H ealthy neurodevelopment in children requires adequate early brain white matter integrity. Two main processes involved in white matter development include establishment of connections between brain regions to form functional networks and myelination of these connections to facilitate efficient neural signal transfer. The former is mostly completed by the end of normal gestation, and the latter starts at approximately the early third trimester of gestation and develops rapidly during early infancy (1). At birth, all major white matter tracts are formed and are similar in organization to the white matter in older infants, despite differences in water diffusion anisotropy values (2,3) mostly due to myelination. It is well known that white matter injuries at birth (or at term-equivalent age) for newborns with medical conditions, such as those born preterm (4), with congenital heart diseases (5), or with hypoxic-ischemic encephalopathy (6), are associated with deficits in neurodevelopmental outcomes. Nevertheless, it is not as clear whether there are similar associations between variations in white matter developmental status in healthy newborns and long-term neurodevelopmental outcomes. A few recent publications revealed relationships between white matter development and cognitive functions in healthy children. The developmental trajectory of whole brain myelin volume fraction in children between age 3 months and 4 years showed significant associations with receptive and expressive language scales (7), while children with above-average ability (reflected in the early learning composite measured using the Mullen Scales of Early Learning) showed differential trajectories of myelin
BACKGROUND AND PURPOSE The complex function of memory has been linked to both brain gray and white matter (WM). WM abnormalities are associated with memory impairment in pathological conditions. We investigated whether variation in WM microstructure in healthy children also correlates with memory performance. METHODS Sixty‐five 7.5 to 8.5‐year‐old healthy children had a brain MRI scan using diffusion tensor imaging (DTI). They were also assessed for memory performance using the Children's Memory Scale (CMS). Eight indices that evaluate verbal and visual memory (immediate and delayed) were measured. DTI parameters reflecting WM microstructure, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were calculated and correlated with memory indices. RESULTS Tract‐based spatial statistics analysis showed multiple WM tracts in which DTI parameters correlated with CMS indices. Specifically, FA (a reflection of WM integrity) and RD values (a reflection of myelination) in multiple projecting, association, and commissural WM tracts correlated with verbal delayed index (P < .05, corrected for voxel‐wise multiple comparisons). Also, FA values in several WM tracts, including superior longitudinal fasciculus and posterior corona radiata, positively correlated with delayed recognition index (P < .05, corrected). Region of interest analyses showed similar correlations between FA/RD and CMS scores in WM regions involving these tracts and additionally in the cingulum, and detected additional MD–CMS correlations in several regions. CONCLUSIONS Significant correlations between DTI parameter values and CMS indices in multiple WM tracts in healthy children indicate that neuroimaging can sensitively detect brain WM changes associated with variations of memory function, even for that in the normal range.
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