Altered myelin maturation in four year old children born very preterm

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Radiology

Background:

• Children born very preterm (VPT) face higher risks for cognitive deficits later in life.
• Myelin maturation is crucial for cognitive development and can be assessed using MRI.
• Early detection of neurodevelopmental alterations in VPT infants is critical for timely intervention.

Purpose of the Study:

• To investigate if myelin maturational differences in VPT children can be detected by myelin-sensitive MRI measures before school age.
• To explore the relationship between MRI-based myelin measures and cognitive development in VPT children.
• To determine if altered myelination in VPT children is associated with specific brain regions.

Main Methods:

• Magnetization transfer (MT) and T1/T2-weighted MRI were used in 4-year-old VPT and full-term (FT) children.
• Tract-based spatial statistics (TBSS) and region of interest (ROI) analyses were performed on white, subcortical gray, and cortical gray matter.
• Developmental assessments were correlated with MRI measures (MT ratio [MTR] and T1-w/T2-w ratio).

Main Results:

• VPT children exhibited significantly reduced MTR and T1-w/T2-w ratio in white matter compared to FT children.
• Reductions in T1-w/T2-w ratio were also observed in subcortical (thalamus, putamen, amygdala) and cortical gray matter regions in VPT children.
• Both MTR and T1-w/T2-w ratio were strongly correlated across all brain tissue types and positively associated with developmental assessments.

Conclusions:

• Findings suggest delayed myelination in children born VPT, detectable by MRI at age 4.
• MRI measures of myelin integrity are linked to cognitive performance in VPT children.
• These results highlight the potential of sensitive MRI techniques for early identification of neurodevelopmental risks in VPT populations.