Case Report
Vanadia E, Di Renzo M, Trapoli
Abstract
Background: The Regulatory-Sensory Processing Disorder (RSPD), defined on the diagnostic manual DC: 0-3 R as "the child's difficulties to regulate his own behaviour, his physiological, sensory, attention, motor or affective processes and difficulties in organizing a state of calm, of alert or a positive affective state", is a neurodevelopmental disorder of the early infancy for which it has not yet been determined a clear etiopathology. Clinical practice has led us to hypothesize an association between "minor" injuries of the white matter, in particular periventricular hyperyntensities (PVHs) and RSPD. Method: We conducted a prospective clinical and neuroradiological study of 20 children aged between 2 and 4 years; the sample was divided into children with RDSP (N = 10) and healthy children (N = 10). Findings: The MRI revealed the presence of a low-grade non-cystic diffuse hyperintensity of the periventricular white matter in 8 of the 10 children with RSPD. In none of the healthy children these anomalies were found. Conclusion: The findings of our study revealed that the RSPD may be associated with periventricular hyperyntensities (PVHs), so demonstrating a probable neurobiological origin of the disorder. An interesting fact is that in the children with RSPD we analyzed, we found a posterior-anterior gradient in the localization of the altered PVWM areas, in two cases with involvement of the deep WM of temporal and parietal areas, and this seems to be in accordance with the estimated dysfunction of the associative posterior and limbic areas, with an inevitable impact on the child's emotional sphere too. However, further studies will be necessary to define the specificity of those neuroimaging findings that can be used as RSPD markers.