title: Regional white matter development in very preterm infants: perinatal predictors and early developmental outcomes.
abstract: BACKGROUND
  Preterm infants are at risk for white matter (WM) injury and adverse neurodevelopmental outcomes.
  
  
  METHODS
  Serial diffusion tensor magnetic resonance imaging data were obtained from very preterm infants (N = 78) born <30 wk gestation imaged up to four times from 26-42 wk postmenstrual age. Slopes were calculated for fractional anisotropy (FA) and mean diffusivity (MD) within regions of interest for infants with ≥2 scans (N = 50). Sixty-five children underwent neurodevelopmental testing at 2 y of age.
  
  
  RESULTS
  FA slope for the posterior limb of the internal capsule was greater than other regions. The anterior limb of the internal capsule (ALIC), corpus callosum, and optic radiations demonstrated greater FA slope with increasing gestational age. Infants with patent ductus arteriosus had lower FA slope in the ALIC. MD slope was lower with prolonged ventilation or lack of antenatal steroids. At 2 y of age, lower motor scores were associated with lower FA in the left but higher FA in the right inferior temporal lobe at term-equivalent age. Better social-emotional competence was related to lower FA in the left cingulum bundle.
  
  
  CONCLUSIONS
  This study demonstrates regional variability in the susceptibility/sensitivity of WM maturation to perinatal factors and relationships between altered diffusion measures and developmental outcomes in preterm neonates.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri.|Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Cynthia E
authors.initials: CE
authors.lastname: Rogers
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Tara
authors.initials: T
authors.lastname: Smyser
authors.affiliation: Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri.|Department of Neurology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Smyser
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Joshua
authors.initials: J
authors.lastname: Shimony
authors.affiliation: Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Inder
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Neil
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000342:Affective Symptoms / Q000209:etiology / Q000473:pathology; D016880:Anisotropy; D002653:Child Behavior Disorders / Q000209:etiology / Q000473:pathology; D015897:Comorbidity; D003337:Corpus Callosum / Q000473:pathology; D056324:Diffusion Tensor Imaging; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology; D020772:Internal Capsule / Q000473:pathology; D008297:Male; D009069:Movement Disorders / Q000209:etiology / Q000473:pathology; D065886:Neurodevelopmental Disorders / Q000209:etiology / Q000473:pathology*; D009928:Organ Specificity; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects; D011379:Prognosis; D012121:Respiration, Artificial / Q000009:adverse effects; D013702:Temporal Lobe / Q000473:pathology; D066127:White Matter / Q000473:pathology*
chemical_list: D000305:Adrenal Cortex Hormones