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Anatomical MRI of the Developing Human Brain: What Have We Learned?

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ABSTRACT

Objective

To critically review and integrate the existing literature on magnetic resonance imaging (MRI) studies of the normally developing brain in childhood and adolescence and discuss the implications for clinical MRI studies.

Method

Changes in regional brain volume with age and differences between the sexes are summarized from reports in refereed journal articles pertaining to MRI of the developing human brain.

Results

White matter volume increases with age. Gray matter volumes increase during childhood and then decrease before adulthood. On average, boys have larger brains than girls; after correction for overall brain volume the caudate is relatively larger in girls, and the amygdala is relatively larger in boys. Differences are of clinical interest given gender-related differences in the age of onset, symptomatology, and prevalence noted for nearly all childhood-onset psychiatric disorders. Attention-deficit/hyperactivity disorder is frequently used as an example to demonstrate these points.

Conclusions

Understanding the developmental trajectories of normal brain development and differences between the sexes is important for the interpretation of clinical imaging studies.

Section snippets

METHOD

The articles summarized were retrieved through Medline and included healthy subjects younger than 18 years of age (Table 1). Healthy is defined as either normal volunteers or, in some cases, nonpsychiatric patients. Twenty-two articles were included. Fifteen normative articles were excluded as they reported qualitative or area measures rather than quantitative or volumetric measures. The only exception was studies of the corpus callosum, as all relied on area measures. Thirty-five articles

Developmental Changes

Consistent with postmortem studies (Kretschmann et al., 1986), total brain size does not increase significantly after age 5. This relative stability of total brain volume belies a dynamic interplay of simultaneously occurring progressive and regressive events, with different regions following different time courses.

White matter volume increases significantly during childhood and into adulthood. This is probably related to ongoing myelination of axons by oligodendrocytes, following a pattern

DISCUSSION

While the reviewed reports describe an increase in brain volume over the first few years, significant decreases in regional volumes and overall stability in brain size are shown to occur during later childhood and adolescence, contrary to general misconceptions of brain growth over this period. Regional changes in brain volume throughout childhood and adolescence are relevant in relation to landmarks in behavioral development and the emergence of clinical disorders over this age period.

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  • Cited by (0)

    The first author thanks Prof. A.J. Durston and Dr. B.N.M. van Berckel for their critical review of the manuscript.

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