Brain Advance Access published online on October 24, 2008
Brain, doi:10.1093/brain/awn268
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Specific relations between neurodevelopmental abilities and white matter microstructure in children born preterm
1Imaging Sciences Department, MRC Clinical Sciences Centre, 2Hammersmith/St Mary's Comprehensive Biomedical Research Centre, DuCane Road, London, W12 0HS and 3Department of Paediatrics, Imperial College London, Hammersmith Campus, UK
Correspondence to:
Dr Serena J. Counsell, Robert Steiner MR Unit, Imaging Sciences Department, Imperial College London, Hammersmith Hospital, DuCane Road, London W12 0HS, UK E-mail: serena.counsell{at}imperial.ac.uk
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.
Key Words: preterm; infant; brain; diffusion tensor imaging; white matter
Abbreviations: DTI, diffusion tensor imaging; DQ, developmental quotient; FA, fractional anisotropy; MR, magnetic resonance; TBSS, Tract-based spatial statistics
Received May 1, 2008. Revised August 15, 2008. Accepted September 22, 2008.
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