Selective neuroanatomical alterations in children with growth hormone deficiency: a volumetric MRI analysis using automated segmentation.

OBJECTIVES: To quantitatively evaluate global and regional brain volumes in children with biochemically confirmed growth hormone deficiency (GHD) using standardized volumetric MRI. METHODS: This retrospective case-control study included 64 children with isolated GHD (43 boys, 21 girls; mean age, 11.4 ± 3.2 years) and 64 age- and sex-matched healthy controls. High-resolution 3D T1-weighted MRI scans were processed using the volBrain automated segmentation pipeline. Global, cortical, and subcortical volumes were normalized to intracranial cavity volume (ICV). Group differences were analyzed with age-, sex-, and ICV-adjusted models, corrected for multiple comparisons (FDR<0.05). RESULTS: ; q=0.003) volumes compared with controls, while white matter volume was preserved. Regionally, hippocampal (q=0.02), thalamic (q=0.03), and caudate (q=0.04) volumes were smaller in GHD. ICV-normalized models showed reduced gray matter and limbic shares, with relatively higher thalamic and white matter proportions. Differences were more pronounced in prepubertal subjects and partially attenuated during puberty. CONCLUSIONS: Pediatric GHD is associated with selective reductions in gray matter-dominant and limbic-striatal regions, with relative preservation of white matter. Quantitative volumetric MRI provides a reproducible biomarker framework for assessing GH-related neurodevelopmental alterations.