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Updated: Apr 29, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Diffuse excessive high signal intensity in low-risk preterm infants at term-equivalent age does not predict outcome
Yael Leitner1, Maya Weinstein, Vicki Myers
1Child Development Centre, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Centre, Weizman 6, 64239, Tel Aviv, Israel, leitnery@tlvmc.gov.il.
Insights
Diffuse excessive high signal intensity (DEHSI) in premature infants does not predict short-term neurobehavioral outcomes. However, DEHSI is associated with altered white matter (WM) maturation, suggesting potential long-term effects.
Area of Science:
- Neonatal Neurology
- Neuroimaging
- Developmental Pediatrics
Background:
- The neurodevelopmental outcome of premature infants with diffuse excessive high signal intensity (DEHSI) remains unclear.
- This study investigates DEHSI in preterm infants without major brain abnormalities.
Purpose of the Study:
- To explore the relationship between DEHSI, white matter (WM) diffusion characteristics, perinatal factors, and neurobehavioral outcomes at one year.
- To assess the predictive value of DEHSI for short-term neurodevelopmental outcomes in preterm infants.
Main Methods:
- MRI and diffusion tensor imaging (DTI) were performed at term-equivalent age in 58 preterm infants.
- Neurobehavioral assessments (Griffiths Mental Developmental Scales), neurological exams, and Parental Stress Index (PSI) were conducted at one year corrected age.
- Infants were classified based on DEHSI presence (none, mild, moderate) to compare outcomes and WM maturation.
Main Results:
- No significant differences in perinatal characteristics or one-year neurobehavioral outcomes were found across DEHSI groups.
- Infants with DEHSI exhibited increased axial and radial diffusivities in specific WM regions, indicating delayed maturation.
- A correlation between time from birth to MRI and WM microstructure was observed in infants without DEHSI.
Conclusions:
- DEHSI is not a predictor of short-term adverse neurobehavioral outcomes or linked to perinatal risks in preterm infants.
- Extrauterine exposure time differentially impacts WM maturation trajectories in infants with and without DEHSI.
- DEHSI may signify alterations in WM maturational characteristics requiring further investigation for long-term consequences.
Introduction:
The outcome of premature infants with only diffuse excessive high signal intensity (DEHSI) is not clear. We explored the relationship between DEHSI, white matter (WM) diffusion characteristics, perinatal characteristics, and neurobehavioral outcome at 1 year in a homogenous group of preterm infants without major brain abnormalities.
Methods:
Fifty-eight preterm infants, gestational age 29 ± 2.6 weeks, underwent an MRI at term-equivalent age (TEA). Griffiths Mental Developmental Scales, neurological assessment, and Parental Stress Index (PSI) were performed at 1 year corrected age. These measures were compared between preterm infants according to DEHSI classification (none, mild, moderate). Diffusion tensor imaging was used in major WM volumes of interest to objectively measure the degree of WM maturation.
Results:
No significant differences were detected in the perinatal risk characteristics, neurobehavioral outcome, and PSI at 1 year between infants with different DEHSI classifications. In infants with DEHSI, increased axial and radial diffusivities were detected in the optic radiations, centrum semiovale, and posterior limb of the internal capsule, indicating less advanced maturation of the WM. Significant correlations were detected between the time interval from birth to MRI and the WM microstructure in infants without DEHSI.
Conclusion:
DEHSI in premature infants is neither a predictive measure for short-term adverse neurobehavioral outcome nor related to perinatal risk characteristics. Extrauterine exposure time had a differential effect on WM maturational trajectories in infants with DEHSI compared to those without. We suggest DEHSI may represent an alteration in WM maturational characteristics. Further follow-up studies may verify later consequences of DEHSI in premature infants.
