title: PPREMO: a prospective cohort study of preterm infant brain structure and function to predict neurodevelopmental outcome.
abstract: BACKGROUND
  More than 50 percent of all infants born very preterm will experience significant motor and cognitive impairment. Provision of early intervention is dependent upon accurate, early identification of infants at risk of adverse outcomes. Magnetic resonance imaging at term equivalent age combined with General Movements assessment at 12 weeks corrected age is currently the most accurate method for early prediction of cerebral palsy at 12 months corrected age. To date no studies have compared the use of earlier magnetic resonance imaging combined with neuromotor and neurobehavioural assessments (at 30 weeks postmenstrual age) to predict later motor and neurodevelopmental outcomes including cerebral palsy (at 12-24 months corrected age). This study aims to investigate i) the relationship between earlier brain imaging and neuromotor/neurobehavioural assessments at 30 and 40 weeks postmenstrual age, and ii) their ability to predict motor and neurodevelopmental outcomes at 3 and 12 months corrected age.
  
  
  METHODS
  This prospective cohort study will recruit 80 preterm infants born ≤ 30 week's gestation and a reference group of 20 healthy term born infants from the Royal Brisbane & Women's Hospital in Brisbane, Australia. Infants will undergo brain magnetic resonance imaging at approximately 30 and 40 weeks postmenstrual age to develop our understanding of very early brain structure at 30 weeks and maturation that occurs between 30 and 40 weeks postmenstrual age. A combination of neurological (Hammersmith Neonatal Neurologic Examination), neuromotor (General Movements, Test of Infant Motor Performance), neurobehavioural (NICU Network Neurobehavioural Scale, Premie-Neuro) and visual assessments will be performed at 30 and 40 weeks postmenstrual age to improve our understanding of the relationship between brain structure and function. These data will be compared to motor assessments at 12 weeks corrected age and motor and neurodevelopmental outcomes at 12 months corrected age (neurological assessment by paediatrician, Bayley scales of Infant and Toddler Development, Alberta Infant Motor Scale, Neurosensory Motor Developmental Assessment) to differentiate atypical development (including cerebral palsy and/or motor delay).
  
  
  CONCLUSIONS
  Earlier identification of those very preterm infants at risk of adverse neurodevelopmental and motor outcomes provides an additional period for intervention to optimise outcomes.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12613000280707. Registered 8 March 2013.
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia. j.george2@uq.edu.au.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: George
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia. r.boyd@uq.edu.au.|Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Australia. r.boyd@uq.edu.au.
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
authors.affiliation: University of Queensland Centre for Clinical Research, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia. p.colditz@uq.edu.au.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Colditz
authors.affiliation: Digital Productivity Flagship, The Australian e-Health Research Centre, CSIRO, Brisbane, Australia. Stephen.rose@csiro.au.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Rose
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia. k.pannek@imperial.ac.uk.|Digital Productivity Flagship, The Australian e-Health Research Centre, CSIRO, Brisbane, Australia. k.pannek@imperial.ac.uk.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Pannek
authors.affiliation: Digital Productivity Flagship, The Australian e-Health Research Centre, CSIRO, Brisbane, Australia. Jurgen.Fripp@csiro.au.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Fripp
authors.affiliation: University of Queensland Centre for Clinical Research, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia. b.lingwood@uq.edu.au.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Lingwood
authors.affiliation: University of Queensland Centre for Clinical Research, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia. Melissa.lai@uq.edu.au.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Lai
authors.affiliation: University of Queensland Centre for Clinical Research, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia. a.kong1@uq.edu.au.
authors.forename: Annice H T
authors.initials: AH
authors.lastname: Kong
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia. r.ware@sph.uq.edu.au.|Queensland Children's Medical Research Institute, Children's Health Queensland Hospitals and Health Service, Brisbane, Australia. r.ware@sph.uq.edu.au.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.affiliation: Royal Brisbane and Women's Hospital, Brisbane, Australia. a.coulthard@uq.edu.au.|Academic Discipline of Medical Imaging, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia. a.coulthard@uq.edu.au.
authors.forename: Alan
authors.initials: A
authors.lastname: Coulthard
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia. Christine.finn@uq.edu.au.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Finn
authors.affiliation: Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Australia. sasaka.bandaranayake@health.qld.gov.au.
authors.forename: Sasaka E
authors.initials: SE
authors.lastname: Bandaranayake
mesh_terms: D001921:Brain / Q000033:anatomy & histology* / Q000502:physiology* / Q000503:physiopathology; D002547:Cerebral Palsy / Q000175:diagnosis; D002658:Developmental Disabilities / Q000175:diagnosis; D004569:Electroencephalography; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D011446:Prospective Studies; D018570:Risk Assessment