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Abnormal deep grey matter development following preterm birth detected using deformation-based morphometry
James P Boardman1, Serena J Counsell, Daniel Rueckert
1Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
Insights
Preterm birth is linked to brain abnormalities, specifically reduced deep grey matter volumes. This white matter injury impacts remote brain structures, affecting neurodevelopment in infants.
Area of Science:
- Neuroscience
- Developmental Biology
- Radiology
Background:
- Preterm birth is a major risk factor for neurodevelopmental and cognitive impairments.
- Diffuse white matter abnormality is common in preterm infants but its impact is unclear.
- Understanding brain alterations in preterm infants is crucial for early intervention.
Purpose of the Study:
- To investigate cerebral morphological alterations in preterm infants.
- To correlate white matter injury with deep grey matter development.
- To explore the impact of prematurity on brain structure.
Main Methods:
- Magnetic resonance (MR) imaging at term equivalent age.
- Diffusion-weighted imaging for tissue damage quantification.
- Deformation-based morphometry for whole-brain analysis.
Main Results:
- Preterm infants showed reduced thalamic and lentiform volumes.
- These alterations worsened with increased prematurity.
- Deep grey matter growth failure was associated with white matter injury.
Conclusions:
- White matter injury in preterm infants is linked to maldevelopment of remote structures.
- Corticothalamic connectivity may be disturbed during critical developmental periods.
- Deformation-based morphometry is valuable for studying infant brain development and injury.
Abstract:
Preterm birth is a leading risk factor for neurodevelopmental and cognitive impairment in childhood and adolescence. The most common known cerebral abnormality among preterm infants at term equivalent age is a diffuse white matter abnormality seen on magnetic resonance (MR) images. It occurs with a similar prevalence to subsequent impairment, but its effect on developing neural systems is unknown. MR images were obtained at term equivalent age from 62 infants born at 24-33 completed weeks gestation and 12 term born controls. Tissue damage was quantified using diffusion-weighted imaging, and deformation-based morphometry was used to make a non-subjective survey of the whole brain to identify significant cerebral morphological alterations associated with preterm birth and with diffuse white matter injury. Preterm infants at term equivalent age had reduced thalamic and lentiform volumes without evidence of acute injury in these regions (t = 5.81, P < 0.05), and these alterations were more marked with increasing prematurity (t = 7.13, P < 0.05 for infants born at less than 28 weeks) and in infants with diffuse white matter injury (t = 6.43, P < 0.05). The identification of deep grey matter growth failure in association with diffuse white matter injury suggests that white matter injury is not an isolated phenomenon, but rather, it is associated with the maldevelopment of remote structures. This could be mediated by a disturbance to corticothalamic connectivity during a critical period in cerebral development. Deformation-based morphometry is a powerful tool for modelling the developing brain in health and disease, and can be used to test putative aetiological factors for injury.
