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Published on: September 12, 2011
Diffusion MRI Microstructural Abnormalities at Term-Equivalent Age Are Associated with Neurodevelopmental Outcomes at
M N Parikh1, M Chen2,3, A Braimah2
1From the Perinatal Institute (M.N.P., J.K., L.H., N.A.P.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Background And Purpose:
Microstructural white matter abnormalities on DTI using Tract-Based Spatial Statistics at term-equivalent age are associated with cognitive and motor outcomes at 2 years of age or younger. However, neurodevelopmental tests administered at such early time points are insufficiently predictive of mild-moderate motor and cognitive impairment at school age. Our objective was to evaluate the microstructural antecedents of cognitive and motor outcomes at 3 years' corrected age in a cohort of very preterm infants.
Materials And Methods:
We prospectively recruited 101 very preterm infants (<32 weeks' gestational age) and performed DTI at term-equivalent age. The Differential Ability Scales, 2nd ed, Verbal and Nonverbal subtests, and the Bayley Scales of Infant and Toddler Development, 3rd ed, Motor subtest, were administered at 3 years of age. We correlated DTI metrics from Tract-Based Spatial Statistics with the Bayley Scales of Infant and Toddler Development, 3rd ed, and the Differential Ability Scales, 2nd ed, scores with correction for multiple comparisons.
Results:
Of the 101 subjects, 84 had high-quality DTI data, and of these, 69 returned for developmental testing (82%). Their mean (SD) gestational age was 28.4 (2.5) weeks, and birth weight was 1121.4 (394.1) g. DTI metrics were significantly associated with Nonverbal Ability in the corpus callosum, posterior thalamic radiations, fornix, and inferior longitudinal fasciculus and with Motor scores in the corpus callosum, internal and external capsules, posterior thalamic radiations, superior and inferior longitudinal fasciculi, cerebral peduncles, and corticospinal tracts.
Conclusions:
We identified widespread microstructural white matter abnormalities in very preterm infants at term that were significantly associated with cognitive and motor development at 3 years' corrected age.
Insights
White matter abnormalities in very preterm infants at term predict later cognitive and motor development. Diffusion Tensor Imaging (DTI) findings at birth correlate with outcomes at three years old.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Diffusion Tensor Imaging (DTI) reveals white matter abnormalities in preterm infants.
- Early neurodevelopmental tests have limited predictive power for school-age outcomes.
- Predicting long-term cognitive and motor function in very preterm infants is crucial.
Purpose of the Study:
- To investigate the association between term-equivalent age white matter microstructure and 3-year corrected age cognitive and motor outcomes.
- To evaluate microstructural antecedents of neurodevelopmental trajectories in very preterm infants.
Main Methods:
- Prospective cohort study of 101 very preterm infants (<32 weeks' gestational age).
- Diffusion Tensor Imaging (DTI) performed at term-equivalent age.
- Cognitive (Differential Ability Scales) and motor (Bayley Scales) assessments at 3 years corrected age.
- Tract-Based Spatial Statistics (TBSS) used to correlate DTI metrics with developmental scores.
Main Results:
- 84 infants had high-quality DTI data; 69 completed developmental testing.
- White matter abnormalities in specific tracts (corpus callosum, thalamic radiations, etc.) were linked to cognitive outcomes.
- Abnormalities in several white matter tracts correlated with motor development scores.
Conclusions:
- Widespread microstructural white matter abnormalities are detectable in very preterm infants at term.
- These early abnormalities significantly predict cognitive and motor development at 3 years corrected age.
