title: Brain structural and microstructural alterations associated with cerebral palsy and motor impairments in adolescents born extremely preterm and/or extremely low birthweight.
abstract: OBJECTIVE
  To elucidate neurobiological changes underlying motor impairments in adolescents born extremely preterm (gestation <28wks) and/or with extremely low birthweight (ELBW, <1000g), our aims were the following: (1) to compare corticospinal tract (CST) microstructure and primary motor cortex (M1) volume, area, and thickness between extremely preterm/ELBW adolescents and a comparison group with normal birthweight (>2499g); (2) to compare CST microstructure and M1 volume, area, and thickness between extremely preterm/ELBW adolescents with cerebral palsy (CP), motor impairment without CP, and no motor impairment; and (3) to investigate associations between CST microstructure and M1 measures.
  
  
  METHODS
  This study used diffusion and structural magnetic resonance imaging to examine the CST and M1 in a geographical cohort of 191 extremely preterm/ELBW adolescents (mean age 18y 2.4mo [SD 9.6mo]; 87 males, 104 females) and 141 adolescents in the comparison group (mean age 18y 1.2mo [SD 9.6mo]; 59 males, 82 females).
  
  
  RESULTS
  Extremely preterm/ELBW adolescents had higher CST axial, radial, and mean diffusivities and lower M1 thickness than the comparison group. Extremely preterm/ELBW adolescents with CP had higher CST diffusivities than non-motor-impaired extremely preterm/ELBW adolescents. CST diffusivities correlated with M1 volume and area.
  
  
  CONCLUSIONS
  Extremely preterm/ELBW adolescents have altered CST microstructure, which is associated with CP. Furthermore, the results elucidate how CST and M1 alterations interrelate to potentially influence motor function in extremely preterm/ELBW adolescents.
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Kelly
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Chan
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Alice C
authors.initials: AC
authors.lastname: Burnett
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Florey Institute of Neuroscience and Mental Health, Melbourne, Vic., Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Connelly
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
authors.affiliation: Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
authors.affiliation: Department of Neonatal Services, Royal Women's Hospital, Melbourne, Vic., Australia.
authors.forename: Jeanie L Y
authors.initials: JL
authors.lastname: Cheong
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia.
authors.forename: Deanne K
authors.initials: DK
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000473:pathology*; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000473:pathology*; D009069:Movement Disorders / Q000473:pathology*; D011712:Pyramidal Tracts / Q000473:pathology*