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Longitudinal Structural and Diffusion-Weighted Neuroimaging of Young Children Born Preterm
Julia Adrian1, Carolyn Sawyer2, Roger Bakeman3
1Department of Cognitive Science, University of California, San Diego, La Jolla, California; Center for Human Development, University of California, San Diego, La Jolla, California.
Insights
Preterm birth impacts children's brain development, causing smaller volumes in key subcortical structures and larger ventricles. These differences persist from ages five to seven, suggesting a delayed developmental trajectory.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Children born preterm face risks for subcortical gray and white matter injury.
- Preterm birth can lead to diffuse brain injury in neonates.
Purpose of the Study:
- To examine subcortical gray and white matter volumes and white matter tract diffusivity in children born preterm.
- To assess the developmental trajectory of brain structures from ages five to seven in preterm-born children.
Main Methods:
- Longitudinal cohort study of 47 preterm and 28 term-born children.
- Structural and diffusion-weighted magnetic resonance imaging (MRI) scans at ages five, six, and seven.
- Analysis of volumes and diffusion measures (fractional anisotropy, mean diffusivity) of specific brain structures and white matter tracts.
Main Results:
- Preterm children had smaller volumes in the thalamus, brainstem, cerebellar white matter, cingulum, corticospinal tract, inferior frontal occipital fasciculus, uncinate fasciculus, and temporal superior longitudinal fasciculus.
- Preterm children exhibited larger ventricles compared to term-born controls.
- No significant differences in white matter diffusivity measures were observed between groups.
Conclusions:
- Preterm birth has a lasting effect on early brain development, even without significant neonatal injury.
- Persistent differences in brain structure suggest a delayed developmental trajectory in preterm-born children.
- Group differences in brain development remained consistent across ages five, six, and seven.
Background:
Children born preterm are at risk for diffuse injury to subcortical gray and white matter.
Methods:
We used a longitudinal cohort study to examine the development of subcortical gray matter and white matter volumes, and diffusivity measures of white matter tracts following preterm birth. Our participants were 47 children born preterm (24 to 32 weeks gestational age) and 28 children born at term. None of the children born preterm had significant neonatal brain injury. Children received structural and diffusion weighted magnetic resonance imaging scans at ages five, six, and seven years. We examined volumes of amygdala, hippocampus, caudate nucleus, putamen, thalamus, brainstem, cerebellar white matter, intracranial space, and ventricles, and volumes, fractional anisotropy, and mean diffusivity of anterior thalamic radiation, cingulum, corticospinal tract, corpus callosum, inferior frontal occipital fasciculus, inferior longitudinal fasciculus, temporal and parietal superior longitudinal fasciculus, and uncinate fasciculus.
Results:
Children born preterm had smaller volumes of thalamus, brainstem, cerebellar white matter, cingulum, corticospinal tract, inferior frontal occipital fasciculus, uncinate fasciculus, and temporal superior longitudinal fasciculus, whereas their ventricles were larger compared with term-born controls. We found no significant effect of preterm birth on diffusivity measures. Despite developmental changes and growth, group differences were present and similarly strong at all three ages.
Conclusion:
Even in the absence of significant neonatal brain injury, preterm birth has a persistent impact on early brain development. The lack of a significant term status by age interaction suggests a delayed developmental trajectory.
