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Can cerebral MRI at age 1 year predict motor and intellectual outcomes in very-low-birthweight children?
1Department of Pediatrics, Central Hospital of Aust-Agder, Arendal, Norway.
Insights
Cerebral MRI in very-low-birthweight infants without disabilities at age 1 did not predict later fine motor or intellectual function. Abnormal MRI findings were linked to poorer gross motor skills, but infant weight and development scores were stronger predictors.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Neuroimaging
Background:
- Very-low-birthweight (VLBW) infants are at risk for neurodevelopmental deficits.
- Cerebral magnetic resonance imaging (MRI) is used to assess brain development in VLBW infants.
- The predictive value of early MRI findings for long-term neurodevelopmental outcomes requires further investigation.
Purpose of the Study:
- To evaluate cerebral MRI findings in VLBW infants without disabilities at age 1 year.
- To correlate these findings with motor, intellectual, and perceptual function at age 6 years.
- To compare the predictive value of MRI with other infant assessments for neurodevelopmental outcomes.
Main Methods:
- Follow-up study of 20 VLBW infants without disabilities.
- Cerebral MRI performed at age 1 year.
- Neurodevelopmental assessment at age 6 years using Peabody Developmental Motor Scales and Wechsler Preschool and Primary Scale of Intelligence.
- Comparison of MRI findings, anthropometrics, and Bayley Scales of Infant Development scores as predictors.
Main Results:
- Infants with specific myelin hyperintensities (centrum semiovale, occipital with ventricular dilatation) scored lower on gross motor function at age 6.
- No association found between abnormal MRI findings and later fine motor, intellectual, or perceptual function.
- MRI abnormality score predicted gross motor function, but Bayley scores and infant weight were stronger predictors of overall motor and intellectual outcomes.
Conclusions:
- Cerebral MRI findings at age 1 year in VLBW infants without disabilities are not reliable predictors of fine motor, intellectual, or perceptual function at age 6.
- While MRI can indicate potential motor fiber damage, it is less predictive than standard developmental assessments.
- Routine cerebral MRI screening for VLBW infants without disabilities at 1 year of age is not recommended.
Abstract:
This follow-up study reports on cerebral MRI findings in 20 very-low-birthweight (VLBW) infants without disabilities at age 1 year in relation to motor, intellectual, and perceptual function at age 6 years. MRI findings, anthropometrics, and Bayley Scales of Infant Development scores at age 1 year as predictors of psychomotor status at age 6 years are also evaluated and compared. Outcome parameters were the Peabody Developmental Motor Scales and the Wechsler Preschool and Primary Scale of Intelligence. The results show that infants with myelin hyperintensities including the centrum semiovale or with occipital hyperintensities with associated ventricular dilatation at age 1 scored lower on the Peabody Gross Motor Locomotion Scale at age 6 than infants with normal myelination or with isolated occipital hyperintensities. This may indicate damage to motor fibers caused by perinatal periventricular leukomalacia. No relation was found between abnormal MRI findings at age 1 and later fine motor, intellectual, and perceptual function. Comparing different age 1-year predictors, an abnormality score defined by MRI was used as an independent predictor of gross motor locomotion function at age 6 years. However, the Bayley Mental Development Index scores and weight at age 1 were more important predictors of later motor and intellectual outcome, respectively, than MRI findings. It is recommended that cerebral MRI should not be used routinely to examine VLBW infants without disabilities at 1 year of age.