The association of lung disease with cerebral white matter abnormalities in preterm infants.
OBJECTIVE
Preterm infants have a high incidence of neurodevelopmental impairment associated with diffuse cerebral white matter abnormalities and also a high incidence of serious respiratory disease. However, it is unclear if lung disease and brain injury are related, and previous research has been impeded by confounding effects, including prematurity and infection. Using a new approach that permits multivariate statistical analysis, we tested the hypothesis that lung disease is associated with specific white matter abnormalities, detected as reduced fractional anisotropy (FA) in diffusion tensor imaging data.


METHODS
Fifty-three preterm infants with no evidence of focal abnormality on conventional MRI were studied at term-equivalent age by using tract-based spatial statistics, an automated observer-independent method for voxelwise analysis of major white matter pathways.


RESULTS
In several white matter tracts, FA decreased with a linear relation to the gestational age at birth. Independent of the confounding effects of prematurity and age at scan, respiratory disease was associated with specific white matter abnormalities in preterm infants; those infants receiving mechanical ventilation for >2 days in the perinatal period (n = 10) showed reduced FA in the genu of the corpus callosum, whereas subjects with chronic lung disease (n = 15) displayed a reduction in FA in the left inferior longitudinal fasciculus.


CONCLUSIONS
Independent of the degree of prematurity, respiratory disease is associated with cerebral white matter abnormalities.
Anjari
Mustafa
M
Division of Clinical Sciences, Imperial College London and MRC Clinical Sciences Centre, London, United Kingdom.
Counsell
Serena J
SJ
Srinivasan
Latha
L
Allsop
Joanna M
JM
Hajnal
Joseph V
JV
Rutherford
Mary A
MA
Edwards
A David
AD
D016880:Anisotropy; D054022:Cerebrum / Q000473:pathology*; D003337:Corpus Callosum / Q000473:pathology; D002658:Developmental Disabilities / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007231:Infant, Newborn; D007234:Infant, Premature; D008171:Lung Diseases / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D015999:Multivariate Analysis; D009434:Neural Pathways / Q000473:pathology*; D012121:Respiration, Artificial