Abstract
BACKGROUND AND PURPOSE: Microstructural white matter abnormalities on DTI using Tract-Based Spatial Statistics at term-equivalent age are associated with cognitive and motor outcomes at 2 years of age or younger. However, neurodevelopmental tests administered at such early time points are insufficiently predictive of mild-moderate motor and cognitive impairment at school age. Our objective was to evaluate the microstructural antecedents of cognitive and motor outcomes at 3 years’ corrected age in a cohort of very preterm infants.
MATERIALS AND METHODS: We prospectively recruited 101 very preterm infants (<32 weeks’ gestational age) and performed DTI at term-equivalent age. The Differential Ability Scales, 2nd ed, Verbal and Nonverbal subtests, and the Bayley Scales of Infant and Toddler Development, 3rd ed, Motor subtest, were administered at 3 years of age. We correlated DTI metrics from Tract-Based Spatial Statistics with the Bayley Scales of Infant and Toddler Development, 3rd ed, and the Differential Ability Scales, 2nd ed, scores with correction for multiple comparisons.
RESULTS: Of the 101 subjects, 84 had high-quality DTI data, and of these, 69 returned for developmental testing (82%). Their mean (SD) gestational age was 28.4 (2.5) weeks, and birth weight was 1121.4 (394.1) g. DTI metrics were significantly associated with Nonverbal Ability in the corpus callosum, posterior thalamic radiations, fornix, and inferior longitudinal fasciculus and with Motor scores in the corpus callosum, internal and external capsules, posterior thalamic radiations, superior and inferior longitudinal fasciculi, cerebral peduncles, and corticospinal tracts.
CONCLUSIONS: We identified widespread microstructural white matter abnormalities in very preterm infants at term that were significantly associated with cognitive and motor development at 3 years’ corrected age.
ABBREVIATIONS:
- Bayley-III
- Bayley Scales of Infant and Toddler Development, 3rd ed
- CA
- corrected age
- DAS-II
- Differential Ability Scales, 2nd ed
- FA
- fractional anisotropy
- IFOF
- inferior fronto-occipital fasciculi
- ILF
- inferior longitudinal fasciculus
- MD
- mean diffusivity
- PTR
- posterior thalamic radiations
Footnotes
This work was supported by National Institutes of Health grants R01NS094200 (to N.A.P.), R01 NS096037 (to N.A.P.), and R21HD094085 and a Trustee Grant from the Cincinnati Children’s Hospital Medical Center (to L.H.).
Disclosures: Milan N. Parikh—RELATED: Grant: National Institutes of Health.* Kelly McNally—RELATED: Other: Cincinnati Children’s Hospital, Comments: A subcontract was set up from the study Principal Investigator at Cincinnati Children’s Hospital to support the cost of data collection at my site, Nationwide Children’s Hospital.* John W. Logan—RELATED: Grant: The Nationwide Children’s Hospital received grant support to conduct neurodevelopmental follow-up for this study, Comments: no conflict of interest*; UNRELATED: Expert Testimony: I once provided expert testimony in a case in Florida, unrelated to this work; no conflict of interest. Leanne Tamm—UNRELATED: Employment: Cincinnati Children’s Hospital Medical Center. Keith O. Yeates—RELATED: Grant: National Institutes of Health, Comments: The work was supported by the National Institute of Child Health and Human Development network.* Lili He—RELATED: Grant: This study was supported by the National Institutes of Health grant R21-HD094085.* Nehal A. Parikh—RELATED: Grant: This study was supported by the National Institutes of Health grants R01-NS094200 and R01-NS096037.* *Money paid to the institution.
- © 2021 by American Journal of Neuroradiology
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