had undergone multiple shunt revisions. The mean DTI metrics along parietal pathways predicted IQ scores, but intellectual ability was not significantly correlated with ventricular volume or with the number of lifetime shunt revisions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Significant changes in DTI metrics were observed as a function of ventricular volume. An increased lateral ventricle volume was associated with elevated FA and decreased RD. Given that the participants were medically stable at the time of the MRI examination, the results suggested that those who have enlarged ventricles show a DTI pattern consistent with axonal compression due to increased intracranial pressure (ICP) in attenuated hydrocephalus. Although limited by a cross-sectional design, the study's findings suggest that DTI metrics may serve as sensitive indicators for chronic, mild hydrocephalus in the absence of overt clinical symptoms due to increased ICP. Having enlarged ventricles and undergoing multiple shunt revisions did not affect intellectual ability in children with SBH.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.10.peds13644","type":"journal-article","created":{"date-parts":[[2015,1,30]],"date-time":"2015-01-30T08:08:15Z","timestamp":1422605295000},"page":"410-419","source":"Crossref","is-referenced-by-count":23,"title":["Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus"],"prefix":"10.3171","volume":"15","author":[{"given":"Victoria J.","family":"Williams","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Houston;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenifer","family":"Juranek","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla K.","family":"Stuebing","sequence":"additional","affiliation":[{"name":"Texas Institute for Measurement, Evaluation, and Statistics, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Cirino","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Houston;"},{"name":"Texas Institute for Measurement, Evaluation, and Statistics, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Dennis","sequence":"additional","affiliation":[{"name":"Department of Surgery and Psychology, University of Toronto;"},{"name":"Program in Neuroscience and Mental Health, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin M.","family":"Bowman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Blaser","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry A.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack M.","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Houston;"},{"name":"Texas Institute for Measurement, Evaluation, and Statistics, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds13644","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"385","DOI":"10.3171\/2009.11.PEDS09343","article-title":"Longitudinal comparison of pre- and postoperative diffusion tensor imaging parameters in young children with hydrocephalus","volume":"5","author":"Air","year":"2010"},{"key":"b2-peds13644","series-title":"Neurotherapeutics","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.nurt.2007.05.011","article-title":"Diffusion tensor imaging of the brain","volume":"4","author":"Alexander","year":"2007"},{"issue":"5 Suppl","key":"b3-peds13644","series-title":"J Neurosurg","first-page":"332","article-title":"Neuronal damage in hydrocephalus and its restoration by shunt insertion in experimental hydrocephalus: a study involving the neurofilament-immunostaining method","volume":"104","author":"Aoyama","year":"2006"},{"key":"b4-peds13644","series-title":"AJNR Am J Neuroradiol","first-page":"1717","article-title":"Diffusion tensor imaging in hydrocephalus: initial experience","volume":"27","author":"Assaf","year":"2006"},{"key":"b5-peds13644","series-title":"J Magn Reson B","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1006\/jmrb.1994.1037","article-title":"Estimation of the effective self-diffusion tensor from the NMR spin echo","volume":"103","author":"Basser","year":"1994"},{"key":"b6-peds13644","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.neuroimage.2006.09.018","article-title":"Probabilistic diffusion tractography with multiple fibre orientations: what can we gain?","volume":"34","author":"Behrens","year":"2007"},{"key":"b7-peds13644","series-title":"Nat Neurosci","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1038\/nn1075","article-title":"Non-invasive mapping of connections between human thalamus and cortex using diffusion imaging","volume":"6","author":"Behrens","year":"2003"},{"key":"b8-peds13644","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1002\/mrm.10609","article-title":"Characterization and propagation of uncertainty in diffusion-weighted MR imaging","volume":"50","author":"Behrens","year":"2003"},{"key":"b9-peds13644","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1002\/mrm.21200","article-title":"Toward accurate diagnosis of white matter pathology using diffusion tensor imaging","volume":"57","author":"Budde","year":"2007"},{"key":"b10-peds13644","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1016\/j.neuroimage.2006.04.187","article-title":"Diffusion tensor imaging of time-dependent axonal and myelin degradation after corpus callosotomy in epilepsy patients","volume":"32","author":"Concha","year":"2006"},{"key":"b11-peds13644","series-title":"Acta Neuropathol","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1007\/BF00334666","article-title":"Neuropathological changes caused by hydrocephalus","volume":"85","author":"Del Bigio","year":"1993"},{"key":"b12-peds13644","series-title":"Dev Disabil Res Rev","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1002\/ddrr.94","article-title":"Neuropathology and structural changes in hydrocephalus","volume":"16","author":"Del Bigio","year":"2010"},{"key":"b13-peds13644","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1002\/ana.10453","article-title":"Chronic hydrocephalus in rats and humans: white matter loss and behavior changes","volume":"53","author":"Del Bigio","year":"2003"},{"key":"b14-peds13644","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"134","DOI":"10.3171\/2010.11.PEDS10275","article-title":"Variability among pediatric neurosurgeons in the threshold for ventricular shunting in asymptomatic children with hydrocephalus","volume":"7","author":"Dias","year":"2011"},{"issue":"2 Suppl","key":"b15-peds13644","series-title":"J Neurosurg","first-page":"196","article-title":"Effects of hydrocephalus and ventriculoperitoneal shunt therapy on afferent and efferent connections in the feline sensorimotor cortex","volume":"101","author":"Eskandari","year":"2004"},{"key":"b16-peds13644","series-title":"Neuroimage","first-page":"195","article-title":"Cortical surface-based analysis. II: Inflation, flattening, and a surface-based coordinate system","volume":"9","author":"Fischl","year":"1999"},{"key":"b17-peds13644","series-title":"Cereb Cortex","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1093\/cercor\/bhg087","article-title":"Automatically parcellating the human cerebral cortex","volume":"14","author":"Fischl","year":"2004"},{"key":"b18-peds13644","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1001\/archneur.1992.00530320042010","article-title":"Cerebral white matter and cognition in hydrocephalic children","volume":"49","author":"Fletcher","year":"1992"},{"issue":"3 Suppl","key":"b19-peds13644","series-title":"J Neurosurg","first-page":"268","article-title":"Spinal lesion level in spina bifida: a source of neural and cognitive heterogeneity","volume":"102","author":"Fletcher","year":"2005"},{"key":"b20-peds13644","series-title":"Z Kinderchir Grenzgeb","first-page":"314","article-title":"Myelination of the corpus callosum. II. The effect of relief of hydrocephalus upon the processes of myelination","volume":"28","author":"Gadsdon","year":"1979"},{"key":"b21-peds13644","series-title":"Dev Med Child Neurol","first-page":"286","article-title":"The effect of intracranial pressure on myelination and the relationship with neurodevelopment in infantile hydrocephalus","volume":"39","author":"Hanlo","year":"1997"},{"key":"b22-peds13644","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"1846","DOI":"10.1002\/mrm.24204","article-title":"Model-based analysis of multishell diffusion MR data for tractography: how to get over fitting problems","volume":"68","author":"Jbabdi","year":"2012"},{"key":"b23-peds13644","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/j.neuroimage.2011.09.015","article-title":"FSL","volume":"62","author":"Jenkinson","year":"2012"},{"key":"b24-peds13644","series-title":"Cerebellum","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1007\/s12311-010-0157-x","article-title":"The cerebellum in children with spina bifida and Chiari II malformation: quantitative volumetrics by region","volume":"9","author":"Juranek","year":"2010"},{"key":"b25-peds13644","series-title":"Dev Disabil Res Rev","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/ddrr.88","article-title":"Anomalous development of brain structure and function in spina bifida myelomeningocele","volume":"16","author":"Juranek","year":"2010"},{"key":"b26-peds13644","series-title":"Exp Neurol","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.expneurol.2006.02.113","article-title":"Brain damage in neonatal rats following kaolin induction of hydrocephalus","volume":"200","author":"Khan","year":"2006"},{"issue":"Suppl 1","key":"b27-peds13644","series-title":"Eur J Pediatr Surg","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1055\/s-2008-1071252","article-title":"Differential ventricular expansion in hydrocephalus","volume":"8","author":"McAllister","year":"1998"},{"key":"b28-peds13644","series-title":"Fluids Barriers CNS","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/2045-8118-9-19","article-title":"The relationship between ventricular dilatation, neuropathological and neurobehavioural changes in hydrocephalic rats","volume":"9","author":"Olopade","year":"2012"},{"key":"b29-peds13644","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"832","DOI":"10.3171\/2009.7.JNS09550","article-title":"Evaluation of ventriculomegaly using diffusion tensor imaging: correlations with chronic hydrocephalus and atrophy","volume":"112","author":"Osuka","year":"2010"},{"key":"b30-peds13644","series-title":"Pediatr Radiol","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1007\/s00247-011-2180-6","article-title":"Diffusion tensor imaging evaluation of white matter in adolescents with myelomeningocele and Chiari II malformation","volume":"41","author":"Ou","year":"2011"},{"key":"b31-peds13644","series-title":"Neurol Res","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1080\/01616412.2000.11741049","article-title":"The effects of multiple shunt revisions on neuropsychological functioning and memory","volume":"22","author":"Ralph","year":"2000"},{"key":"b32-peds13644","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1007\/s00701-012-1377-2","article-title":"Diffusion tensor imaging in hydrocephalus\u2014findings before and after shunt surgery","volume":"154","author":"Scheel","year":"2012"},{"key":"b33-peds13644","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1016\/j.neuroimage.2003.07.005","article-title":"Diffusion tensor imaging detects and differentiates axon and myelin degeneration in mouse optic nerve after retinal ischemia","volume":"20","author":"Song","year":"2003"},{"key":"b34-peds13644","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1006\/nimg.2002.1267","article-title":"Dysmyelination revealed through MRI as increased radial (but unchanged axial) diffusion of water","volume":"17","author":"Song","year":"2002"},{"key":"b35-peds13644","series-title":"The Spina Bifida: Management And Outcome","first-page":"405","article-title":"Intellectual outcome in spina bifida","author":"Spennato","year":"2008"},{"key":"b36-peds13644","series-title":"The Stanford-Binet Intelligence Scale: Guide for Administering and Scoring","author":"Thorndike","year":"1986"},{"key":"b37-peds13644","series-title":"Cereb Cortex","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.1093\/cercor\/bhs226","article-title":"Functional significance of atypical cortical organization in spina bifida myelomeningocele: relations of cortical thickness and gyrification with IQ and fine motor dexterity","volume":"23","author":"Treble","year":"2013"},{"key":"b38-peds13644","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1002\/mrm.21965","article-title":"About \u201caxial\u201d and \u201cradial\u201d diffusivities","volume":"61","author":"Wheeler-Kingshott","year":"2009"},{"key":"b39-peds13644","series-title":"Brain Connect","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1089\/brain.2013.0171","article-title":"Examination of frontal and parietal tectocortical attention pathways in spina bifida meningomyelocele using probabilistic diffusion tractography","volume":"3","author":"Williams","year":"2013"},{"key":"b40-peds13644","series-title":"Acad Radiol","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/S1076-6332(03)00671-8","article-title":"Statistical validation of image segmentation quality based on a spatial overlap index","volume":"11","author":"Zou","year":"2004"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/15\/4\/article-p410.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/15\/4\/article-p410.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/15\/4\/article-p410.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T20:02:17Z","timestamp":1681588937000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/15\/4\/article-p410.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4]]},"references-count":40,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2014.10.peds13644","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4]]}}}