Diffusion tractography and neuromotor outcome in very preterm children with white matter abnormalities.
BACKGROUND
Moderate-to-severe white matter abnormality (WMA) in the newborn has been shown to produce persistent disruptions in cerebral connectivity but does not universally result in neurodevelopmental disability in very preterm (VPT) children. The aims of this hypothesis-driven study were to apply diffusion imaging to: (i) examine whether bilateral WMA detected in VPT children in the newborn period can predict microstructural organization at the age of 7 y and (ii) compare corticospinal tract and corpus callosum (CC) measures in VPT children at the age of 7 y with neonatal WMA with normal vs. impaired motor functioning.


METHODS
Diffusion parameters of the corticospinal tract and CC were compared between VPT 7-y olds with (n = 20) and without (n = 42) bilateral WMA detected in the newborn period. For those with WMA, diffusion parameters were further examined.


RESULTS
Microstructural organization of corticospinal tract and CC tracts at the age of 7 y were altered in VPT children with moderate-to-severe WMA detected at term equivalent age as compared with those without injury. Furthermore, diffusion parameters differed in the CC for children with WMA categorized by motor outcome (n = 8).


CONCLUSIONS
WMA on conventional magnetic resonance imaging at term equivalent age is associated with altered microstructural organization of the corticospinal tract and CC at 7 y of age.
Department of Pediatrics, Washington University, St Louis, Missouri.
Meredith E
ME
Estep
1] Department of Pediatrics, Washington University, St Louis, Missouri [2] Department of Neurology, Washington University, St Louis, Missouri.
Christopher D
CD
Smyser
1] Critical Care and Neurosciences, Murdoch Children's Research Institute, Melbourne, Australia [2] Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Peter J
PJ
Anderson
Department of Pediatrics, Washington University, St Louis, Missouri.
Cynthia M
CM
Ortinau
Division of Biostatistics, Washington University, St Louis, Missouri.
Michael
M
Wallendorf
Department of Pediatrics, Washington University, St Louis, Missouri.
Charles S
CS
Katzman
1] Critical Care and Neurosciences, Murdoch Children's Research Institute, Melbourne, Australia [2] Department of Paediatrics, University of Melbourne, Melbourne, Australia [3] Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne, Australia.
Lex W
LW
Doyle
Critical Care and Neurosciences, Murdoch Children's Research Institute, Melbourne, Australia.
Deanne K
DK
Thompson
1] Department of Pediatrics, Washington University, St Louis, Missouri [2] Department of Neurology, Washington University, St Louis, Missouri [3] Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri.
Jeffery J
JJ
Neil
1] Department of Pediatrics, Washington University, St Louis, Missouri [2] Department of Neurology, Washington University, St Louis, Missouri [3] Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri.
Terrie E
TE
Inder
Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri.
Joshua S
JS
Shimony
D016880:Anisotropy; D001921:Brain / Q000002:abnormalities* / Q000473:pathology*; D002648:Child; D056324:Diffusion Tensor Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D056784:Leukoencephalopathies / Q000150:complications / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009048:Motor Skills