title: Tractography of white-matter tracts in very preterm infants: a 2-year follow-up study.
abstract: OBJECTIVE
  The aim of this study was to determine whether tractography of white-matter tracts can independently predict neurodevelopmental outcome in very preterm infants.
  
  
  METHODS
  Out of 84 very preterm infants admitted to a neonatal intensive care unit, 64 (41 males, 23 females; median gestational age 29.1 weeks [range 25.6-31.9]; birthweight 1163 g [range 585-1960]) underwent follow-up at 2 years. Diffusion tensor imaging (DTI) values obtained around term were associated with a neurological examination and mental and psychomotor developmental index scores at 2 years based on the Bayley Scales of Infant Development (version 3). Univariate and logistic regression analyses tested for associations between DTI values and follow-up parameters. Cut-off values predicting motor delay and cerebral palsy (CP) were determined for fractional anisotropy, apparent diffusion coefficient (ADC), and fibre lengths.
  
  
  RESULTS
  Infants with psychomotor delay and CP had significantly lower fractional anisotropy values (p=0.002, p=0.04 respectively) and shorter fibre lengths (p=0.02, p=0.02 respectively) of the posterior limb of the internal capsule. Infants with psychomotor delay also had significantly higher ADC values (p=0.03) and shorter fibre lengths (p=0.002) of the callosal splenium. Fractional anisotropy values of the posterior limb of the internal capsule independently predicted motor delay and CP, with sensitivity between 80 and 100% and specificity between 66 and 69%. ADC values of the splenium independently predicted motor delay with sensitivity of 100% and specificity of 65%.
  
  
  CONCLUSIONS
  Diffusion tensor imaging tractography at term-equivalent age independently predicts psychomotor delay at 2 years of age in preterm infants.
authors: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. F.T.Wiggers-de_Bruine@lumc.nl
authors: Francisca T
authors: FT
authors: De Bruïne
authors: Gerda
authors: G
authors: Van Wezel-Meijler
authors: Lara M
authors: LM
authors: Leijser
authors: Sylke J
authors: SJ
authors: Steggerda
authors: Annette A
authors: AA
authors: Van Den Berg-Huysmans
authors: Monique
authors: M
authors: Rijken
authors: Mark A
authors: MA
authors: Van Buchem
authors: Jeroen
authors: J
authors: Van Der Grond
mesh_terms: D016880:Anisotropy; D001921:Brain / Q000254:growth & development* / Q000473:pathology; D001931:Brain Mapping; D002547:Cerebral Palsy / Q000209:etiology / Q000473:pathology; D003337:Corpus Callosum / Q000473:pathology*; D002658:Developmental Disabilities / Q000150:complications / Q000209:etiology / Q000473:pathology; D056324:Diffusion Tensor Imaging; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000473:pathology / Q000503:physiopathology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology