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Effect of antenatal growth on brain white matter maturation in preterm infants at term using tract-based spatial
Virva Lepomäki1, Jaakko Matomäki, Helena Lapinleimu
1Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland. vikale@utu.fi
Insights
Preterm infants born small for gestational age (SGA) show impaired white matter maturation compared to appropriate for gestational age (AGA) infants. Diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) revealed differences in key white matter tracts.
Area of Science:
- Neonatal neuroscience
- Pediatric neuroimaging
- Developmental biology
Background:
- Diffusion tensor imaging (DTI) is crucial for studying infant white matter maturation, offering key clinical insights into brain organization and integrity.
- Assessing white matter development in preterm infants is vital for understanding long-term neurological outcomes.
Purpose of the Study:
- To compare white matter maturation between preterm infants born small for gestational age (SGA) and those appropriate for gestational age (AGA).
- To investigate the impact of antenatal growth on early white matter development.
Main Methods:
- Utilized diffusion tensor imaging (DTI) to assess white matter maturation in 36 preterm infants (9 SGA, 27 AGA).
- Employed tract-based spatial statistics (TBSS), a rater-independent method, for objective white matter analysis.
Main Results:
- Tract-based spatial statistics (TBSS) revealed significantly lower fractional anisotropy (FA) values in multiple white matter tracts for SGA infants compared to AGA infants.
- Key affected tracts included the anterior thalamic radiation, corticospinal tract, and various longitudinal and occipitofrontal fasciculi.
- No significant differences in mean diffusivity were observed between the SGA and AGA groups.
Conclusions:
- Tract-based spatial statistics (TBSS) objectively confirmed impaired white matter maturation in preterm infants with small for gestational age (SGA) growth compared to appropriate for gestational age (AGA) infants.
- The observed white matter differences were predominantly in tracts that undergo early myelination.
- Findings highlight the impact of antenatal growth on early brain development and white matter integrity.
Background:
White matter maturation of infants can be studied using diffusion tensor imaging (DTI). DTI of the white matter of the infant brain provides the best available clinical measures of brain tissue organisation and integrity.
Objective:
The purpose of this study was to compare white matter maturation between preterm infants born small for gestational age (SGA) and preterms with weight appropriate for gestational age (AGA) at birth.
Materials And Methods:
A total of 36 preterm infants were enrolled in the study (SGA, n = 9). A rater-independent method called tract-based spatial statistics (TBSS) was used to assess white matter maturation.
Results:
When measured by TBSS, the AGA infants showed higher fractional anisotrophy values in several white matter tracts than the SGA infants. Areas with significant differences included anterior thalamic radiation, corticospinal tract, forceps major and minor, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus, uncinate fasciculus, and superior longitudinal fasciculus (temporal part). No significant difference was found for mean diffusivity.
Conclusion:
As an objective and user-independent method, TBSS confirmed that preterm infants with impaired antenatal growth have impaired white matter maturation compared to preterm infants with normal antenatal growth. The differences were mainly detected in radiations that are myelinated first.
