MRI Structural and Functional Changes in Children with Growth Hormone Deficiency: A Chronological Review

Noor Hamed; Ashraf Soliman; Fawzia Alyafei; Noora AlHemedi; Nada Alaaraj; Shayma Ahmed; Ahmed Elawwa; Elsaid Bedair

Introduction: This review aims to chronologically summarize MRI findings in children with GHD, correlating these changes with clinical characteristics and GH testing results, and IGF-1 levels.

Methods: We reviewed MRI studies conducted from 1991 to 2024, focusing on structural and functional brain changes in children with GHD. Data were extracted from various studies and arranged chronologically.

Results: The earliest studies by Maghnie et al. (1991) identified anterior pituitary hypoplasia and stalk agenesis as common MRI findings in GHD. Subsequent research highlighted additional structural anomalies like posterior pituitary ectopia and non-visible stalk. In the last decade, advancements in MRI technology allowed for more detailed assessments. Studies by Zhang (2020) and Hu (2019) explored cortical changes, revealing reduced gray matter volume and altered cortical thickness in GHD patients. Functional MRI studies, by Zhang. (2021) and Ding (2024), identified abnormalities in brain activity and resting-state networks, correlating these findings with cognitive and behavioural deficits.

Discussion: The chronological review underscores the progression in understanding GHD-related brain changes through MRI. Early studies primarily focused on structural anomalies, Later research integrated functional MRI, uncovering the brain function alterations and their clinical implications. Notably, in recent studies MRI aids in predicting treatment outcomes based on pituitary morphology and brain activity patterns.


Author	Year	No Patients	Findings
Maghnie et al.	1991	37	Anterior pituitary hypoplasia, stalk agenesis, and ectopic posterior pituitary in GHD
Zucchini et al.	1995	29	MRI identified posterior lobe ectopia, non-visible stalk, and hypoplasia in GHD
Deeb et al.	2015	60	Pituitary volume useful marker for diagnosing IGHD
Krasnow et al.	2018	618	Greater pituitary cyst volume and POGO in GHD vs ISS
Hu Y et al.	2019	84	FCD differences in brain networks between GHD and ISS
Zhang Z et al.	2020	48	IGHD patients had smaller gray matter volume, cortical surface area, gray matter thickness
Zhang Z et al.	2021	60	Significant morphological changes in central sulcus in IGHD vs ISS
Zhang F et al.	2021	26	ALFF abnormalities in GHD correlating with cognitive deficits
Zhou Z et al.	2023	21	Structural and functional brain changes in GHD correlating with IGF-1 levels
Ding et al.	2024	41	RSN differences in GHD, correlating with cognitive and behavioral issues

Conclusion: MRI has evolved as a critical tool in diagnosing and understanding GHD in children. Chronological analysis reveals significant advancements in detecting both structural and functional brain changes, enhancing our comprehension of GHD’s clinical impact.

ESPE Abstracts

P3-314