Brainstem size and function at term age in relation to later neurosensory disability in high-risk, preterm infants.
The aim of this study was to measure brainstem size on magnetic resonance imaging (MRI) scans of high-risk. preterm infants, to assess brainstem function by brainstem auditory-evoked potentials (BAEP) and to determine the predictive value of these measures for the neurosensory outcome. A total of 51 preterm infants (gestational age <34 wk, birthweight <1,500 g) underwent examinations at term age; neuromotor outcome and hearing were followed up until a corrected age of 18 mo. Fourteen (27%) infants had neurosensory disability. Those with a later neurosensory disability had a significantly smaller brain stem than those with a normal outcome. The preterm infants had significantly longer peak latency (L) V and interpeak latency (IPL) III-V than the full-term control infants. Most of the preterm infants with severe cerebral palsy or hearing loss had abnormal BAEP. Sensitivity of morphometric dimensions for predicting neurosensory disability was only 20-31%, but specificity was 97-100%. Abnormal L I and IPL III-V in BAEP predicted disability with a sensitivity of 93% and a specificity of 57-59%.


CONCLUSIONS
We conclude that adverse events during the perinatal period may lead to morphofunctional changes in the brain stem in high-risk, preterm infants, and it seems that functional changes are accurate in predicting neurosensory disability in such patients.
Valkama
A M
AM
Department of Paediatric, University of Oulu, Finland. marita.valkama@oulu.fi
Tolonen
E U
EU
Kerttul
L I
LI
Pääkkö
E L
EL
Vainionpää
L K
LK
Koivist
M E
ME
D001933:Brain Stem / Q000473:pathology* / Q000503:physiopathology; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000209:etiology; D015331:Cohort Studies; D003638:Deafness / Q000175:diagnosis* / Q000209:etiology; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D012680:Sensitivity and Specificity