Specific relations between neurodevelopmental abilities and white matter microstructure in children born preterm

Abstract

Survivors of preterm birth have a high incidence of neurodevelopmental impairment which is not explained by currently understood brain abnormalities. The aim of this study was to test the hypothesis that the neurodevelopmental abilities of 2-year-old children who were born preterm and who had no evidence of focal abnormality on conventional MR imaging were consistently linearly related to specific local changes in white matter microstructure. We studied 33 children, born at a median (range) gestational age of 28(+5) (24(+4)-32(+1)) weeks. The children were recruited as infants from the Neonatal Intensive Care Unit at Queen Charlotte's and Hammersmith Hospital in the early neonatal period and imaged at a median corrected age of 25.5 (24-27) months. The children underwent diffusion tensor imaging to measure fractional anisotropy (FA) as a measure of tissue microstructure, and neurodevelopmental assessment using the Griffiths Mental Development Scales [giving an overall developmental quotient (DQ) and sub-quotients scores for motor, personal-social, hearing-language, eye-hand coordination and performance scales] at 2 years corrected age. Tract-based spatial statistics with linear regression analysis of voxel-wise cross-subject statistics were used to assess the relationship between FA and DQ/sub-quotient scores and results confirmed by reduced major axis regression of regions with significant correlations. We found that DQ was linearly related to FA values in parts of the corpus callosum; performance sub-scores to FA values in the corpus callosum and right cingulum; and eye-hand coordination sub-scores to FA values in the cingulum, fornix, anterior commissure, corpus callosum and right uncinate fasciculus. This study shows that specific neurodevelopmental impairments in infants born preterm are precisely related to microstructural abnormalities in particular regions of cerebral white matter which are consistent between individuals. FA may aid prognostication and provide a biomarker for therapeutic or mechanistic studies of preterm brain injury.

Neonatal brain microstructure correlates of neurodevelopment and gait in preterm children 18–22 mo of age: an MRI and DTI study

“…At near-term age, the genu and splenium of the CC have not yet myelinated (29), although posterior aspects (splenium) develop earlier than anterior (genu) aspects (16,30). Lesion studies indicate that genu WM mediates motor coordination (31), and prior studies reported neonatal CC WM structure associated with future motor function (32,33), consistent with our findings.…”

The emergence of functional architecture during early brain development

“…Not surprisingly, preterm birth is associated with impaired brain development reflected in reduced brain volumes, diminished cortical gyrification and delayed maturation of gray and white matter structures (Ball et al, 2012;Keunen et al, 2012;Rathbone et al, 2011;Shimony et al, 2016;Volpe, 2009). These deficits are also present in the absence of focal brain injury and have been noted to persist through childhood (Counsell et al, 2008;Fischigómez et al, 2015;Monson et al, 2016). Behavioral sequelae of these structural disturbances in brain development are observed across a wide spectrum of neurodevelopmental outcomes and include cognitive delay, working memory impairment, learning disabilities, executive functioning deficits, internalizing and externalizing behavioral problems and developmental psychopathology including autism and attention deficit hyperactivity disorder (Fischi-gómez et al, 2015;Johnson et al, 2010Johnson et al, , 2009Monson et al, 2016;Urben et al, 2015).…”

Fractional anisotropy alterations in individuals born preterm: a diffusion tensor imaging meta‐analysis

“…Counsell et al 51 found linear correlations between the developmental quotient and fractional anisotropy values in the corpus callosum and right cingulum, between performance subscores and fractional anisotropy in the corpus callosum and right cingulum, and between hand-eye coordination scores and fractional anisotropy in the cingulum, fornix, anterior commissure, corpus callosum, and right uncinate fasciculus in 2-year-old children born preterm. Similarly, fractional anisotropy values in the left anterior uncinate fasciculus in school-age children born preterm were correlated with the Wechsler Intelligence Scale for Children Verbal IQ, Wechsler Intelligence Scale for Children Full-scale IQ, and Peabody Picture Vocabulary TestRevised scores for preterm groups at 12 years of age.…”