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Published on: November 3, 2016
White matter alterations and their associations with motor function in young adults born preterm with very low birth
Ingrid Marie Husby Hollund1, Alexander Olsen2, Jon Skranes3
1Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
Insights
Very low birth weight (VLBW) young adults show persistent white matter alterations and motor deficits. Poorer motor function in VLBW individuals is linked to altered white matter microstructure, particularly in crossing fiber regions.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Very low birth weight (VLBW) is associated with increased risks of neurodevelopmental issues, including motor impairments.
- White matter microstructure alterations are common in VLBW individuals, potentially impacting long-term neurological function.
Purpose of the Study:
- To investigate white matter microstructure differences in VLBW young adults compared to term-born controls.
- To examine the relationship between white matter microstructure (using diffusion tensor imaging - DTI) and fine and gross motor function in VLBW young adults.
Main Methods:
- A hospital-based follow-up study comparing 31 VLBW young adults (without cerebral palsy) and 31 term-born controls.
- Assessment of fine and gross motor function using standardized tests (TMT-5, Grooved Pegboard, MABC-2, HiMAT).
- Diffusion tensor imaging (DTI) with probabilistic tractography of the corticospinal tract (CST) and corpus callosum (CC), analyzing fractional anisotropy (FA) in crossing and non-crossing fiber regions.
Main Results:
- VLBW individuals exhibited poorer motor test performance compared to controls, significantly for TMT-5.
- VLBW group showed lower FA in non-crossing and higher FA in crossing fiber regions of the CST.
- Poorer motor function in VLBW individuals correlated with altered FA in crossing fiber regions of the CST and CC; widespread white matter alterations persisted into adulthood.
Conclusions:
- Persistent white matter alterations in VLBW young adults are linked to motor function deficits.
- The relationship between FA and motor function is complex, with higher FA not always indicating better function, possibly due to involvement of adjacent white matter tracts.
- Findings highlight the enduring impact of VLBW on brain microstructure and motor development into adulthood.
Abstract:
Very low birth weight (VLBW: ≤ 1500 g) individuals have an increased risk of white matter alterations and neurodevelopmental problems, including fine and gross motor problems. In this hospital-based follow-up study, the main aim was to examine white matter microstructure and its relationship to fine and gross motor function in 31 VLBW young adults without cerebral palsy compared with 31 term-born controls, at mean age 22.6 ± 0.7 years. The participants were examined with tests of fine and gross motor function (Trail Making Test-5: TMT-5, Grooved Pegboard, Triangle from Movement Assessment Battery for Children-2: MABC-2 and High-level Mobility Assessment Tool: HiMAT) and diffusion tensor imaging (DTI). Probabilistic tractography of motor pathways of the corticospinal tract (CST) and corpus callosum (CC) was performed. Fractional anisotropy (FA) was calculated in non-crossing (capsula interna in CST, body of CC) and crossing (centrum semiovale) fibre regions along the tracts and examined for group differences. Associations between motor test scores and FA in the CST and CC were investigated with linear regression. Tract-based spatial statistics (TBSS) was used to examine group differences in DTI metrics in all major white matter tracts. The VLBW group had lower scores on all motor tests compared with controls, however, only statistically significant for TMT-5. Based on tractography, FA in the VLBW group was lower in non-crossing fibre regions and higher in crossing fibre regions of the CST compared with controls. Within the VLBW group, poorer fine motor function was associated with higher FA in crossing fibre regions of the CST, and poorer bimanual coordination was additionally associated with lower FA in crossing fibre regions of the CC. Poorer gross motor function was associated with lower FA in crossing fibre regions of the CST and CC. There were no associations between motor function and FA in non-crossing fibre regions of the CST and CC within the VLBW group. In the TBSS analysis, the VLBW group had lower FA and higher mean diffusivity compared with controls in all major white matter tracts. The findings in this study may indicate that the associations between motor function and FA are caused by other tracts crossing the CST and CC, and/or by alterations in the periventricular white matter in the centrum semiovale. Some of the associations were in the opposite direction than hypothesized, thus higher FA does not always indicate better function. Furthermore, widespread white matter alterations in VLBW individuals persist into young adulthood.
