Alterations in white matter integrity in Egyptian youth with smartphone dependence: does DTI have a role?

Abstract

Smartphones provide various functions that facilitate our communication, organization, and entertainment in different situations. Diffusion tensor imaging (DTI) is a method measuring tissue microstructure as well as white matter integrity of the brain and detecting early changes. Several research studies recently aim to utilize conventional MRI for assessing brain structural alterations among smartphone users, but our study was aimed at identifying the DTI value while assessing white matter alterations in Egyptian youth with smartphone dependence. Our prospective case–control study involved fifty-three individuals with smart phone dependence (SPD group) as well as twenty-five volunteers who represented the control group. SPD individuals and controls were right-handed. The SPD group mean age exhibited 20.54 ± 1.56 years, while controls exhibited 26.8 ± 15.1 years. When utilizing smart phone addiction scale-short version, SPD group median total score exhibited 33. The diagnostic performance of fornix (fractional anisotropy) FA and external capsule fractional anisotropy (EC FA) regarding area under curve (AUC) exhibited significant increase as opposed to all other tested regions, with a sensitivity of 90.6% as well as a specificity of 96%. While regarding the mean diffusivity (MD), the greatest (AUC) was for EC (0.927, p < 0.001), in which the MD value = 0.825 was the cutoff value and able to diagnose the smart phone dependency with a sensitivity of 92.5% as well as a specificity of 76%. Quantitative DTI parameters (FA, MD) in different white matter regions can diagnose and detect white matter changes in excessive smartphone users even when conventional MRI data are normal. This study demonstrates the recent noninvasive MRI technique value while revealing covered brain white matter alterations in Egyptian youth due to smartphone overuse.