Longitudinal White Matter Maturation in Preterm Infants: Functional Pathway-Specific Trajectories and Associations...

Area of Science:

• Neuroscience
• Developmental Biology
• Medical Imaging

Background:

• Human white matter (WM) undergoes critical development in the first two years, forming the basis for neurodevelopment.
• Preterm birth can impact this crucial early WM development, potentially leading to long-term neurodevelopmental challenges.

Purpose of the Study:

• To investigate and compare the developmental trajectories of 26 distinct white matter (WM) pathways in preterm versus full-term infants up to two years of age.
• To identify specific WM pathways associated with motor, visual, and cognitive functions and their developmental differences.
• To explore the relationship between WM maturation rates and long-term neurodevelopmental outcomes, particularly motor function.

Main Methods:

• A mixed-model analysis for repeated measures was employed.
• Diffusion tensor imaging (DTI) was used to assess 26 functionally distinct WM pathways in 174 infants (58 preterm, 23 full-term).
• Inter-regional correlation matrix analysis was performed to examine pathway connectivity.

Main Results:

• Significant differences in developmental trajectories were observed between preterm and full-term infants in motor (e.g., corticospinal tract), visual (e.g., optic radiation), and cognitive (e.g., corpus callosum) pathways.
• Preterm infants exhibited stronger connectivity within motor and visual pathways, suggesting adaptive resilience mechanisms.
• Faster maturation of the middle cerebellar peduncle (MCP) tract was strongly associated with better motor scores, indicating a compensatory role.

Conclusions:

• Longitudinal analysis of specific WM pathway maturation rates reveals distinct neurodevelopmental sequelae of prematurity.
• Aberrant WM development in preterm infants highlights potential early biomarkers for neurodevelopmental outcomes.
• Targeted interventions guided by WM pathway analysis may improve neurodevelopmental outcomes in preterm infants.