title: White Matter Injury and General Movements in High-Risk Preterm Infants.
abstract: Very preterm infants (birth weight, <1500 g) are at increased risk of cognitive and motor impairment, including cerebral palsy. These adverse neurodevelopmental outcomes are associated with white matter abnormalities on MR imaging at term-equivalent age. Cerebral palsy has been predicted by analysis of spontaneous movements in the infant termed "General Movement Assessment." The goal of this study was to determine the utility of General Movement Assessment in predicting adverse cognitive, language, and motor outcomes in very preterm infants and to identify brain imaging markers associated with both adverse outcomes and aberrant general movements.
  
  
  
  In this prospective study of 47 preterm infants of 24-30 weeks' gestation, brain MR imaging was performed at term-equivalent age. Infants underwent T1- and T2-weighted imaging for volumetric analysis and DTI. General movements were assessed at 10-15 weeks' postterm age, and neurodevelopmental outcomes were evaluated at 2 years by using the Bayley Scales of Infant and Toddler Development III.
  
  
  
  Nine infants had aberrant general movements and were more likely to have adverse neurodevelopmental outcomes, compared with infants with normal movements. In infants with aberrant movements, Tract-Based Spatial Statistics analysis identified significantly lower fractional anisotropy in widespread white matter tracts, including the corpus callosum, inferior longitudinal and fronto-occipital fasciculi, internal capsule, and optic radiation. The subset of infants having both aberrant movements and abnormal neurodevelopmental outcomes in cognitive, language, and motor skills had significantly lower fractional anisotropy in specific brain regions.
  
  
  
  Aberrant general movements at 10-15 weeks' postterm are associated with adverse neurodevelopmental outcomes and specific white matter microstructure abnormalities for cognitive, language, and motor delays.
authors: From the Departments of Therapy Services (C.P.) colleen.peyton@uchospitals.edu.
authors: C
authors: 0000-0003-4753-7246
authors: C
authors: Peyton
authors: Pediatrics (E.Y., M.E.M., M.D.S., J.D.M.), University of Chicago, Chicago, Illinois.
authors: E
authors: 0000-0002-9912-4163
authors: E
authors: Yang
authors: Pediatrics (E.Y., M.E.M., M.D.S., J.D.M.), University of Chicago, Chicago, Illinois.
authors: M E
authors: 0000-0003-2037-5769
authors: ME
authors: Msall
authors: Department of Laboratory Medicine (L.A., T.F.), Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors: L
authors: 0000-0001-5532-0034
authors: L
authors: Adde
authors: Department of Pediatrics (R.S.).
authors: R
authors: 0000-0001-8814-0451
authors: R
authors: Støen
authors: Department of Laboratory Medicine (L.A., T.F.), Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.|Clinics of Clinical Services (T.F.), St. Olav University Hospital, Trondheim, Norway.
authors: T
authors: 0000-0002-9022-3050
authors: T
authors: Fjørtoft
authors: Division of Neonatology (A.F.B.), University of Groningen, Groningen, the Netherlands.
authors: A F
authors: 0000-0002-6103-6125
authors: AF
authors: Bos
authors: Institute of Physiology (C.E.), Center for Physiological Medicine, Medical University of Graz, Graz, Austria.
authors: C
authors: 0000-0002-7875-0632
authors: C
authors: Einspieler
authors: Center for Biomedical Research Informatics (Y.Z.).
authors: Y
authors: 0000-0003-1681-5207
authors: Y
authors: Zhou
authors: Pediatrics (E.Y., M.E.M., M.D.S., J.D.M.), University of Chicago, Chicago, Illinois.
authors: M D
authors: 0000-0003-0379-0258
authors: MD
authors: Schreiber
authors: Pediatrics (E.Y., M.E.M., M.D.S., J.D.M.), University of Chicago, Chicago, Illinois.
authors: J D
authors: 0000-0002-2644-5257
authors: JD
authors: Marks
authors: Department of Pediatrics (A.D.), NorthShore University Health System, Evanston, Illinois.
authors: A
authors: 0000-0002-5862-3310
authors: A
authors: Drobyshevsky
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature / Q000254:growth & development; D007231:Infant, Newborn; D008297:Male; D009068:Movement / Q000502:physiology*; D065886:Neurodevelopmental Disorders / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D066127:White Matter / Q000000981:diagnostic imaging* / Q000254:growth & development / Q000473:pathology