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Updated: May 22, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Qualitative brain MRI at term and cognitive outcomes at 9 years after very preterm birth
Sachiko Iwata1, Tomohiko Nakamura, Eriko Hizume
1Centre for Developmental & Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011 Japan.
Insights
Abnormal white matter on term MRI in very preterm infants is linked to cognitive impairments at age 9. This finding supports using term MRI to identify risks in this vulnerable population.
Area of Science:
- Neuroimaging
- Developmental Pediatrics
- Cognitive Neuroscience
Background:
- Very preterm birth (<32 weeks gestation) is associated with increased risk of neurodevelopmental deficits.
- Cerebral magnetic resonance imaging (MRI) at term-equivalent age is a valuable tool for assessing brain development in preterm infants.
- Cognitive outcomes in early childhood are crucial indicators of long-term neurodevelopmental trajectories.
Purpose of the Study:
- To investigate the association between term-equivalent cerebral MRI findings and cognitive functioning at 9 years of age in very preterm infants.
- To determine if white matter and gray matter abnormalities on MRI predict cognitive outcomes, cerebral palsy, or need for special educational assistance.
- To evaluate the predictive value of term MRI for cognitive development in very preterm infants, considering clinical risk factors.
Main Methods:
- A prospective cohort study included 76 very preterm infants who underwent cerebral MRI at term-equivalent age.
- Brain structures (white and gray matter) were assessed using established composite scores.
- Cognitive function at 9 years was evaluated in 60 participants using the Wechsler Intelligence Scale for Children, Third Edition (WISC-III).
Main Results:
- 23.3% to 41.7% of infants exhibited mildly low IQ scores, and 3.3% to 11.7% had moderately low scores.
- Abnormal white matter appearance on term MRI was significantly associated with lower verbal, performance, and full-scale IQs, cerebral palsy, and need for special assistance.
- Abnormal gray matter appearance did not predict any of the assessed neurodevelopmental outcomes.
Conclusions:
- Abnormal white matter development on term-equivalent MRI is a consistent predictor of cognitive impairments in very preterm infants at 9 years of age.
- Term MRI provides valuable prognostic information for neurodevelopmental outcomes in very preterm populations.
- Routine term MRI screening is recommended for very preterm infants to identify those at risk for cognitive deficits and guide early interventions.
Objective:
A prospective study was performed to assess the relationship between the appearance of cerebral MRI at term and the cognitive functioning at 9 years old in very preterm born infants.
Methods:
Seventy-six very preterm born infants (birth weight <1500 g or gestational age ≤32 weeks) obtained cerebral MRI at term-equivalent period, which was assessed by using established composite scores for the white and gray matter; cognitive outcomes at 9 years old were assessed in 60 subjects by using Wechsler Intelligence Scale for Children, Third Edition.
Results:
Mildly low scores on the different IQ indices (<85) were observed in 23.3% (verbal IQ), 41.7% (performance IQ), and 30.0% (full-scale IQ) of the cohort, whereas moderately low scores (<70) were noted in 3.3% (verbal IQ), 11.7% (performance IQ), and 11.7% (full-scale IQ); cerebral palsy was diagnosed in 10.0%, whereas special assistance at school was required in 56.7%. Abnormal white matter appearances predicted mildly low verbal, performance, and full-scale IQs; moderately low performance and full-scale IQs; cerebral palsy; and the requirement for special assistance at school. Abnormal white matter appearances predicted mild cognitive impairment even after the adjustment for known clinical risk factors. In contrast, abnormal gray matter appearances did not predict any of the outcome measures.
Conclusions:
In a cohort of very preterm born infants, abnormal white matter appearance on term MRI showed consistent associations with cognitive impairments at 9 years old, further supporting the benefit of obtaining term MRI for very preterm born infants.
