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Delayed Maturation of the Middle Cerebellar Peduncles at Near-Term Age Predicts Abnormal Neurodevelopment in Preterm
Yong-Ho Choi1, Jong-Min Lee1, Joo Young Lee2,3
1Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea.
Insights
White matter maturation in very-low-birth-weight (VLBW) infants, specifically the middle cerebellar peduncle (MCP) fractional anisotropy (FA), can predict neurodevelopmental outcomes at 18 months. This finding aids in early identification of potential cognitive and motor impairments in VLBW infants.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- The neonatal brain undergoes rapid microstructural development, with white matter being particularly vulnerable in very-low-birth-weight (VLBW) infants.
- Altered white matter maturation and impaired growth are common concerns in VLBW infants.
Purpose of the Study:
- To investigate the association between abnormal white matter maturation in VLBW infants and their neurodevelopmental outcomes at 18 months corrected age.
- To determine if specific white matter regions can predict cognitive and motor development in this population.
Main Methods:
- Sixty VLBW infants and 15 full-term controls underwent magnetic resonance imaging (MRI) using diffusion tensor imaging (DTI) at near-term age.
- Participants were assessed at 18 months corrected age using the Bayley Scales of Infant and Toddler Development, Third Edition.
- Multivariable linear regression was used to analyze associations between white matter fractional anisotropy (FA) and developmental outcomes, controlling for relevant covariates.
Main Results:
- Fractional anisotropy (FA) in the splenium of the corpus callosum, corticospinal tract, middle cerebellar peduncle (MCP), and cingulum were related to cognitive scores.
- Only the MCP FA remained significantly associated with cognitive scores after multiple comparisons correction.
- MCP FA was also significantly associated with motor scores and could predict both cognitive and motor impairment in VLBW infants.
Conclusions:
- Fractional anisotropy (FA) of the middle cerebellar peduncle (MCP) measured at near-term age shows potential as a predictor for neurodevelopmental outcomes in VLBW infants at 18 months corrected age.
- This finding may facilitate early intervention strategies for VLBW infants at risk for developmental delays.
Background:
The infant brain grows quickly with elaborate microstructural development during the neonatal period. The white matter, during critical periods of development, is selectively vulnerable to altered maturation and impaired growth in very-low-birth-weight (VLBW) infants.
Objective:
To evaluate whether abnormal white matter maturation in VLBW infants is associated with poor neurodevelopmental outcomes at 18 months of corrected age.
Methods:
Between 2015 and 2017, we recruited 60 VLBW infants at 24-32 weeks of gestational age and 15 full-term controls. All participants underwent magnetic resonance imaging at near-term age and were assessed at 18 months of corrected age with the Bayley Scales of Infant and Toddler Development, Third Edition. The associations between regional white matter fractional anisotropy (FA) and mean diffusivity on diffusion tensor imaging (DTI) and developmental outcomes were explored using multivariable linear regression after correcting for gestational age, postmenstrual age at DTI scan, and maternal education level.
Results:
The FA values of the splenium of the corpus callosum (p = 0.032), corticospinal tract (p = 0.025), middle cerebellar peduncle (MCP) (p < 0.001), and cingulum (p = 0.043) were significantly related to cognitive scores; however, only the association corresponding to the MCP remained significant after correcting for multiple comparisons. The MCP FA (p = 0.008) was associated with motor scores after correction for multiple comparisons (p = 0.008). Cognitive impairment (area under the curve [AUC] = 0.823, 95% confidence interval [CI] = 0.722-0.911) and motor impairment (AUC = 0.776, 95% CI = 0.656-0.899) were predicted by MCP FA.
Conclusions:
The FA of MCP at near-term age may predict developmental outcomes of VLBW infants at 18 months of corrected age.
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