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Published on: January 7, 2018
Reduced cerebellar diameter in very preterm infants with abnormal general movements
Alicia J Spittle1, Lex W Doyle, Peter J Anderson
1Murdoch Childrens Research Institute, Victoria, Australia. aspittle@unimelb.edu.au <aspittle@unimelb.edu.au>
Insights
Reduced cerebellar diameter in preterm infants at term-equivalent age predicts abnormal general movements (GMs) at 3 months corrected age, independent of other brain abnormalities. This finding aids in early neuromotor deficit prediction.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Abnormal General Movements (GMs) in infancy are linked to future neuromotor deficits and white matter issues on MRI.
- Previous research has not fully defined other structural brain correlates of abnormal GMs.
Purpose of the Study:
- To investigate brain-metrics (linear MRI measurements of brain volumes) at term as predictors of abnormal GMs at 1 and 3 months corrected age in preterm infants.
- To test the hypothesis that reduced brain-metrics in motor areas (cerebellum, parietal lobes) would correlate with abnormal GMs.
Main Methods:
- Eighty-three preterm infants (<30 weeks gestational age) underwent MRI at term-equivalent age.
- MRI assessed white matter abnormality and brain-metrics (bifrontal, biparietal, lateral ventricles, transverse cerebellar diameters, inter-hemispheric distance).
- General Movements (GMs) were assessed from video at 1 and 3 months corrected age.
Main Results:
- At 1 month corrected age, 63% of infants had abnormal GMs with no brain-metric associations.
- At 3 months corrected age, 23% had abnormal GMs; reduced bifrontal, biparietal, cerebellar diameters, and enlarged lateral ventricles were associated with increased GM abnormality risk.
- Only reduced cerebellar transverse diameter remained predictive of abnormal GMs at 3 months after controlling for white matter abnormality and intraventricular hemorrhage.
Conclusions:
- Reduced cerebellar diameter at term-equivalent age is a significant predictor of abnormal General Movements (GMs) at 3 months corrected age.
- This association is independent of white matter abnormalities and intraventricular hemorrhage, highlighting the cerebellum's role.
Background:
Abnormal General Movements (GMs) early in life are predictive of later neuromotor deficits and are related to white matter abnormalities on magnetic resonance imaging (MRI). However, other structural correlates of abnormal GMs have not been defined.
Aims:
The objective of this study was to explore brain-metrics (linear brain measurements on MRI representative of 3-D brain volumes) at term as a predictor of abnormal GMs at 1 and 3months' corrected age in preterm infants. It was hypothesized that abnormal GMs would be related to reduced brain-metrics in primary motor areas, namely the cerebellum and parietal lobes.
Study Design:
Eighty three preterm infants (<30weeks' gestational age) were scanned at term-equivalent age. MRI was assessed for white matter abnormality and brain-metrics in six predefined brain regions (i.e. bifrontal, biparietal, lateral ventricles and transverse cerebellar diameters, and inter-hemispheric distance).
Outcome Measures:
At 1 and 3months' corrected age infants' GMs were assessed from video-taped footage and rated as normal or abnormal using standardized methodology.
Results:
At 1month, 63% (n=52) of infants had abnormal GMs with no association between any of the brain-metrics and abnormal GMs. At 3months, 23% (n=18) of infants had abnormal GMs (absent fidgety movements n=18; abnormal fidgety movements n=0). Reduced bifrontal, biparietal, and cerebellar transverse diameters, along with an increase in lateral ventricle sizes were associated with an increased risk of abnormal GMs at 3months' corrected age. After controlling for white matter abnormality and grade III/IV intraventricular haemorrhage, only the cerebellar transverse diameter was predictive of abnormal GMs at 3months.
Conclusions:
Reduced cerebellar diameter at term equivalent age is related to abnormal GMs at 3months' corrected age, independent of white matter abnormality and intraventricular haemorrhage.
