Regional Brain Volumes and Their Later Neurodevelopmental Correlates in Term and Preterm Infants

Abstract

These findings of reduced volumes in sensorimotor and parieto-occipital regions in preterm infants, and the prospective correlations of regional volumes with cognitive outcome, confirm and extend findings previously reported in a cross-sectional study of 8-year-old prematurely born children. The data suggest that regional brain volumes near term are a promising marker for predicting disturbances of cognitive outcome in preterm infants. Further prospective, longitudinal studies of neonatal brain volumes and developmental indices into later childhood are required to confirm the utility of regional brain volumes as predictors of longer term outcome.

Regional Brain Development in Serial Magnetic Resonance Imaging of Low-Risk Preterm Infants

“…An alternative definition of parcels may also improve sensitivity to differences in myelination, because myelination follows an anatomically specific developmental process. 62 Similar to the current study, Peterson et al 47 reported findings of decreased white matter in the central region, which includes the sensor-motor system, as well as the auditory processing areas of the frontotemporal lobes. In addition, the preterm infants in that study displayed decreased white matter volumes in the parieto-occipital regions when compared with term infants.…”

“…Several investigations in preterm infants with brain injury have identified an association between increased CSF volumes and decreased cerebral volumes. 11,13,47 The current study provides the first evidence to suggest that, in lowrisk preterm infants, those selected to have a head circumference appropriate for their PMA, cerebral volume is normal, yet CSF volume is increased. Considering that an appropriate head circumference between the 10th and 90th percentile corresponds with 33-to 38-cm head circumference measured at birth, this gives a broad range of variable brain tissue and CSF volumes, which may obscure true group differences in a small cohort.…”

“…45,46 Hence, most newborn infant studies that involve tissue classification have used intracranial volume as an indicator for the infant's head size and expressed brain tissue volumes relative to intracranial volume. 11,13,14,33,47 This approach assumes that head growth progresses in a similar fashion after preterm and term birth and that cerebral growth influences head size and shape similarly in both populations.…”

“…14,32,47 These changes have been further associated with impaired neurodevelopmental outcome. 32 During late gestation, after the migration of neurons into the cortex is completed, decreased gray matter volumes may be caused by atrophy and neuronal loss, disruption of the formation of neural connectivity and of dendrite growth during synaptogenesis.…”

The development of potentially better practices to support the neurodevelopment of infants in the NICU

“…Some studies of these at risk infants demonstrate abnormality in gyral grey matter development, marked by decreased gray matter volume. [453][454][455][456] This loss of grey matter may reflect neuronal cell loss and diminished dendritic growth and synaptogenesis. 457,458 Diminished head growth has been associated with cognitive delay and behavioral deficits.…”