Altered white matter development in children born very preterm.

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Radiology

Background:

• Children born very preterm (VPT) often experience disrupted white matter maturation, potentially impacting cognitive development.
• Understanding white matter microstructure and connectivity differences in VPT children is crucial for identifying developmental risks.

Purpose of the Study:

• To compare white matter microstructure and connectivity between VPT children and term-born controls at 4 years of age.
• To investigate the relationship between white matter measures, cognitive outcomes, and early brain injury in VPT children.

Main Methods:

• Diffusion tensor imaging (DTI) and T1-weighted MRI were used to assess white matter in 31 VPT and 28 term-born children.
• Tract-based spatial statistics (TBSS) and whole-brain tractography were employed for microstructure and connectivity analysis.
• Graph theoretical measures quantified network properties, with statistical analyses performed using FSL Randomise.

Main Results:

• VPT children showed reduced fractional anisotropy (FA) in major white matter tracts compared to term-born controls.
• VPT children exhibited decreased local strength, clustering coefficient, and local/global efficiency in several brain regions.
• Reduced global efficiency was observed in VPT children with a history of white matter injury (WMI) or germinal matrix/intraventricular hemorrhage (GMH/IVH).

Conclusions:

• Children born VPT demonstrate under-developed and less interconnected white matter compared to term-born children.
• These findings highlight the long-term white matter consequences of preterm birth and early brain injury.
• Further research is needed to understand the specific impact on cognitive outcomes in the VPT population.