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Updated: May 3, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Brain Growth Gains and Losses in Extremely Preterm Infants at Term
Nelly Padilla1, Georgios Alexandrou2, Mats Blennow3
1Department of Women's and Children's Health Department of Maternal-Fetal Medicine and Neonatology (ICGON), Hospital Clínic, Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Insights
Extremely preterm infants show altered brain development, with reduced gray matter and increased fluid volume compared to full-term infants. Perinatal factors further impact brain structure, affecting cerebellar development.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Premature birth significantly impacts brain development.
- Understanding neuroanatomical differences in extremely preterm infants is crucial.
Purpose of the Study:
- Compare brain morphology in extremely preterm (EPT) infants versus term-born infants.
- Investigate associations between perinatal factors and neuroanatomical alterations in EPT infants.
Main Methods:
- Magnetic resonance imaging (MRI) at term-equivalent age (TEA).
- 47 EPT infants (born <27 weeks gestation) and 15 term-born controls.
- Automatic segmentation and voxel-based morphometry (DARTEL).
Main Results:
- EPT infants had reduced gray matter, brainstem, and increased cerebrospinal fluid volume.
- Decreased volumes observed in all brain tissues, especially cortical gray matter.
- Perinatal factors like prematurity, intraventricular hemorrhage, and PDA ligation correlated with reduced volumes, particularly in the cerebellum.
Conclusions:
- EPT infants without focal lesions exhibit altered brain growth at TEA, primarily affecting gray matter.
- Neuroanatomical alterations vary based on the presence of perinatal risk factors.
- Extended extrauterine exposure may contribute to brain growth in EPT infants.
Abstract:
Premature exposure to the extrauterine environment negatively affects the brains' developmental trajectory. Our aim was to determine whether extremely preterm (EPT) infants, with no evidence of focal brain lesions, show morphological brain differences when compared with term-born infants. Additionally, we investigated associations between perinatal factors and neuroanatomical alterations. Conventional magnetic resonance imaging was acquired at term-equivalent age (TEA) from 47 EPT infants born before 27 weeks of gestation, and 15 healthy, term-born controls. Automatic segmentation and voxel-based morphometry-Diffeomorphic Anatomical Registration through Exponentiated Lie algebra (DARTEL) were used. Compared with controls, EPT infants displayed global reductions in cortical and subcortical gray matter, brainstem, and an increased cerebrospinal fluid volume. Regionally, they showed decreased volumes of all brain tissues, in particular cortical gray matter. Increased volumes of cortical gray and white matter were observed in regions involved in visual processing. Increasing prematurity, intraventricular hemorrhage grade I-II, and patent ductus arteriosus ligation were associated with decreased volumes and had a particular effect on the cerebellum. Concluding, EPT infants without focal brain lesions had an altered brain growth at TEA that particularly affected the gray matter, and varied when it came to the presence of perinatal risk factors. Brain growth gains in EPT infants may be related to a longer extrauterine experience.
