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Published on: November 20, 2015
Region-specific growth restriction of brain following preterm birth
Sachiko Iwata1,2, Reiji Katayama3, Masahiro Kinoshita1
1Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.
Insights
Brain growth in preterm infants is restricted after birth, especially in more mature infants. This restricted growth, measured by head MRI, may impact cognitive development.
Area of Science:
- Neonatal neuroscience
- Developmental neuroimaging
- Pediatric neurology
Background:
- Regional brain sizes in very-preterm infants differ from term-born peers, potentially impacting cognitive function.
- Detailed studies on how gestational age influences regional brain volume loss are lacking.
Purpose of the Study:
- To investigate the spatial pattern of brain growth in neonates without brain lesions.
- To assess the dependence of regional brain metrics on gestational age at birth and corrected age at MRI scan.
Main Methods:
- Head MRI scans of 189 neonates (24-42 weeks gestation) were analyzed using simple metric measurements.
- Correlations between regional brain metrics and gestational age at birth (Age_birth) and age at MRI scan (Age_MRI) were evaluated.
Main Results:
- Head circumference correlated positively with Age_MRI, but not Age_birth.
- Bi-parietal width, deep grey matter area, and trans-cerebellar diameter correlated positively with both Age_birth and Age_MRI.
- Callosal thickness, lateral ventricle atrial width, and inter-hemispheric distance correlated exclusively with Age_birth.
- Callosal thickness and cerebral/cerebellar transverse diameters showed greater dependence on Age_birth, indicating restricted postnatal brain growth.
Conclusions:
- Postnatal brain growth in preterm infants is significantly restricted compared to in utero growth.
- This growth restriction appears more pronounced in relatively more mature preterm infants.
- Observed linear relationships suggest postnatal growth restriction may impact cognitive development.
Abstract:
Regional brain sizes of very-preterm infants at term-equivalent age differ from those of term-born peers, which have been linked with later cognitive impairments. However, dependence of regional brain volume loss on gestational age has not been studied in detail. To investigate the spatial pattern of brain growth in neonates without destructive brain lesions, head MRI of 189 neonates with a wide range of gestational age (24-42 weeks gestation) was assessed using simple metrics measurements. Dependence of MRI findings on gestational age at birth (Agebirth) and the corrected age at MRI scan (AgeMRI) were assessed. The head circumference was positively correlated with AgeMRI, but not Agebirth. The bi-parietal width, deep grey matter area and the trans-cerebellar diameter were positively correlated with both Agebirth and AgeMRI. The callosal thickness (positive), atrial width of lateral ventricle (negative) and the inter-hemispheric distance (negative) were exclusively correlated with Agebirth. The callosal thickness and cerebral/cerebellar transverse diameters showed predominant dependence on Agebirth over AgeMRI, suggesting that brain growth after preterm-birth was considerably restricted or even became negligible compared with that in utero. Such growth restriction after preterm birth may extensively affect relatively more matured infants, considering the linear relationships observed between brain sizes and Agebirth.
