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Quantitative Diffusion and Spectroscopic Neuroimaging Combined with a Novel Early-Developmental Assessment Improves
H G Moss1,2, L G Wolf3, P Coker-Bolt4
1From the Department of Neuroscience (H.G.M., J.H.J.) mossh@musc.edu.
Insights
Early motor assessments in preterm infants correlate with brain imaging. Combining these methods improves prediction of 12-month developmental outcomes in premature infants.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Preterm infants face risks of central nervous system (CNS) injury with unpredictable developmental outcomes.
- The Specific Test of Early Infant Motor Performance (STEP) shows early promise in predicting later motor and cognitive scores.
- Predicting long-term neurodevelopmental consequences in preterm infants remains a challenge.
Purpose of the Study:
- To investigate the correlation between early functional motor performance (STEP) and CNS integrity using advanced neuroimaging techniques.
- To determine if MR spectroscopy and diffusion kurtosis imaging enhance the prediction of 12-month developmental outcomes.
- To assess if quantitative neuroimaging can serve as a biomarker for early developmental trajectories in preterm infants.
Main Methods:
- Acquired MR spectroscopy and diffusion MR imaging data in preterm infants at term-corrected age.
- Administered the Specific Test of Early Infant Motor Performance at term and 3 months.
- Utilized multiple linear regression to model the relationship between neuroimaging data and developmental scores at 12 months (Bayley Scales).
Main Results:
- MR spectroscopy (NAA ratios in frontal white matter and basal ganglia) and kurtosis metrics in white matter tracts strongly correlated with STEP scores.
- Neuroimaging data, including MR spectroscopy and diffusion imaging, independently improved the prediction of 12-month developmental outcomes.
- Early functional performance on the STEP test reflects underlying CNS microstructural integrity.
Conclusions:
- The microstructural integrity of white matter tracts and basal ganglia metabolism are closely linked to early motor performance in preterm infants.
- The Specific Test of Early Infant Motor Performance serves as an indicator of CNS integrity post-preterm birth.
- Integrating quantitative neuroimaging with early functional assessments offers a more accurate prediction of neurodevelopmental outcomes at 12 months in premature infants.
Background And Purpose:
Preterm infants are at risk for overt and silent CNS injury, with developmental consequences that are difficult to predict. The novel Specific Test of Early Infant Motor Performance, administered in preterm infants at term age, is indicative of later developmental gross motor and cognitive scores at 12 months. Here, we assessed whether functional performance on this early assessment correlates with CNS integrity via MR spectroscopy or diffusional kurtosis imaging and whether these quantitative neuroimaging methods improve predictions for future 12-month developmental scores.
Materials And Methods:
MR spectroscopy and quantitative diffusion MR imaging data were acquired in preterm infants (n = 16) at term. Testing was performed at term and 3 months using the Specific Test of Early Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, Third Edition, at 12 months. We modeled the relationship of MR spectroscopy and diffusion MR imaging data with both test scores via multiple linear regression.
Results:
MR spectroscopy NAA ratios at a TE of 270 ms in the frontal WM and basal ganglia and kurtosis metrics in major WM tracts correlated strongly with total Specific Test of Early Infant Motor Performance scores. The addition of MR spectroscopy and diffusion separately improved the functional predictions of 12-month outcomes.
Conclusions:
Microstructural integrity of the major WM tracts and metabolism in the basal ganglia and frontal WM strongly correlate with early developmental performance, suggesting that the Specific Test of Early Infant Motor Performance reflects CNS integrity after preterm birth. This study demonstrates that combining quantitative neuroimaging and early functional movement improves the prediction of 12-month outcomes in premature infants.
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