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White matter volume and anisotropy in preterm children: a pilot study of neurocognitive correlates
Ada Yung1, Grace Poon, De-Qiang Qiu
1Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
Insights
Preterm children show reduced whole brain white matter (WM) volume and anisotropy in late childhood. These reductions significantly impact long-term cognitive outcomes, highlighting the lasting effects of prematurity.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Prematurity and low birth weight are associated with long-term neurological and cognitive deficits.
- White matter (WM) integrity is crucial for cognitive development.
- Understanding the long-term impact of prematurity on WM structure is essential for predicting cognitive outcomes.
Purpose of the Study:
- To compare whole brain white matter (WM) volume and fractional anisotropy (FA) between preterm and term children.
- To investigate the relationship between WM characteristics and cognitive outcomes in preterm children.
Main Methods:
- Volumetric and diffusion-tensor magnetic resonance imaging (DTI) were used to assess WM in 25 preterm and 13 term children.
- Intelligence quotient (IQ) testing was performed on preterm children.
- Statistical analyses, including multiple regression, were employed to determine relationships.
Main Results:
- Preterm children exhibited significantly lower mean WM volume and FA compared to term controls.
- Both WM volume and FA were significant independent predictors of full-scale IQ (FSIQ) in preterm children, even after adjusting for birth weight, gestational age, and gender.
- Reduced WM volume and FA persisted into late childhood.
Conclusions:
- Preterm children demonstrate persistent reductions in whole brain white matter volume and anisotropy in late childhood.
- These microstructural WM differences are significantly associated with long-term cognitive deficits in individuals born preterm.
- Findings underscore the critical role of WM development in cognitive outcomes following prematurity.
Abstract:
The objectives of this study were to evaluate the differences in whole brain white matter (WM) volume and anisotropy between preterm and term children and to determine the relationships with cognitive outcome. Twenty-five low birth weight (BW), preterm, neurologically normal children between 8.8 and 11.5 y of age were recruited for volumetric and diffusion-tensor magnetic resonance imaging (DTI), together with 13 age-matched term control subjects. Subsequent intelligence quotient (IQ) testing was performed for 21 preterm children within 6 mo of imaging studies. We computed the mean volume and fractional anisotropy (FA) of the whole brain WM and compared the differences between the two groups. Mean WM volume and FA were significantly lower in the preterm group (p = 0.014 and p < 0.001, respectively). Multiple regression analysis found both WM volume and FA to be independent variables significantly affecting full scale IQ (FSIQ) (r2 = 0.407, p = 0.021 and r2 = 0.496, p = 0.005, respectively) after adjusting for BW, gestational age (GA), and gender. In the evaluation of the whole brain WM of preterm children, we found that both volume and FA remain reduced at late childhood with both parameters significantly affecting long-term cognitive outcome.
