title: Aberrant Executive and Frontoparietal Functional Connectivity in Very Preterm Infants With Diffuse White Matter Abnormalities.
abstract: BACKGROUND
  Diffuse white matter abnormalities are identified in up to 80% of very preterm infants on magnetic resonance imaging at 40 weeks' postmenstrual age. Several studies have observed an association between diffuse white matter abnormalities and cognitive deficits. We hypothesized that very preterm infants (gestational age ≤32 weeks) with diffuse white matter abnormalities will exhibit reduced executive control and frontoparietal functional connectivity compared with infants without diffuse white matter abnormalities measured using resting state functional magnetic resonance imaging at term-equivalent age.
  
  
  METHODS
  We quantified diffuse white matter abnormality volume objectively using an automated segmentation approach and defined diffuse white matter abnormality severity as no-mild (volume ≤50th percentile; N = 13) and moderate-severe (N = 14). Resting state networks of interests were identified using probabilistic independent component analysis. Within network functional connectivity was calculated between the different pair of nodes in a given network using partial correlation coefficients.
  
  
  RESULTS
  We studied 27 very preterm infants born at a mean (standard deviation) gestational age of 26.9 (2.0) weeks and imaged at 39.6 (1.4) weeks' postmenstrual age. Within-network connectivity was significantly reduced in the moderate-severe diffuse white matter abnormalities group than in the no-mild diffuse white matter abnormalities group for the executive control (P < 0.001) and frontoparietal (P = 0.02) networks. As expected, connectivity in three control resting state networks was similar: visual (P = 0.17), motor (P = 0.89), and somatosensory (P = 0.69) networks.
  
  
  CONCLUSIONS
  Very preterm infants with moderate or severe diffuse white matter abnormalities exhibited reduced functional connectivity in important cognitive and attention networks. This aberrant connectivity may be the early life antecedent to the cognitive deficits reported at 2 years of age or later in such infants.
authors.affiliation: Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio. Electronic address: Lili.He@nationwidechildrens.org.
authors.forename: Lili
authors.initials: L
authors.lastname: He
authors.affiliation: Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; The Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio. Electronic address: Nehal.Parikh@nationwidechildrens.org.
authors.forename: Nehal A
authors.initials: NA
authors.lastname: Parikh
mesh_terms: D001921:Brain / Q000002:abnormalities* / Q000503:physiopathology*; D001931:Brain Mapping; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D062071:Infant, Extremely Premature / Q000502:physiology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000002:abnormalities / Q000503:physiopathology; D009929:Organ Size; D010363:Pattern Recognition, Automated; D012146:Rest; D066127:White Matter / Q000002:abnormalities* / Q000503:physiopathology*
keywords: diffuse white matter abnormalities; extremely low birth weight; functional connectivity; resting state functional magnetic resonance imaging; very preterm infant