Noushin Yahyavi-Firouz-Abadi MD, Presenter: Nothing to Disclose

Jerrel Rutlin, Abstract Co-Author: Nothing to Disclose

James Hoekel, Abstract Co-Author: Nothing to Disclose

Robert C. McKinstry MD, PhD, Abstract Co-Author: Travel support, Siemens AG Speaker, Siemens AG

Joshua S. Shimony MD, PhD, Abstract Co-Author: Nothing to Disclose

David Gutmann MD, PhD, Abstract Co-Author: Nothing to Disclose

Optic pathway Glioma (OPG) occurs in 15-20% of children with neurofibromatosis type 1 (NF1) and may result in vision loss in as many as 50% of patients. To date, no radiologic finding or other reliable factor has been identified to predict NF1-OPG vision loss or to determine which patients will require treatment. The purpose of this study was to investigate the utility of resting state fMRI (rsfMRI) as a potential marker for vision loss in a cohort of children with NF1-OPG.

Ophthalmologic evaluations and concurrent rsfMRI measurements were performed in 26 patients with NF1-OPG (9 with progressive and 17 with stable disease), some of which underwent as many as 4 paired MRI-ophthalmology exams. The intra- and inter-connectivity of five resting state networks were evaluated in the following systems: default-mode network (DMN), dorsal attention network (DAN), control (CTL), salience (SAL) and sensory-motor network (SMN). Visual acuity was measured by the logarithm of the minimal angle of resolution (logMAR).

Evaluation of the rsfMRI demonstrates a correlation between increased intra-network connectivity of SAL (p<0.001) and SMN (P=0.01) with an increase in LogMAR. In addition, there was a correlation between increased inter-network functional connectivity in DAN-SMN pair (p<0.001) and SAL-SMN (P<0.01) pair with increased LogMAR.

In a small cohort of patients with NF1- OPG, we demonstrated that functional connectivity measures derived from rsfMRI correlate with vision loss. A prospective study in a larger cohort with longer follow-up is needed to evaluate whether rsfMRI can be a used as a reliable predictor of vision loss and a marker for early treatment in this population.

Our preliminary results indicate that functional connectivity as measured using rsfMRI may be useful as a marker of vision loss in children with NF1-OPG.

Yahyavi-Firouz-Abadi, N, Rutlin, J, Hoekel, J, McKinstry, R, Shimony, J, Gutmann, D, Resting State fMRI as a Predictor of Vision Loss in Patients with Neurofibromatosis Type 1 (NF1)-associated Optic Pathway Gliomas.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015116.html