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Updated: Apr 17, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Deep grey matter growth predicts neurodevelopmental outcomes in very preterm children
Julia M Young1, Tamara L Powell2, Benjamin R Morgan2
1Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8; Department of Psychology, University of Toronto, Toronto, Ontario, Canada, M5S 3G3.
Insights
Brain structure growth in very preterm infants, measured by MRI, predicts cognitive and motor skills at age 4. Deep grey matter growth is a key biomarker for neurodevelopmental outcomes in these children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Very preterm birth (<32 weeks) is associated with significant neurodevelopmental deficits often detected later in childhood.
- Early identification of at-risk infants is crucial for timely intervention and improved long-term outcomes.
- Current neurodevelopmental assessments are typically performed at school age, missing early predictive windows.
Purpose of the Study:
- To investigate if early MRI-based brain structure volume and growth rates in very preterm neonates can predict neurodevelopmental outcomes at 4 years of age.
- To identify specific brain regions and growth patterns that serve as reliable biomarkers for cognitive and motor development.
- To explore the relationship between early brain development, maternal education, and perinatal factors.
Main Methods:
- Structural T2-weighted MRI scans were acquired in 96 very preterm neonates within 2 weeks of birth and in 70 at term-equivalent age.
- An automated 3D image analysis procedure quantified the volume of selected brain structures at both time points.
- Neuropsychological assessments (IQ, language, visual motor integration) were conducted at 4 years of age in 53 children.
Main Results:
- Growth rates of the caudate and globus pallidus between preterm birth and term-equivalent age significantly predicted visual motor integration scores at 4 years.
- Caudate and putamen growth were associated with IQ and language scores, highlighting deep grey matter's role.
- Maternal education correlated with IQ and language, but not visual motor integration, suggesting distinct developmental influences.
Conclusions:
- Deep grey matter growth rates in the early weeks after very preterm birth are promising biomarkers for predicting long-term neurodevelopmental outcomes.
- These findings enhance understanding of brain-behavior relationships in extremely preterm infants.
- Early MRI-based growth metrics offer a potential window for early detection and intervention strategies.
Abstract:
We evaluated whether the volume and growth rate of critical brain structures measured by MRI in the first weeks of life following very preterm (<32/40 weeks) birth could predict subsequent neurodevelopmental outcomes at 4 years of age. A significant proportion of children born very prematurely have cognitive deficits, but these problems are often only detected at early school age. Structural T2-weighted magnetic resonance images were acquired in 96 very preterm neonates scanned within 2 weeks of birth and 70 of these at term-equivalent age. An automated 3D image analysis procedure was used to measure the volume of selected brain structures across all scans and time points. At 4 years of age, 53 children returned for neuropsychological assessments evaluating IQ, language and visual motor integration. Associations with maternal education and perinatal measures were also explored. Multiple regression analyses revealed that growth of the caudate and globus pallidus between preterm birth and term-equivalent age predicted visual motor integration scores after controlling for sex and gestational age. Further associations were found between caudate and putamen growth with IQ and language scores. Analyses at either preterm or term-equivalent age only found associations between normalized deep grey matter growth and visual motor integration scores at term-equivalent age. Maternal education levels were associated with measures of IQ and language, but not visual motor integration. Thalamic growth was additionally linked with perinatal measures and presence of white matter lesions. These results highlight deep grey matter growth rates as promising biomarkers of long-term outcomes following very preterm birth, and contribute to our understanding of the brain-behaviour relations in these children.
