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Published on: November 20, 2015
The association of lung disease with cerebral white matter abnormalities in preterm infants
Mustafa Anjari1, Serena J Counsell, Latha Srinivasan
1Division of Clinical Sciences, Imperial College London and MRC Clinical Sciences Centre, London, United Kingdom.
Insights
Respiratory disease in preterm infants is linked to specific brain white matter abnormalities, even when accounting for prematurity. This suggests a connection between lung health and brain development in premature babies.
Area of Science:
- Neonatal neurology
- Pediatric respiratory medicine
- Neuroimaging
Background:
- Preterm infants face high risks of neurodevelopmental impairment and respiratory disease.
- The relationship between lung disease and brain injury in neonates is not well understood.
- Previous studies were limited by confounding factors like prematurity and infection.
Purpose of the Study:
- To investigate the association between lung disease and specific white matter abnormalities in preterm infants.
- To test the hypothesis that respiratory disease correlates with reduced fractional anisotropy (FA) in diffusion tensor imaging (DTI) data.
- To utilize multivariate statistical analysis to overcome confounding variables.
Main Methods:
- Studied 53 preterm infants at term-equivalent age using diffusion tensor imaging (DTI).
- Employed tract-based spatial statistics (TBSS) for automated, observer-independent voxelwise analysis of white matter.
- Assessed fractional anisotropy (FA) to detect white matter abnormalities.
Main Results:
- Fractional anisotropy (FA) showed a linear decrease with decreasing gestational age at birth across several white matter tracts.
- Infants requiring mechanical ventilation for over 2 days exhibited reduced FA in the genu of the corpus callosum.
- Infants with chronic lung disease showed reduced FA in the left inferior longitudinal fasciculus, independent of prematurity and scan age.
Conclusions:
- Respiratory disease is significantly associated with cerebral white matter abnormalities in preterm infants.
- This association is independent of the degree of prematurity.
- Findings highlight the impact of respiratory health on brain development in neonates.
Objective:
Preterm infants have a high incidence of neurodevelopmental impairment associated with diffuse cerebral white matter abnormalities and also a high incidence of serious respiratory disease. However, it is unclear if lung disease and brain injury are related, and previous research has been impeded by confounding effects, including prematurity and infection. Using a new approach that permits multivariate statistical analysis, we tested the hypothesis that lung disease is associated with specific white matter abnormalities, detected as reduced fractional anisotropy (FA) in diffusion tensor imaging data.
Methods:
Fifty-three preterm infants with no evidence of focal abnormality on conventional MRI were studied at term-equivalent age by using tract-based spatial statistics, an automated observer-independent method for voxelwise analysis of major white matter pathways.
Results:
In several white matter tracts, FA decreased with a linear relation to the gestational age at birth. Independent of the confounding effects of prematurity and age at scan, respiratory disease was associated with specific white matter abnormalities in preterm infants; those infants receiving mechanical ventilation for >2 days in the perinatal period (n = 10) showed reduced FA in the genu of the corpus callosum, whereas subjects with chronic lung disease (n = 15) displayed a reduction in FA in the left inferior longitudinal fasciculus.
Conclusion:
Independent of the degree of prematurity, respiratory disease is associated with cerebral white matter abnormalities.
