Structural connectivity at term equivalent age and language in preterm children at 2 years corrected

Area of Science:

• Neuroscience
• Developmental Neuroscience
• Pediatric Neurology

Background:

• Previous research indicated atypical interhemispheric structural hyperconnectivity bypassing the corpus callosum in extremely preterm infants (<28 weeks), positively associated with later language skills.
• This study investigates the developmental trajectory of extracallosal connectivity in extremely preterm infants without significant brain injury.

Purpose of the Study:

• To determine if extracallosal white matter pathways are present in extremely preterm infants at term equivalent age.
• To assess the predictive value of this connectivity for language development at 22-26 months corrected age.

Main Methods:

• Utilized a prospective cohort of 95 extremely preterm infants without significant brain injury from the Cincinnati Infant Neurodevelopment Early Prediction Study.
• Employed higher-order diffusion MRI modeling (generalized q-sampling imaging and constrained spherical deconvolution) at term equivalent age (39-44 weeks post-menstrual age).
• Conducted structural connectometry and connectivity-based fixel enhancement analyses, correlating white matter connectivity with language scores at 2 years corrected age, controlling for covariates.

Main Results:

• Structural connectometry revealed inverse correlations between language scores and connectivity in bilateral cerebellar white matter, middle cerebellar peduncles, corticospinal tracts, posterior commissure, and the posterior inferior fronto-occipital fasciculus.
• No significant associations were found using the constrained spherical deconvolution/connectivity-based fixel enhancement methods after multiple comparison correction.
• These findings suggest that increased connectivity in specific posterior white matter tracts at term equivalent age may be disadvantageous for subsequent language development.

Conclusions:

• The study provides insights into the early development of structural brain networks supporting language in extremely preterm infants.
• Greater connectivity in posterior brain regions, including cerebellar pathways, at term equivalent age is associated with poorer language outcomes.
• These findings highlight the complex relationship between early brain structure and neurodevelopmental trajectories in this vulnerable population.