Development of Normative Pediatric Brain Myelin and Iron Atlases and Application to Adrenoleukodystrophy (ALD)

Motivation: Current pediatric brain susceptibility atlases were created using a small number of subjects or do not distinguish the contribution of myelin and iron. Goal(s): To create normative pediatric atlases of brain myelin and iron using susceptibility source separation. Approach: Sex-specific atlases of negative and positive susceptibility sources were created using data from 52 male and 54 female subjects aged 5-10 years. Myelin and iron maps obtained from two ALD patients were compared with the normative male atlases. Results: ALD patients showed severe myelin loss in the splenium of corpus callosum. One ALD patient showed abnormally high iron accumulation consistent with microglial ferroptosis. Impact: The creation of age- and sex-specific normative pediatric brain atlases of negative and positive susceptibility sources enables the study of spatiotemporal distribution of brain myelin and iron in children under normal neurodevelopment and in various clinical conditions.