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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
White matter microstructure and cognitive outcomes in relation to neonatal inflammation in 6-year-old children born
Sarah E Dubner1, Cory K Dodson1, Virginia A Marchman2
1Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Insights
Neonatal inflammation in preterm infants is linked to poorer white matter microstructure and executive function at age six. These findings highlight inflammation as a key factor influencing long-term neurodevelopmental outcomes in preterm children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Preterm birth is associated with altered white matter microstructure.
- Neonatal inflammatory conditions can negatively impact cognitive development in preterm children.
- Understanding the relationship between inflammation, white matter, and cognition is crucial for preterm infant neurodevelopment.
Purpose of the Study:
- To investigate differences in white matter microstructure and cognitive outcomes in preterm children with and without neonatal inflammatory conditions.
- To compare preterm children with (PT+) and without (PT-) severe neonatal inflammation to full-term controls (FT).
- To explore correlations between white matter integrity and cognitive performance.
Main Methods:
- Diffusion MRI and cognitive testing (intelligence, reading, executive function) were performed at age 6 years.
- Preterm children (n=35) were classified as PT+ (n=12) or PT- (n=23) based on neonatal inflammatory history.
- Full-term children (n=43) served as controls; corpus callosum microstructure (FA, MD) was analyzed.
Main Results:
- Preterm children with neonatal inflammation (PT+) showed significantly lower fractional anisotropy (FA) and higher mean diffusivity (MD) in corpus callosum segments compared to PT- and FT groups.
- Executive function scores were lower in the PT+ group compared to the PT- group.
- Occipital FA correlated with IQ and reading, while frontal and parietal FA correlated with executive function.
Conclusions:
- Neonatal inflammation significantly impacts white matter microstructure in the corpus callosum of preterm children.
- History of neonatal inflammation is associated with poorer executive function in preterm children at age six.
- Neonatal inflammation is a critical factor contributing to neurobiological and neuropsychological variations in preterm populations.
Background:
Cognitive outcomes in preterm (PT) children have been associated with microstructural properties of white matter. PT children who experienced neonatal inflammatory conditions have poorer cognitive outcomes than those who did not. The goal of this study was to contrast white matter microstructure and cognitive outcomes after preterm birth in relation to the presence or absence of severe inflammatory conditions in the neonatal period.
Methods:
PT children (n = 35), born at gestational age 22-32 weeks, were classified as either PT+ (n = 12) based on a neonatal history of inflammatory conditions, including bronchopulmonary dysplasia, necrotizing enterocolitis or culture positive sepsis, or PT- (n = 23) based on the absence of the three inflammatory conditions. Full term (FT) children (n = 43) served as controls. Participants underwent diffusion MRI and cognitive testing (intelligence, reading, and executive function) at age 6 years. The corpus callosum was segmented into 7 regions using deterministic tractography and based on the cortical projection zones of the callosal fibers. Mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated for each segment. General linear models with planned contrasts assessed group differences in FA, MD and cognitive outcomes. Pearson correlations assessed associations of white matter metrics and cognitive outcome measures.
Results:
FA was significantly lower and MD was significantly higher in PT+ compared to PT- or FT groups in multiple callosal segments, even after adjusting for gestational age. Executive function scores, but not intelligence or reading scores, were less favorable in PT+ than in PT- groups. Among the entire sample, occipital FA was significantly correlated with IQ (r = 0.25, p < 0.05), reading (r = 0.32, p < 0.01), and executive function (r = -0.28, p < 0.05) measures. Anterior frontal FA and superior parietal FA were significantly correlated with executive function (r = -0.25, r = 0.23, respectively, p < 0.05).
Conclusions:
We observed differences in the white matter microstructure of the corpus callosum and in the cognitive skills of 6-year-old PT children based on their history of neonatal inflammation. Neonatal inflammation is one medical factor that may contribute to variation in long-term neurobiological and neuropsychological outcomes in PT samples.
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