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T 2-Weighted Hyperintensities (Unidentified Bright Objects) in Children With Neurofibromatosis 1: Their Impact on Cognitive Function

Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, The Duchess of Kent Children's Habilitation Institute, Hong Kong, gohhs{at}ha.org.hk, whsgoh{at}hkucc.hku.hk

Pek-Lan Khong, MD

Department of Diagnostic Radiology, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong

Connie S. Y. Leung, MSc(ClinPsy)

Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, The Duchess of Kent Children's Habilitation Institute, Hong Kong

Virginia C. N. Wong, MD

Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, The Duchess of Kent Children's Habilitation Institute, Hong Kong

The impact of magnetic resonance imaging (MRI)—identified T₂-weighted hyperintensities (unidentified bright objects) on the cognitive function of children with neurofibromatosis 1 is controversial. We recruited 32 right-handed children with neurofibromatosis 1 (22 boys, 10 girls) aged between 5 and 16 years (mean age 10.2 years) for magnetic resonance imaging examinations and neuropsychologic evaluation. Statistical analysis was performed to evaluate the significance of the hyperintensities. Twenty-four children had unidentified bright objects, whereas eight children did not. Using the t-test, thalamic lesions were associated with lower intellectual function (P = .031). Left globus pallidus hyperintensities were associated with a lower attention score ( P = .04), and right middle cerebellar peduncle hyperintensities were associated with a lower sensorimotor score (P = .05). The size of the thalamic lesions correlated with cognitive function (P < .05). Among the group with unidentified bright objects, there was a significant association between more involved sites on the dominant hemisphere and impaired verbal function (r = —.55; P = .005). Unidentified bright objects in the thalamus, globus pallidus, and middle cerebellar peduncles and the laterality of the lesions had an impact on cognitive function. (J Child Neurol 2004; 19:853-858).

Journal of Child Neurology, Vol. 19, No. 11, 853-858 (2004)
DOI: 10.1177/08830738040190110201


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