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Myelination of preterm brain networks at adolescence
Beatriz Laureano1, Hassna Irzan2, Helen O'Reilly3
1School of Biomedical Engineering & Imaging Sciences, King's College London, UK.
Insights
Extremely preterm birth impacts adult brain development, showing reduced myelination in key white matter regions. This may explain cognitive differences observed in adults born prematurely.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Prematurity significantly impacts infant neurodevelopment, leading to increased disability rates despite advances in neonatal care.
- Understanding long-term effects on the adult brain is crucial for improved interventions and prognoses.
- Few studies investigate the fully developed brains of extremely preterm individuals.
Purpose of the Study:
- To assess the long-term effects of extreme prematurity on adult brain myelination and white matter integrity.
- To explore the relationship between brain myelination and cognitive outcomes in adults born extremely preterm.
- To identify specific brain regions affected by preterm birth into adulthood.
Main Methods:
- Utilized multi-modal Magnetic Resonance (MR) imaging techniques, including T2 relaxometry and neurite density imaging.
- Measured myelin-related biomarkers such as myelin water fraction (MWF) and g-ratio.
- Analyzed a cohort of 19-year-old extremely preterm born subjects.
Main Results:
- Adults born extremely preterm exhibited reduced myelination in specific white matter regions, including the posterior limb of the internal capsule and corpus callosum.
- A weak positive correlation was observed between myelin water fraction values and Full-Scale Intelligence Quotient (FSIQ) scores in multiple brain regions.
- Findings suggest persistent white matter alterations and potential impacts on cognitive function in adulthood.
Conclusions:
- Prematurity leads to lasting effects on brain myelination and white matter structure evident in adulthood.
- Altered brain connectivity in adult preterm individuals may contribute to observed cognitive outcome differences.
- These findings highlight the need for continued research into long-term neurodevelopmental outcomes for preterm infants.
Abstract:
Prematurity and preterm stressors severely affect the development of infants born before 37 weeks of gestation, with increasing effects seen at earlier gestations. Although preterm mortality rates have declined due to the advances in neonatal care, disability rates, especially in middle-income settings, continue to grow. With the advances in MR imaging technology, there has been a focus on safely imaging the preterm brain to better understand its development and discover the brain regions and networks affected by prematurity. Such studies aim to support interventions and improve the neurodevelopment of preterm infants and deliver accurate prognoses. Few studies, however, have focused on the fully developed brain of preterm born infants, especially in extremely preterm subjects. To assess the long-term effect of prematurity on the adult brain, myelin related biomarkers such as myelin water fraction and g-ratio are measured for a cohort of 19-year-old extremely preterm born subjects. Using multi-modal imaging techniques that combine T2 relaxometry and neurite density information, the results show that specific brain regions associated with white matter injuries due to preterm birth, such as the posterior limb of the internal capsule and corpus callosum, are still less myelinated in adulthood. Furthermore, a weak positive relationship between myelin water fraction values and Full-Scale Intelligence Quotient (FSIQ) scores was found in multiple brain regions previously defined as less myelinated in the Extremely Preterm (EPT) cohort. These findings might suggest altered connectivity in the adult preterm brain and explain differences in cognitive outcomes.
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