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Brain White Matter Development Over the First 13 Years in Very Preterm and Typically Developing Children Based on the
Deanne K Thompson1, Joseph Y M Yang2, Jian Chen2
1From the Victorian Infant Brain Study (VIBeS) (D.T., C.K.), Developmental Imaging (J. Chen, C.L.A., M.S.), and Clinical Epidemiology and Biostatistics Unit (K.J.L.), Murdoch Children's Research Institute; Department of Neurosurgery (J.Y.-M.Y., B.A.) and Neonatal Medicine (R.H.), The Royal Children's Hospital, Parkville; Neurodevelopment in Health and Disease Program (C.G.), School of Health and Biomedical Sciences, RMIT University, Bundoora; Turner Institute for Brain and Mental Health (L.M., M.S.-S., P.A.), Monash University, Clayton; Neonatal Services (J. Cheong), The Royal Women's Hospital, Parkville, Melbourne, Australia; Department of Pediatric Neurology (J.N.), Washington University School of Medicine, St. Louis, MO; Department of Pediatric Newborn Medicine (T.I.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Obstetrics and Gynaecology (L.D.), The University of Melbourne, Parkville, Australia. deanne.thompson@mcri.edu.au.
Insights
Very preterm birth is linked to long-term white matter changes in children, impacting development. However, higher T1-w/T2-w ratios at 13 years correlate with better motor and memory skills.
Area of Science:
- Neuroscience
- Developmental Biology
- Radiology
Background:
- Investigating white matter development in full-term (FT) and very preterm (VP) children is crucial for understanding long-term neurodevelopmental outcomes.
- The T1-weighted/T2-weighted (T1-w/T2-w) MRI ratio offers insights into white matter microstructure and myelin content.
Purpose of the Study:
- To examine longitudinal changes in brain regional white matter development using the T1-w/T2-w ratio in FT and VP children.
- To determine if these changes differ between birth groups or sexes.
- To assess associations with perinatal risk factors in VP children and neurodevelopmental outcomes at 13 years.
Main Methods:
- A prospective longitudinal cohort study followed VP and FT infants from birth to 13 years.
- T1-w/T2-w MRI data were collected at term equivalent, 7, and 13 years, with white matter parcellated into 48 regions.
- Neurodevelopmental assessments were conducted at 13 years.
Main Results:
- T1-w/T2-w values generally increased with age, with minimal differences between birth groups or sexes.
- VP birth, neonatal brain abnormalities, SGA, and postnatal infection were associated with lower regional T1-w/T2-w values.
- Higher T1-w/T2-w values at 13 years correlated with better motor and working memory, while FT-specific findings showed associations with attention, executive function, and math performance.
Conclusions:
- Very preterm birth and perinatal risk factors are linked to persistent reductions in white matter T1-w/T2-w ratio, suggesting altered microstructure and myelin.
- Higher T1-w/T2-w ratios at 13 years are associated with improved motor and working memory functions.
- Developmental trajectories and outcomes related to attention, executive function, and math performance may differ between VP and FT children.
Background And Objectives:
To investigate brain regional white matter development in full-term (FT) and very preterm (VP) children at term equivalent and 7 and 13 years of age based on the ratio of T 1- and T 2-weighted MRI (T 1-w/T 2-w), including (1) whether longitudinal changes differ between birth groups or sexes, (2) associations with perinatal risk factors in VP children, and (3) relationships with neurodevelopmental outcomes at 13 years.
Methods:
Prospective longitudinal cohort study of VP (born <30 weeks' gestation or <1,250 g) and FT infants born between 2001 and 2004 and followed up at term equivalent and 7 and 13 years of age, including MRI studies and neurodevelopmental assessments. T 1-w/T 2-w images were parcellated into 48 white matter regions of interest.
Results:
Of 224 VP participants and 76 FT participants, 197 VP and 55 FT participants had useable T 1-w/T 2-w data from at least one timepoint. T 1-w/T 2-w values increased between term equivalent and 13 years of age, with little evidence that longitudinal changes varied between birth groups or sexes. VP birth, neonatal brain abnormalities, being small for gestational age, and postnatal infection were associated with reduced regional T 1-w/T 2-w values in childhood and adolescence. Increased T 1-w/T 2-w values across the white matter at 13 years were associated with better motor and working memory function for all children. Within the FT group only, larger increases in T 1-w/T 2-w values from term equivalent to 7 years were associated with poorer attention and executive function, and higher T 1-w/T 2-w values at 7 years were associated with poorer mathematics performance.
Discussion:
VP birth and multiple known perinatal risk factors are associated with long-term reductions in the T 1-w/T 2-w ratio in white matter regions in childhood and adolescence, which may relate to alterations in microstructure and myelin content. Increased T 1-w/T 2-w ratio at 13 years appeared to be associated with better motor and working memory function and there appeared to be developmental differences between VP and FT children in the associations for attention, executive functioning, and mathematics performance.
