Altered cerebral morphometry and individual-based morphological brain network in children with beta-thalassaemia major.

Beta-thalassemia major (TM) is a severe genetic blood disorder that frequently leads to cognitive impairments in pediatric patients, yet its neurological impact remains insufficiently explored. This study investigates alterations in cerebral gray matter morphology and brain network topology in children with TM and their associations with cognitive performance. High-resolution brain MRI data were processed using FreeSurfer to extract cortical morphological features, from which individual-based Morphological Brain Networks (MBNs) were constructed based on vertex-wise similarity across gray matter regions. A cohort of 27 children with TM and 40 age-matched healthy controls underwent structural network analysis, standardized cognitive assessments, and comprehensive blood testing, including evaluations of hemoglobin and iron concentrations. Results revealed marked structural disruptions in the motor and temporal cortices of TM patients. Network-level analysis further identified topological abnormalities within fronto-parietal regions, suggesting altered structural connectivity patterns that may underlie observed cognitive deficits. Notably, iron overload was significantly correlated with both regional brain changes and impaired network organization, indicating a plausible mechanistic link between systemic iron dysregulation and neural dysfunction. These findings underscore the neurological vulnerability of children with TM and illuminate the structural basis of their cognitive challenges. The study highlights the need to integrate neuroimaging biomarkers with clinical hematological profiles to better understand TM's effects on brain development. Future work should aim to expand these findings through longitudinal designs and larger samples to inform early neurocognitive interventions and optimize treatment strategies for this vulnerable population.