Brain Volumes at Term-Equivalent Age in Preterm Infants: Imaging Biomarkers for Neurodevelopmental Outcome through Early School Age

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• 作者：Kristin Keunen ; MD¹ ; ² ; Ivana I&scaron ; gum ; PhD² ; ³ ; Britt J.M. van Kooij ; MD ; PhD¹ ; Petronella Anbeek ; PhD¹ ; ³ ; Ingrid C. van Haastert ; PhD¹ ; Corine Koopman-Esseboom ; MD ; PhD¹ ; Petronella C. Fieret-van Stam ; PhD⁴ ; Rutger A.J. Nievelstein ; MD ; PhD⁵ ; Max A. Viergever ; PhD² ; ³ ; Linda S. de Vries ; MD ; PhD¹ ; ² ; Floris Groenendaal ; MD ; PhD¹ ; ² ; ^&lowast ; ; Manon J.N.L. Benders ; MD ; PhD¹ ; ² ; ^&lowast ; ; ^{m.benders@umcutrecht.nl" class="auth_mail" title="E-mail the corresponding author}
• 关键词：BGT ; Basal ganglia and thalami ; BSITD-III ; Bayley Scales of Infant and Toddler Development ; Third Edition ; BW ; Birthweight ; CA ; Corrected age ; CGM ; Cortical gray matter ; CSF ; Cerebrospinal fluid ; DQ ; Developmental quotient ; GA ; Gestational age ; ICV ; Intracranial volume ; MABC-2 ; Movement Assessment Battery for Children ; Second Edition ; MRI ; Magnetic resonance imaging ; MWM ; Myelinated white matter ; PHVD ; Posthemorrhagic ventricular dilatation ; PIQ ; Performance IQ ; PMA ; Postmenstrual age ; PVHI ; Per
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：172
• 期：Complete
• 页码：88-95
• 全文大小：256 K

文摘

To evaluate the relationship between brain volumes at term and neurodevelopmental outcome through early school age in preterm infants.

Study design

One hundred twelve preterm infants (born mean gestational age 28.6 ± 1.7 weeks) were studied prospectively with magnetic resonance imaging (imaged at mean 41.6 ± 1.0 weeks). T2- and T1-weighted images were automatically segmented, and volumes of 6 tissue types were related to neurodevelopmental outcome assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (cognitive, fine, and gross motor scores) at 24 months corrected age (n = 112), Griffiths Mental Development Scales (developmental quotient) at age 3.5 years (n = 98), Movement Assessment Battery for Children, Second Edition (n = 85), and Wechsler Preschool and Primary Scale of Intelligence, Third Edition at age 5.5 years (n = 44). Corrections were made for intracranial volume, maternal education, and severe brain lesions.

Results

Ventricular volumes were negatively related to neurodevelopmental outcome at age 24 months and 3.5 years, as well as processing speed at age 5.5 years. Unmyelinated white matter (UWM) volume was positively associated with motor outcome at 24 months and with processing speed at age 5.5 years. Cortical gray matter (CGM) volume demonstrated a negative association with motor performance and cognition at 24 months and with developmental quotient at age 3.5 years. Cerebellar volume was positively related to cognition at these time points. Adjustment for brain lesions attenuated the relations between cerebellar and CGM volumes and cognition.

Conclusions

Brain volumes of ventricles, UWM, CGM, and cerebellum may serve as biomarkers for neurodevelopmental outcome in preterm infants. The relationship between larger CGM volumes and adverse neurodevelopment may reflect disturbances in neuronal and/or axonal migration at the UWM-CGM boundary and warrants further investigation.