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How to Obtain Reliable Visual Event-related Potentials in Newborns
Published on: October 24, 2019
Quantitative fiber tracking of the optic radiation is correlated with visual-evoked potential amplitude in preterm
H C Glass1, J I Berman, A M Norcia
1Department of Pediatrics, University ofCalifornia, San Francisco, San Francisco, CA, USA. Hannah.Glass@ucsf.edu
Insights
Brain microstructure in preterm infants, measured by DTI, correlates with visual function. Early neuroimaging may predict visual outcomes in these high-risk children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Infants born preterm face increased risks for adverse outcomes, including visual impairment.
- Early detection and prediction of visual deficits are crucial for timely intervention.
Purpose of the Study:
- To investigate the relationship between neonatal diffusion tensor imaging (DTI) measurements of optic radiations and visual outcomes assessed by steady-state visual evoked potentials (sVEP) in preterm infants.
- To determine if early brain microstructure assessments can predict later visual function.
Main Methods:
- Diffusion tensor imaging (DTI) was performed on preterm infants (<34 weeks gestation) before term-equivalent age to analyze optic radiation microstructure (FA, D(av), diffusivity).
- Steady-state visual evoked potentials (sVEP) were recorded at 6-20 months to assess visual function across spatial frequency, contrast, and vernier offset.
- Spearman correlation and linear regression were used to evaluate associations between DTI metrics and sVEP responses.
Main Results:
- Higher fractional anisotropy (FA) and lower mean diffusivity (D(av)) in optic radiations were associated with peak spatial frequency response amplitudes (P ≤ .006).
- No significant association was found with parallel diffusivity.
- Modest correlations were observed with swept contrast, but not with vernier offset sweeps.
Conclusions:
- Neonatal optic radiation microstructure, assessed via DTI, is linked to visual responses in infancy, particularly for moderate-to-high contrast stimuli.
- This study supports the connection between early brain white matter microstructure and functional visual outcomes in preterm infants.
- Quantitative neuroimaging may offer a valuable tool for predicting visual prognosis in neonates born prematurely.
Background And Purpose:
Children born preterm are at risk for adverse outcome, including visual impairment. We examined the relationship between neonatal DTI and sVEP in children born preterm to determine whether visual outcomes are related to early measurements of brain microstructure.
Materials And Methods:
Subjects were born at <34 weeks gestation and imaged before term-equivalent age. DTI fiber tracking was used to delineate the optic radiations and measure tract-specific average FA, D(av), and parallel and transverse diffusivity. Visual-evoked response amplitudes were measured as a function of spatial frequency, contrast, and vernier offset size with sVEP at 6-20 months after birth. The association between DTI and sVEP was assessed by using the Spearman correlation coefficient and linear regression for repeated measures.
Results:
Nine children with 15 scans were included. The peak response amplitudes for spatial frequency sweeps were associated with increasing FA and decreasing D(av) and transverse diffusivity (P ≤ .006) but not with parallel diffusivity (P = 1). There was only modest association with the swept contrast condition and no detectable association with the vernier offset sweeps.
Conclusions:
Microstructure of the optic radiations measured shortly after birth is associated with quantitatively measured responses elicited by moderate-to-high contrast spatiotemporal gratings in infancy. These findings are in keeping with studies showing a relationship between brain microstructure and function. While the clinical impact is not known, quantitative neuroimaging of white matter may ultimately be important for predicting outcome in preterm neonates.
