Children with breath-holding spells showed significantly reduced bilateral amygdala volumes (left: p=0.011, g=0.52; right: p=0.007, g=0.56), decreased right anterior insula thickness (p=0.014, g=0.49) and volume (p=0.021, g=0.41), reduced cortical thickness in bilateral anterior cingulate cortices (left: p=0.019, g=0.43; right: p=0.017, g=0.45), right medial frontal cortex (p=0.009, g=0.52), and decreased volumes in right cerebellar lobule VI (p=0.007, g=0.50), left lobule VIIA crus I (p=0.012, g=0.44), and vermis IX–X (p=0.010, g=0.47) compared to controls.
Cross-Sectional (n=98)
No
Do children with breath-holding spells exhibit regional anatomical differences in brain volume, surface area, and cortical thickness compared to healthy controls?
Children with breath-holding spells demonstrate measurable morphometric reductions in brain regions involved in autonomic and emotional regulation, such as the amygdala and anterior insula.
Effect estimate: Cohen's d (Hedges' g) ranging from 0.41 to 0.56 for significantly different regions
Objectives: To evaluate regional anatomical differences in brain volume, surface area, and cortical thickness between children with breath-holding spells (BHSs) and a control group using morphometric MRI analyses. Methods: Three-dimensional T1-weighted cranial MRI data from 48 children with BHSs and 50 control children were retrospectively analyzed, yielding volumetric, surface area, and cortical thickness measures for 135 brain regions. All measurements were assessed relative to total intracranial volume (ICV). Group comparisons were performed using analysis of covariance with age, sex, and ICV as covariates, followed by Benjamini–Hochberg false discovery rate correction (q < 0.05). Results: The BHS group exhibited reduced bilateral amygdala volumes (left: q = 0.042; right: q = 0.038). Both cortical thickness and volume were reduced in the right anterior insula (thickness: q = 0.046; volume: q = 0.049). In addition, cortical thickness was reduced in the bilateral anterior cingulate cortices (left: p = 0.019, q = 0.045; right: p = 0.017, q = 0.043) as well as in the right medial frontal cortex (p = 0.009, q = 0.036). Subregional cerebellar analysis demonstrated volume reductions in the right lobule VI (q = 0.031), left lobule VIIA (Crus I) (q = 0.043), and vermis IX–X (q = 0.039). Conclusions: Detecting measurable morphometric changes in brain regions involved in autonomic and emotional regulation in children with BHSs will contribute to understanding the neurobiological characteristics associated with BHSs.
Aytaç et al. (2026) conducted a cross-sectional in Children aged 6 months to 6 years with clinically diagnosed breath-holding spells (BHSs), normal neurodevelopment, and normal brain MRI compared to age-matched controls with normal brain MRI and no neurological disorders (n=98). Children with breath-holding spells showed significantly reduced bilateral amygdala volumes (left: p=0.011, g=0.52; right: p=0.007, g=0.56), decreased right anterior insula thickness (p=0.014, g=0.49) and volume (p=0.021, g=0.41), reduced cortical thickness in bilateral anterior cingulate cortices (left: p=0.019, g=0.43; right: p=0.017, g=0.45), right medial frontal cortex (p=0.009, g=0.52), and decreased volumes in right cerebellar lobule VI (p=0.007, g=0.50), left lobule VIIA crus I (p=0.012, g=0.44), and vermis IX–X (p=0.010, g=0.47) compared to controls.