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Serial diffusion tensor images during infancy and their relationship to neuromotor outcomes in preterm infants
So-Yeon Shim1, Hye-Jin Jeong, Dong Woo Son
1Division of Neonatology, Ewha Womans University, School of Medicine, Seoul, Korea.
Insights
Preterm infants show delayed white matter development, particularly in the corpus callosum (CC). Fractional anisotropy (FA) in the CC at one year correlates with motor function, highlighting its importance for neuromotor outcomes in infants without apparent brain abnormalities.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Pediatric Neurology
Background:
- Preterm infants face increased neuromotor dysfunction risk, even with normal MRI scans.
- Subtle white matter (WM) abnormalities may underlie these risks.
Purpose of the Study:
- Compare serial diffusion tensor imaging (DTI) in preterm infants and term controls.
- Investigate WM regions linked to neuromotor outcomes in preterm infants.
Main Methods:
- Serial DTI scans at term-equivalent age (TEA) and 1 year corrected age.
- Bayley Scales of Infant Development (BSID-II) for neuromotor assessment.
- Tract-based spatial statistics and regions of interest analysis.
Main Results:
- WM development delayed in preterm infants at TEA, normalizing by 1 year except for the corpus callosum (CC).
- Positive correlation between psychomotor developmental index and CC fractional anisotropy (FA) at 1 year.
- CC (body and splenium) FA reflected motor function after adjusting for confounders.
Conclusions:
- Corpus callosum (CC) in preterm infants shows persistent underdevelopment compared to term controls.
- CC fractional anisotropy (FA) at 1 year is a sensitive marker for motor function in preterm infants without apparent brain abnormalities.
Background:
Even preterm infants with normal magnetic resonance imaging (MRI) results are at greater risk for neuromotor dysfunction.
Objectives:
Our aim was to compare serial diffusion tensor imaging (DTI) data from preterm infants without apparent brain abnormalities on magnetic resonance imaging with those from term controls and to investigate the white matter (WM) region associated with neuromotor outcomes.
Methods:
We obtained serial DTIs from 21 preterm infants at term-equivalent age (TEA) and 1 year of corrected age. As controls, 15 term neonates and 20 newly recruited term infants aged 1 year underwent DTI. Preterm and term infants at 1 year of age were assessed with the Bayley Scales of Infant Development, second edition. Tract-based spatial statistics and regions of interest were used for analysis.
Results:
At TEA, the entire WM development was delayed in the preterm infants compared with the term controls, but at 1 year of age, the WM development, except for that of the corpus callosum (CC), had reached the development level of the term controls. The psychomotor developmental index was positively correlated with the fractional anisotropy (FA) in the CC (particularly in the body and splenium) at 1 year of age after correcting for gestational age, chronic lung disease, and postnatal infection.
Conclusions:
The CC of the preterm infants was consistently underdeveloped compared with that of the term controls. The FA in the CC, particularly in the body and splenium at 1 year of age, well reflected the degree of motor function in infants without apparent brain abnormalities.
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