Linking integrity of visual pathways trajectories to visual behavior deficit in very preterm infants
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Published on: August 11, 2016
Katušić Ana1, Žunić Išasegi Iris2, Predrijevac Nina3
1Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Croatia.
Insights
Premature infants
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Premature infants frequently experience visual deficits, even without severe brain injury or eye issues.
- Subtle perinatal brain injuries and white matter pathway alterations contribute to these visual impairments.
- Understanding these subtle changes is crucial for early detection and intervention.
Purpose of the Study:
- To investigate the relationship between specific MRI-assessed white matter features and visual behavior in preterm neonates.
- To determine if quantitative and qualitative MRI findings can predict visual assessment scores in this population.
Main Methods:
- Seventy-one very preterm infants without severe brain injury underwent MRI at term-equivalent age.
- MRI analysis included standard brain metrics and scoring of white matter structures (sagittal strata, periventricular crossroads).
- Infants completed a Neonatal Visual Assessment around 41 weeks postmenstrual age.
Main Results:
- Visibility of specific white matter areas (temporal crossroad C6, frontal/occipital sagittal strata) correlated positively with visual tracking skills.
- Frontal and occipital sagittal strata visibility strongly predicted overall Neonatal Visual Assessment scores.
- These white matter features serve as valuable markers in perinatal neuroimaging.
Conclusions:
- MRI assessment of sagittal strata and periventricular crossroads is a useful tool for evaluating preterm infants.
- Alterations in these white matter structures may help predict visual development in very premature infants.
- This research highlights the importance of subtle white matter changes in visual outcome.
Abstract:
Low-risk premature infants often develop visual deficits, even in the absence of ophthalmological complications and high-graded brain injury. These complications can be explained by the nature of subtle perinatal lesions and alterations of brain growth due to the prematurity. Subtle brain injuries and vulnerability of axonal pathways can be observed in spatiotemporal context of the white matter segments. The aim of this study was to examine the link between MRI quantitative (brain metrics data) and qualitative features (visibility of 2nd white matter segment - sagittal strata and periventricular crossroads C1-C6) and visual behavior in preterm neonates at term-equivalent age. Seventy-one very preterm infants without high-graded brain injury on MRI and no ocular pathologies were studies. The infants received MRI scans at term-equivalent age. MRI scans were analyzed using (a) simple brain metrics and (b) scoring the visibility of transient structural patterns (sagittal strata and periventricular crossroads). At the median age of 41+5 PMA weeks infants completed the Neonatal Visual Assessment. Results indicated that visibility of temporal crossroad area C6 and frontal and occipital sagittal strata was positively correlated with visual tracking skills in neonatal period. Furthermore, the visibility of frontal and occipital sagittal strata were strong predictors of total Neonatal Visual Assessment score. The findings confirmed that sagittal strata and periventricular crossroads prominence is a valuable additional marker in perinatal neuroimaging at term-equivalent age. Thus, alteration in MRI appearance of temporal crossroad and sagittal strata may be useful in predicting of visual behavior for very premature born infants.
