Correlating early motor skills to white matter abnormalities in preterm infants using diffusion tensor imaging

Area of Science:

• Neuroimaging
• Developmental Neuroscience
• Pediatric Neurology

Background:

• Diffusion Tensor Imaging (DTI) assesses white matter (WM) integrity.
• WM injury in preterm infants can impact sensorimotor development.
• Fractional Anisotropy (FA) is a key DTI measure of WM microstructure.

Purpose of the Study:

• To investigate if DTI measures of WM fractional anisotropy (FA) can predict early motor performance in preterm infants at risk for WM injury.
• To determine the relationship between WM integrity and nascent motor skills.
• To explore DTI's potential for identifying subtle WM injury.

Main Methods:

• Prospective study of 26 preterm infants (mean gestational age 29.1 weeks).
• Infants underwent the Test of Infant Motor Performance (TIMP) at term and 12 weeks corrected age (CA).
• Non-sedated MRI with DTI was performed at a mean of 42 weeks CA; FA was analyzed using Tract-Based Spatial Statistics (TBSS).

Main Results:

• Significant differences in FA values were observed in left hemispheric WM tracts between infants with poor versus average motor performance at 12 weeks.
• High FA in the left anterior limb of the internal capsule (ALIC) predicted improved TIMP scores for head lift tasks.
• FA values correlated with specific early motor skill outcomes.

Conclusions:

• Subtle WM injury, indicated by reduced FA in left WM tracts, can predict early motor skill performance at 3 months corrected age.
• Early DTI may identify preterm infants with "silent" WM injuries requiring timely intervention.
• Further research is needed to assess FA changes after targeted treatments.