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Published on: November 20, 2015
Specific relations between neurodevelopmental abilities and white matter microstructure in children born preterm
Serena J Counsell1, A David Edwards, Andrew T M Chew
1Imaging Sciences Department, Robert Steiner MR Unit, Imperial College London, Hammersmith Hospital, London, UK. serena.counsell@imperial.ac.uk
Insights
Preterm birth survivors with normal MRIs show impaired neurodevelopment linked to white matter microstructure changes. Fractional anisotropy (FA) in specific brain areas predicts developmental quotient (DQ) and sub-scores, aiding prognostication.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Preterm birth survivors often experience neurodevelopmental impairments not fully explained by conventional brain imaging.
- Conventional MRI may not detect subtle white matter abnormalities impacting neurodevelopment.
Purpose of the Study:
- To investigate the relationship between white matter microstructure and neurodevelopmental outcomes in preterm infants without focal brain abnormalities.
- To test if local changes in white matter microstructure, measured by fractional anisotropy (FA), correlate with neurodevelopmental abilities at 2 years corrected age.
Main Methods:
- Diffusion tensor imaging (DTI) was used to measure FA in 33 preterm children at a median corrected age of 25.5 months.
- Neurodevelopmental assessment was performed using the Griffiths Mental Development Scales, yielding a developmental quotient (DQ) and sub-scores.
- Tract-based spatial statistics and linear regression analyzed the correlation between FA values and DQ/sub-scores.
Main Results:
- Overall developmental quotient (DQ) showed a linear relationship with FA in specific regions of the corpus callosum.
- Performance and eye-hand coordination sub-scores correlated with FA in various white matter tracts, including the corpus callosum, cingulum, fornix, anterior commissure, and uncinate fasciculus.
- These findings indicate precise relationships between microstructural abnormalities and specific neurodevelopmental deficits.
Conclusions:
- Specific neurodevelopmental impairments in preterm infants are precisely linked to consistent, localized white matter microstructural abnormalities.
- Fractional anisotropy (FA) shows potential as a biomarker for prognostication and guiding therapeutic interventions in preterm brain injury.
Abstract:
Survivors of preterm birth have a high incidence of neurodevelopmental impairment which is not explained by currently understood brain abnormalities. The aim of this study was to test the hypothesis that the neurodevelopmental abilities of 2-year-old children who were born preterm and who had no evidence of focal abnormality on conventional MR imaging were consistently linearly related to specific local changes in white matter microstructure. We studied 33 children, born at a median (range) gestational age of 28(+5) (24(+4)-32(+1)) weeks. The children were recruited as infants from the Neonatal Intensive Care Unit at Queen Charlotte's and Hammersmith Hospital in the early neonatal period and imaged at a median corrected age of 25.5 (24-27) months. The children underwent diffusion tensor imaging to measure fractional anisotropy (FA) as a measure of tissue microstructure, and neurodevelopmental assessment using the Griffiths Mental Development Scales [giving an overall developmental quotient (DQ) and sub-quotients scores for motor, personal-social, hearing-language, eye-hand coordination and performance scales] at 2 years corrected age. Tract-based spatial statistics with linear regression analysis of voxel-wise cross-subject statistics were used to assess the relationship between FA and DQ/sub-quotient scores and results confirmed by reduced major axis regression of regions with significant correlations. We found that DQ was linearly related to FA values in parts of the corpus callosum; performance sub-scores to FA values in the corpus callosum and right cingulum; and eye-hand coordination sub-scores to FA values in the cingulum, fornix, anterior commissure, corpus callosum and right uncinate fasciculus. This study shows that specific neurodevelopmental impairments in infants born preterm are precisely related to microstructural abnormalities in particular regions of cerebral white matter which are consistent between individuals. FA may aid prognostication and provide a biomarker for therapeutic or mechanistic studies of preterm brain injury.
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