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Updated: May 9, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Alterations in frontostriatal pathways in children born very preterm
Emma G Duerden1, Dallas Card, Ilyse D Lax
1Diagnostic Imaging, Research Institute, Hospital for Sick Children, Toronto, ON, Canada; Neurosciences & Mental Health, Research Institute, Hospital for Sick Children, Toronto, ON, Canada; Neurology, Research Institute, Hospital for Sick Children, Toronto, ON, Canada.
Very preterm children show persistent white matter differences affecting brain pathways, even without neonatal injury. These microstructural changes may impact cognitive function, with potential sex-specific effects observed in school-aged children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Children born very preterm (<32 weeks' gestation) are at high risk for white matter injury, particularly affecting frontostriatal pathways crucial for executive functions.
- It remains unclear if very preterm children without diagnosed neonatal brain injury exhibit long-term white matter microstructural differences by school age and their relation to cognitive impairments.
Purpose of the Study:
- To investigate long-term white matter microstructural differences in school-aged children born very preterm without neonatal brain injury.
- To explore the relationship between these white matter alterations and cognitive function.
Main Methods:
- Diffusion tensor imaging (DTI) and neurodevelopmental assessments were conducted on 20 school-aged children born very preterm (gestational age 24-30 weeks) and 20 age- and sex-matched term-born controls.
- DTI metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), were analyzed in white matter pathways, particularly frontostriatal projections.
Main Results:
- Children born very preterm demonstrated reduced fractional anisotropy in key white matter tracts, including the left external capsule, superior longitudinal fasciculus, uncinate fasciculus, and inferior fronto-occipital fasciculus.
- Intelligence measures showed a negative correlation with frontostriatal fractional anisotropy specifically in preterm-born males.
Conclusions:
- Very preterm-born children exhibit persistent white matter microstructural disturbances into middle childhood, even in the absence of neonatal brain injury.
- Potential sex differences exist in the association between these persistent white matter alterations and cognitive outcomes.
