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Quantitative MRI Characterization of the Extremely Preterm Brain at Adolescence: Atypical versus Neurotypical
Ryan McNaughton1, Chris Pieper1, Osamu Sakai1
1From the Departments of Mechanical Engineering (R.M., X.Z.) and Biomedical Engineering (H.J.), Boston University College of Engineering, Boston, Mass; Department of Radiology, Boston University School of Medicine, 670 Albany St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department of Psychiatry, University of Massachusetts Medical School, Worcester, Mass (D.N.K., J.A.F.); Department of Pediatrics, Boston University School of Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University School of Public Health, Boston, Mass (T.H.); and Department of Environmental Sciences & Engineering, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC (R.C.F.).
Extremely preterm birth impacts brain development, with quantitative MRI revealing sex-specific differences in neurotypically and atypically developing adolescents. These findings highlight distinct white matter alterations in girls and boys, influencing neurodevelopmental outcomes.
Area of Science:
- Neuroscience
- Radiology
- Developmental Pediatrics
Background:
- Extremely preterm (EP) birth increases the risk of perinatal white matter (WM) injury, potentially leading to adverse neurologic and neurocognitive outcomes.
- Quantitative MRI (qMRI) biomarkers are crucial for understanding the antecedents, clinical correlates, and prognoses of neurologic disorders in EP-born individuals.
Purpose of the Study:
- To compare multiparametric qMRI parameters in adolescents born EP, differentiating between those with and without neurodevelopmental disorders (autism spectrum disorder, cerebral palsy, epilepsy, cognitive impairment).
- To characterize sex-stratified brain development in EP-born adolescents using qMRI.
Main Methods:
- A prospective, multicenter study of 368 adolescents (aged 14-16 years) born EP, part of the Extremely Low Gestational Age Newborns-Environmental Influences on Child Health Outcomes (ELGAN-ECHO) study.
- Participants underwent 3.0-T MRI scans between 2017 and 2019.
- Sex-stratified multiple regression models analyzed associations between qMRI parameters (spatial entropy density [SEd], T1, T2, cerebrospinal fluid-normalized proton density [nPD], and CSF volume), with interaction terms for developmental status.
Main Results:
- Atypically developing girls exhibited lower WM nPD compared to neurotypically developing girls.
- Atypically developing boys showed longer WM T1 and a more moderate association between T1 and WM microstructural organization (SEd) compared to neurotypically developing boys.
- Sex differences were observed: atypically developing girls had lower nPD and shorter T2 than atypically developing boys.
Conclusions:
- Adolescents born EP with atypical development display sexual dimorphisms in WM and gray matter qMRI parameters, specifically nPD and T2.
- These findings underscore distinct patterns of brain development and microstructural organization related to sex in EP-born individuals with neurodevelopmental disorders.
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