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Effects of intraventricular hemorrhage on white matter microstructural changes at term and early developmental
Weihong Yuan1,2, Leanne Tamm3,2, Karen Harpster4,2
1Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Diffusion tensor imaging (DTI) reveals white matter differences in very preterm infants with intraventricular hemorrhage (IVH). IVH severity impacts motor and behavioral outcomes, highlighting DTI
Area of Science:
- Neonatal neuroscience
- Neuroimaging
- Developmental pediatrics
Background:
- Very preterm (VPT) infants face high risks for motor and behavioral deficits.
- Intraventricular hemorrhage (IVH) is a common complication in VPT infants, potentially affecting brain development.
- Understanding the impact of IVH severity on white matter and neurodevelopment is crucial.
Purpose of the Study:
- To investigate microstructural brain differences using diffusion tensor imaging (DTI) in VPT infants with varying intraventricular hemorrhage (IVH) grades.
- To assess the association between these DTI-derived microstructural differences and early motor function and temperament.
- To examine if IVH severity moderates the relationship between white matter structure and neurodevelopmental outcomes.
Main Methods:
- Fifty-seven VPT infants (gestational age ≤32 weeks) with IVH were studied, categorized into Low Grade (Papile I/II) and High Grade (III/IV).
- Diffusion tensor imaging (DTI) was performed between 39-44 weeks postmenstrual age and analyzed using tract-based spatial statistics.
- Early motor function and temperament were assessed at 3-month corrected age using the Hammersmith Infant Neurological Examination (HINE) and Infant Behavioral Questionnaire - Revised, Short Version (IBQ-R-S).
Main Results:
- VPT infants with High Grade IVH exhibited significantly lower fractional anisotropy and higher diffusivity compared to those with Low Grade IVH.
- Significant associations were observed between DTI metrics and motor function in both IVH groups.
- DTI metrics were also associated with Fear temperament ratings in the High Grade IVH group, with IVH severity significantly moderating these relationships.
Conclusions:
- Diffusion tensor imaging (DTI) serves as a sensitive neuroimaging biomarker for understanding the impact of IVH severity on white matter development in very preterm infants.
- Early motor and behavioral outcomes in VPT infants are linked to white matter microstructural changes.
- The severity of intraventricular hemorrhage plays a significant role in influencing the relationship between brain structure and functional outcomes.
Purpose:
Very preterm (VPT) infants are at high risk for motor and behavioral deficits. We investigated microstructural differences using diffusion tensor imaging (DTI) among VPT infants with different grades of intraventricular hemorrhage (IVH), their association with early motor function and temperament ratings, and the potential moderating effect of IVH severity on the above structure-function relations.
Methods:
Fifty-seven VPT (≤32 weeks gestational age) infants with IVH (Low Grade (Papile grading I/II): 42; High Grade (III/IV): 15) were studied. DTI was acquired between 39 and 44 weeks postmenstrual age and was analyzed using the tract-based spatial statistics approach. Early motor function and temperament were assessed at 3-month corrected age based on the Hammersmith Infant Neurological Examination (HINE) and Infant Behavioral Questionnaire - Revised, Short Version (IBQ-R-S), respectively.
Results:
Significantly lower fractional anisotropy and higher mean, axial, and/or radial diffusivity were found in VPT infants with High Grade IVH compared to Low Grade IVH (p < 0.05). Significant associations were found between DTI metrics and motor function in both IVH groups and between DTI and Fear temperament ratings in the High Grade IVH Group (all p < 0.05). IVH severity had a significant moderating effect on the relation between DTI and motor and Fear ratings (p < 0.05).
Conclusion:
DTI is a sensitive neuroimaging biomarker providing a refined understanding of the impact and location of differing severities of IVH on the developing white matter of VPT infants. Early motor and behavioral outcomes are associated with microstructural changes that are influenced by severity of IVH.
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