title: Probabilistic diffusion tractography of the optic radiations and visual function in preterm infants at term equivalent age.
abstract: Children born prematurely have a high incidence of visual disorders which cannot always be explained by focal retinal or brain lesions. The aim of this study was to test the hypothesis that visual function in preterm infants is related to the microstructural development of white matter in the optic radiations. We used diffusion tensor imaging (DTI) with probabilistic diffusion tractography to delineate the optic radiations at term equivalent age and compared the fractional anisotropy (FA) to a contemporaneous evaluation of visual function. Thirty-seven preterm infants (19 male) born at median (range) 28(+4) (24(+1)-32(+3)) weeks gestational age, were examined at a post-menstrual age of 42 (39(+6)-43) weeks. MRI and DTI were acquired on a 3 Tesla MR system with DTI obtained in 15 non-collinear directions with a b value of 750 s/mm(2). Tracts were generated from a seed mask placed in the white matter lateral to the lateral geniculate nucleus and mean FA values of these tracts were determined. Visual assessment was performed using a battery of nine items assessing different aspects of visual abilities. Ten infants had evidence of cerebral lesions on conventional MRI. Multiple regression analysis demonstrated that the visual assessment score was independently correlated with FA values, but not gestational age at birth, post-menstrual age at scan or the presence of lesions on conventional MRI. The occurrence of mild retinopathy of prematurity did not affect the FA measures or visual scores. We then performed a secondary analysis using tract-based spatial statistics to determine whether global brain white matter development was related to visual function and found that only FA in the optic radiations was correlated with visual assessment score. Our results suggest that in preterm infants at term equivalent age visual function is directly related to the development of white matter in the optic radiations.
authors.affiliation: NICU, Institute of Pediatrics and Neonatology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, University of Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bassi
authors.forename: Daniela
authors.initials: D
authors.lastname: Ricci
authors.forename: Anna
authors.initials: A
authors.lastname: Volzone
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Allsop
authors.forename: Latha
authors.initials: L
authors.lastname: Srinivasan
authors.forename: Aakash
authors.initials: A
authors.lastname: Pai
authors.forename: Carmen
authors.initials: C
authors.lastname: Ribes
authors.forename: Luca A
authors.initials: LA
authors.lastname: Ramenghi
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mercuri
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca
authors.forename: A David
authors.initials: AD
authors.lastname: Edwards
authors.forename: Frances M
authors.initials: FM
authors.lastname: Cowan
authors.forename: Mary A
authors.initials: MA
authors.lastname: Rutherford
authors.forename: Serena J
authors.initials: SJ
authors.lastname: Counsell
mesh_terms: D016880:Anisotropy; D001921:Brain / Q000033:anatomy & histology / Q000254:growth & development; D001931:Brain Mapping / Q000379:methods; D002552:Cerebral Ventricles / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004108:Dilatation, Pathologic / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D005133:Eye Movements / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology* / Q000523:psychology; D007235:Infant, Premature, Diseases / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D014785:Vision, Ocular / Q000502:physiology*; D014795:Visual Pathways / Q000033:anatomy & histology* / Q000254:growth & development / Q000502:physiology; D014796:Visual Perception / Q000502:physiology*