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Microstructural Maturation of the Splenium of Corpus Callosum and Cognitive and Motor Outcome in Very Preterm Infants
Ira Winkler1, Anna Posod1, Elke Ruth Gizewski2,3
1Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria.
Insights
Microstructural maturation of the splenium of corpus callosum in preterm infants is linked to neurodevelopmental outcomes. Apparent diffusion coefficient (ADC) may be a stronger predictor than fractional anisotropy (FA) for long-term results.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Neurodevelopmental impairment in preterm infants is not fully explained by common brain injuries.
- The splenium of the corpus callosum's microstructural maturation is increasingly recognized as a key factor.
- This study investigates the link between this specific brain region's development and infant neurodevelopmental outcomes.
Purpose of the Study:
- To examine the correlation between the splenium of the corpus callosum's microstructural maturation and neurodevelopmental outcomes in very preterm infants.
- To assess cognitive and motor function at 24 months corrected age and 5 years chronological age.
- To determine if diffusion tensor imaging metrics can predict neurodevelopmental trajectories.
Main Methods:
- A cohort study included 373 very preterm infants.
- Diffusion tensor imaging (DTI) metrics, fractional anisotropy (FA) and apparent diffusion coefficient (ADC), were used to assess splenium microstructural maturation at term equivalent age (TEA).
- Standardized neurodevelopmental assessments were conducted at 24 months corrected age and 5 years chronological age, with correlation analysis performed using Spearman's rank and multivariate regression.
Main Results:
- At 24 months, lower FA and higher ADC values were associated with poorer mental, psychomotor, and fine motor function.
- Cognitive and motor scores correlated positively with FA and negatively with ADC.
- At 5 years, lower FA and higher ADC were linked to abnormal overall motor function, and higher ADC also correlated with lower full-scale intelligence quotient (FSIQ).
Conclusions:
- Microstructural maturation of the splenium of the corpus callosum at TEA is significantly associated with neurodevelopmental outcomes.
- Apparent diffusion coefficient (ADC) may be a more sensitive indicator than fractional anisotropy (FA) for predicting long-term neurodevelopmental outcomes in very preterm infants.
Introduction:
Common brain injuries of preterm infants do not entirely explain the incidence of neurodevelopmental impairment observed in this population. Evidence suggests an association with microstructural maturation of the splenium of corpus callosum. This study aimed to investigate a correlation between microstructural maturation of the splenium of corpus callosum and neurodevelopmental outcome in very preterm infants.
Method:
In a cohort study of 373 very preterm infants, we used fractional anisotropy (FA) and apparent diffusion coefficient (ADC) derived from diffusion tensor imaging at term equivalent age (TEA) to quantitatively reflect microstructural maturation of the splenium of corpus callosum, and standardized follow-up assessments of cognitive and motor function at 24 months corrected age and 5 years chronological age. Correlation was tested by Spearman's rank correlation coefficients and multivariate regression analysis.
Results:
At 24 months, we found significantly lower FA and higher ADC values in infants with abnormal mental indices, psychomotor developmental indices, and fine motor function. Scores of all three correlated positively with FA and negatively with ADC. Aged 5 years, lower FA values correlated significantly with abnormal overall motor function, and higher ADC values correlated significantly with abnormal full-scale intelligence quotient (FSIQ) and overall motor function. Scores of FSIQ, overall, and fine motor function correlated negatively with ADC.
Conclusion:
The results emphasize an association between microstructural maturation of the splenium of corpus callosum at TEA and neurodevelopmental outcome, and suggest that ADC may be more strongly linked to these outcomes than FA, especially in the long-term.
