Abstract / Summary
Abstract Recombinant human growth hormone (rhGH) is the standard treatment for isolated growth hormone deficiency (IGHD), but its effects on structural brain development remain incompletely understood. This study evaluated the longitudinal volumetric changes in the pituitary gland and selected brain structures in children with IGHD following rhGH therapy. In this ambidirectional cohort study, 43 children with IGHD underwent MRI at baseline and after a mean follow-up of 1.6 ± 1.2 years following rhGH therapy, with age- and sex-matched controls recruited separately for baseline (n = 20) and follow-up (n = 21) evaluation. Pituitary volumes were manually segmented using 3D Slicer, while subcortical and corpus callosum structures were analysed using automated segmentation (Fastsurfer). At baseline, IGHD participants had significantly smaller pituitary and splenium volumes, while the remaining corpus callosum regions were larger compared with controls. Following rhGH therapy, pituitary and splenium volumes increased significantly (p < 0.01), with partial normalisation, while enlarged corpus callosum subregions showed significant volume reduction, indicating region-specific structural adaptation. rhGH therapy is therefore associated with region-specific brain volumetric changes and partial normalisation of structural abnormalities in children with IGHD, and MRI-based volumetry may serve as a useful biomarker for monitoring treatment-related brain structural changes.