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Neuropediatrics ; 47(5): 336-40, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27438376

RESUMEN

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.


Asunto(s)
Computadoras de Mano , Hidrocefalia/rehabilitación , Terapia Ocupacional , Sustancia Blanca/diagnóstico por imagen , Anisotropía , Pedúnculo Cerebral/diagnóstico por imagen , Niño , Cuerpo Calloso/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética , Imagen de Difusión Tensora , Cápsula Externa/diagnóstico por imagen , Femenino , Humanos , Hidrocefalia/diagnóstico por imagen , Hidrocefalia/cirugía , Cápsula Interna/diagnóstico por imagen , Estudios Longitudinales , Masculino , Pruebas Neuropsicológicas , Procedimientos Neuroquirúrgicos , Proyectos Piloto
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