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Updated: Jul 11, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Neonatal microstructural development of the internal capsule on diffusion tensor imaging correlates with severity of
Jessica Rose1, Majid Mirmiran, Erin E Butler
1Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA. jessica.rose@stanford.edu
Insights
Neonatal diffusion tensor imaging (DTI) fractional anisotropy (FA) in the posterior limbs of the internal capsule (PLIC) can predict future motor deficits. Low FA in preterm infants is linked to cerebral palsy and more severe gait impairments at age four.
Area of Science:
- Neuroimaging
- Developmental neuroscience
- Pediatric neurology
Background:
- Preterm birth is associated with increased risk of neurodevelopmental disorders.
- The posterior limbs of the internal capsule (PLIC) are crucial white matter tracts affected in various neurological conditions.
Purpose of the Study:
- To investigate the association between neonatal microstructural development of the PLIC, assessed by fractional anisotropy (FA) using diffusion tensor imaging (DTI), and motor outcomes at 4 years of age in very-low-birthweight preterm infants.
Main Methods:
- Diffusion tensor imaging (DTI) was used to measure fractional anisotropy (FA) in the PLIC of 24 very-low-birthweight preterm infants at 37 weeks' gestational age.
- Infants were followed up to 4 years of age, with gait and motor function assessed using the Gross Motor Function Classification System (GMFCS) and neurological impairment (NI) scores.
Main Results:
- Seven out of ten infants with low neonatal PLIC FA were diagnosed with cerebral palsy (CP) by age 4, compared to none with normal FA.
- Among infants with low neonatal FA, significant negative correlations were found between PLIC FA and log NI (r=-0.89, p=0.001) and GMFCS (r=-0.65, p=0.04).
- No significant correlations between neonatal FA and motor outcomes were observed in infants with normal neonatal FA.
Conclusions:
- Neonatal DTI assessment of PLIC microstructure may serve as an early predictor of motor deficits and CP severity in very-low-birthweight preterm infants.
- This preliminary study highlights the potential of DTI in identifying infants at risk for long-term motor impairments.
Abstract:
Neonatal microstructural development in the posterior limbs of the internal capsule (PLIC) was assessed using diffusion tensor imaging (DTI) fractional anisotropy (FA) in 24 very-low-birthweight preterm infants at 37 weeks' gestational age and compared with the children's gait and motor deficits at 4 years of age. There were 14 participants with normal neonatal FA values (seven females, seven males; born at 27.6 weeks [SD 2.3] gestational age; birthweight 1027g [SD 229]) and 10 participants with low FA values in the PLIC (four females, six males; born at 28.4 weeks [SD 2.0] gestational age; birthweight 1041g [SD 322]). Seven of the 10 children with low FA and none of the children with normal FA had been diagnosed with CP by the time of gait testing. Among children with low neonatal FA, there was a strong negative correlation between FA of the combined left and right side PLIC and log NI (r=-0.89, p=0.001) and between FA and GMFCS (r=-0.65, p=0.04) at 4 years of age. There was no correlation between FA and gait NI or GMFCS at 4 years of age among children with normal neonatal FA. This preliminary study suggests neonatal DTI may be an important predictor of the severity of future gait and motor deficits.
