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Regional Brain Biometrics at Term-Equivalent Age and Developmental Outcome in Extremely Low-Birth-Weight Infants
Launice Melbourne1, Jonathan Murnick2, Taeun Chang2
1Divsion of Neonatology, Children's National Health Systems, Washington, District of Columbia.
Insights
Brain imaging measurements in extremely low-birth-weight (ELBW) infants can predict developmental outcomes. Deep gray matter area (DGMA) on term-equivalent MRI is a strong indicator of cognitive and motor development in preterm survivors.
Area of Science:
- Neuroimaging
- Developmental Pediatrics
- Neonatology
Background:
- Extremely low-birth-weight (ELBW) infants face risks of adverse neurodevelopmental outcomes.
- Early identification of neurodevelopmental risks is crucial for timely intervention.
Purpose of the Study:
- To assess regional brain biometrics from term-equivalent magnetic resonance imaging (TE-MRI) in ELBW infants.
- To determine the association between these biometrics and later developmental outcomes.
Main Methods:
- Retrospective analysis of TE-MRI scans from 27 ELBW infants.
- Measurement of regional brain structures including deep gray matter area (DGMA) and transcerebellar diameter (TCD).
- Correlation of biometrics with Bayley-II developmental scores using linear regression.
Main Results:
- Deep gray matter area (DGMA) showed significant association with both cognitive and motor outcomes.
- Transcerebellar diameter (TCD) and corpus callosum splenium were also linked to cognitive and motor outcomes, respectively.
- A DGMA less than 10.26 cm² was highly specific for predicting poor cognitive and motor outcomes.
Conclusions:
- TE-MRI biometrics, particularly DGMA, are associated with early childhood cognitive and motor development in ELBW infants.
- DGMA appears to be a robust predictor of adverse developmental outcomes in preterm survivors.
- Impaired deep gray matter, callosal, and cerebellar size on TE-MRI correlate with poorer neurodevelopmental trajectories.
Objective:
This study aims to evaluate individual regional brain biometrics and their association with developmental outcome in extremely low-birth-weight (ELBW) infants.
Study Design:
This is a retrospective study evaluating term-equivalent magnetic resonance imaging (TE-MRI) from 27 ELBW infants with known developmental outcomes beyond 12 months corrected age. Regional biometric measurements were performed by a pediatric neuroradiologist blinded to outcome data. Measures included biparietal width, transcerebellar diameter (TCD), deep gray matter area (DGMA), ventricular dilatation, corpus callosum, and interhemispheric distance. The relationship between regional biometrics and Bayley-II developmental scores were evaluated with linear regression models.
Results:
The study cohort had an average±standard deviation birth weight of 684±150 g, gestational age of 24.6±2 weeks and 48% males. DGMA was significantly associated with both cognitive and motor outcomes. Significant associations were also observed between TCD and corpus callosum splenium with cognitive and motor outcomes, respectively. Other biometric measures were not associated with outcome (p>0.05). DGMA<10.26 cm2 was highly specific for poor motor and cognitive outcome.
Conclusion:
TE-MRI biometrics reflecting impaired deep gray matter, callosal, and cerebellar size is associated with worse early childhood cognitive and motor outcomes. DGMA may be the most robust single biometric measure to predict adverse developmental outcome in preterm survivors.
