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Visual alertness and brain diffusion tensor imaging at term age predict neurocognitive development at preschool age
Leena Aho1, Viljami Sairanen2, Piia Lönnberg1
1New Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Early visual alertness in extremely preterm infants is linked to better brain white matter development and improved neurocognitive outcomes later in childhood. This suggests visual function is a key building block for cognitive development.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Cognitive development relies on brain maturation.
- Diffusion-weighted magnetic resonance imaging (dMRI) assesses brain structure and connectivity.
- Understanding early predictors of neurocognitive outcomes is crucial.
Purpose of the Study:
- To investigate the relationship between early visual abilities, brain white matter structure, and later neurocognitive outcomes in extremely preterm infants.
- To explore how visual alertness at term age correlates with white matter integrity and long-term cognitive performance.
Main Methods:
- Included 20 infants born before 28 weeks gestational age, followed until 6.5 years.
- Assessed visual alertness at term age and used dMRI to analyze white matter fractional anisotropy (FA).
- Utilized neuropsychological assessments for neurocognitive performance evaluation at 6.5 years.
Main Results:
- Optimal visual alertness at term age correlated with better visuospatial processing, sensorimotor functioning, and social perception at 6.5 years.
- Higher FA values in white matter were associated with optimal visual alertness.
- FA values positively correlated with neurocognitive outcomes, with detected tract-based spatial differences between groups.
Conclusions:
- Provided neurobiological evidence linking white matter maturation, early visual alertness, and later neurocognitive outcomes in extremely preterm children.
- Suggests that early visual function serves as a foundational element for subsequent neurocognitive development.
- Highlights the importance of assessing early visual abilities as a potential indicator of future cognitive trajectories.
Introduction:
Cognitive development is characterized by the structural and functional maturation of the brain. Diffusion-weighted magnetic resonance imaging (dMRI) provides methods of investigating the brain structure and connectivity and their correlations with the neurocognitive outcome. Our aim was to examine the relationship between early visual abilities, brain white matter structures, and the later neurocognitive outcome.
Methods:
This study included 20 infants who were born before 28 gestational weeks and followed until the age of 6.5 years. At term age, visual alertness was evaluated and dMRI was used to investigate the brain white matter structure using fractional anisotropy (FA) in tract-based spatial statistics analysis. The JHU DTI white matter atlas was used to locate the findings. The neuropsychological assessment was used to assess neurocognitive performance at 6.5 years.
Results:
Optimal visual alertness at term age was significantly associated with better visuospatial processing (p < .05), sensorimotor functioning (p < .05), and social perception (p < .05) at 6.5 years of age. Optimal visual alertness related to higher FA values, and further, the FA values positively correlated with the neurocognitive outcome. The tract-based spatial differences in FA values were detected between children with optimal and nonoptimal visual alertness according to performance at 6.5 years.
Conclusion:
We provide neurobiological evidence for the global and tract-based spatial differences in the white matter maturation between extremely preterm children with optimal and nonoptimal visual alertness at term age and a link between white matter maturation, visual alertness and the neurocognitive outcome at 6.5 years proposing that early visual function is a building block for the later neurocognitive development.
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