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Thirteen-Year Outcomes in Very Preterm Children Associated with Diffuse Excessive High Signal Intensity on Neonatal

Ines M Mürner-Lavanchy1, Hiroyuki Kidokoro2, Deanne K Thompson3

  • 1Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia; Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.

The Journal of Pediatrics
|November 12, 2018
PubMed

Insights

Neonatal white matter diffuse excessive high signal intensity (DEHSI) in very preterm infants showed little association with neurobehavioral outcomes at age 13. Further research is needed on posterior periventricular crossroads.

Area of Science:

  • Neonatal neuroimaging
  • Pediatric neurodevelopment
  • Neuroscience

Background:

  • White matter diffuse excessive high signal intensity (DEHSI) is a finding on neonatal MRI.
  • Its association with long-term neurobehavioral outcomes in very preterm infants is not well understood.

Purpose of the Study:

  • To investigate the link between neonatal DEHSI in very preterm infants and their neurobehavioral outcomes at 13 years of age.
  • To assess the role of posterior periventricular crossroads visibility.

Main Methods:

  • MRI scans of very preterm infants (<30 weeks GA or <1250g BW) were evaluated at term-equivalent age for DEHSI grading.
  • Neurobehavioral assessments (intelligence, memory, attention, executive function, motor, behavior) were conducted at age 13 in 125 children.
  • Linear regression was used to relate DEHSI grades to outcomes.

Main Results:

  • DEHSI was prevalent (93%) in the cohort, with varying grades.
  • No significant differences in neurobehavioral outcomes were observed across DEHSI grades.
  • Weak associations suggested higher DEHSI with higher verbal IQ/attention and lower DEHSI with better planning, but these effects diminished after adjustments.
  • Invisible posterior periventricular crossroads were noted in 12 children, associated with slightly poorer outcomes.

Conclusions:

  • Neonatal DEHSI appears to be a poor biomarker for later neurodevelopmental impairment in very preterm infants.
  • The significance of invisible posterior periventricular crossroads warrants further investigation in larger cohorts.
Abstract

Keywords:
cognitionmagnet resonance imagingneurobehaviorprematurity

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