Navigating Neurodevelopment: A Comprehensive Look At The Clinical Profile And Brain Mri Findings In Children With Global Developmental Delay

Abstract

Childhood developmental disorders impacting 5-10% of preschoolers, often prompt referrals to paediatric neurologists, with Global Developmental Delay (GDD) being a prevalent concern. GDD is identified when performance falls 2SD or more below the mean in at least two developmental domains—gross motor, fine motor, social and language. Despite its prevalence in India, limited research exists on this subject. This study aims to address the data gap by examining children with GDD, delving into their clinical profile (including antenatal factors, birth history, developmental milestones, and detailed CNS examinations). Significantly, the research seeks to correlate these profiles with structural brain abnormalities through Magnetic Resonance Imaging (MRI), a pivotal method for evaluating developmental delays. Past Indian surveys have reported a 5.4% to 15.3% prevalence of developmental disorders. Consequently, the study holds considerable importance in shedding light on this condition among Indian children. Through a comprehensive analysis and MRI insights into brain tissue structures and anomalies, it aims to deepen our understanding of developmental delays, providing valuable contributions to the field.

METHODS:

This study was carried out as a prospective observational case series within a hospital environment. Data collection adhered to a predefined proforma specifically crafted for the study, and the findings from Magnetic Resonance Imaging were meticulously correlated. Conclusions were drawn using established criteria for each variable. Additionally, the study included supplementary investigations that could provide diagnostic insights in select cases, thereby enriching the overall depth of the research.

RESULTS:

Out of the 93 children examined (51 male, 42 female), 82.79% exhibited abnormal Magnetic Resonance Imaging (MRI) findings. Among these cases, the majority (53) displayed features indicative of sequelae to hypoxic ischemic insult, such as periventricular leukomalacia, encephalomalacia, and thinning of the corpus callosum. Additionally, four children exhibited corpus callosum agenesis, and one child was diagnosed with metachromatic leukodystrophy. The most commonly affected areas of the brain included the periventricular white matter, centrum semiovale, and peri trigonal region. Subcortical white matter hyperintensity was observed in all lobes, with a notably high occurrence in the parieto-occipital regions. Deep Gray matter involvement, specifically in the globus pallidus internus and basal ganglia, was noted in four cases. Overall, these findings underscore the diverse and complex nature of MRI abnormalities in this paediatric cohort.

CONCLUSION:

Our study on the clinical profile and brain MRI findings in children with Global Developmental Delay sheds light on the complex interplay between neurodevelopmental challenges and structural anomalies. This research aims to guide precise diagnostics and tailored interventions, contributing to a deeper understanding of Global Developmental Delay. May our findings inspire further advancements, fostering improved outcomes and support for these children in the realm of paediatric neurology.