title: A novel maturation index based on neonatal diffusion tensor imaging reflects typical perinatal white matter development in humans.
abstract: Human birth presents an abrupt transition from intrauterine to extrauterine life. Here we introduce a novel Maturation Index (MI) that considers the relative importance of gestational age at birth and postnatal age at scan in a General Linear Model. The MI is then applied to Diffusion Tensor Imaging (DTI) in newborns for characterizing typical white matter development in neonates. DTI was performed cross-sectionally in 47 neonates (gestational age at birth=39.1±1.6 weeks [GA], postnatal age at scan=25.5±12.2days [SA]). Radial diffusivity (RD), axial diffusivity (AD) and fractional anisotropy (FA) along 27 white matter fiber tracts were considered. The MI was used to characterize inflection in maturation at the time of birth using GLM estimated rates of change before and after birth. It is proposed that the sign (positive versus negative) of MI reflects the period of greatest maturation rate. Two general patterns emerged from the MI analysis. First, RD and AD (but not FA) had positive MI on average across the whole brain (average MIAD=0.31±0.42, average MIRD=0.22±0.34). Second, significant regions of negative MI in RD and FA (but not AD) were observed in the inferior corticospinal regions, areas known to myelinate early. Observations using the proposed method are consistent with proposed models of the white matter maturation process in which pre-myelination is described by changes in AD and RD due to oligodendrocyte proliferation while true myelination is characterized by changes in RD and FA due to myelin formation.
authors.affiliation: Development, Health, and Disease Research Program, University of California, Irvine. Irvine, CA, United States; Department of Pediatrics, University of California, Irvine. Irvine, CA, United States; Department of Biomedical Engineering, University of California, Irvine. Irvine, CA, United States.
authors.forename: Jerod M
authors.initials: JM
authors.lastname: Rasmussen
authors.affiliation: Department of Biomedical Engineering, University of California, Irvine. Irvine, CA, United States.
authors.forename: Frithjof
authors.initials: F
authors.lastname: Kruggel
authors.affiliation: Departments of Psychiatry and Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: John H
authors.initials: JH
authors.lastname: Gilmore
authors.affiliation: Departments of Psychiatry and Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: Martin
authors.initials: M
authors.lastname: Styner
authors.affiliation: Development, Health, and Disease Research Program, University of California, Irvine. Irvine, CA, United States; Charité University Medicine Berlin, Institute for Medical Psychology,  Luisenstraße 57, 10117 Berlin, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Entringer
authors.affiliation: Departments of Psychiatry and Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: Kirsten N Z
authors.initials: KN
authors.lastname: Consing
authors.affiliation: Department of Psychiatry and Human Behavior, University of California, Irvine. Irvine, CA, United States.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Potkin
authors.affiliation: Development, Health, and Disease Research Program, University of California, Irvine. Irvine, CA, United States; Department of Pediatrics, University of California, Irvine. Irvine, CA, United States; Department of Psychiatry and Human Behavior, University of California, Irvine. Irvine, CA, United States.
authors.forename: Pathik D
authors.initials: PD
authors.lastname: Wadhwa
authors.affiliation: Development, Health, and Disease Research Program, University of California, Irvine. Irvine, CA, United States; Department of Pediatrics, University of California, Irvine. Irvine, CA, United States; Charité University Medicine Berlin, Institute for Medical Psychology,  Luisenstraße 57, 10117 Berlin, Germany. Electronic address: claudia.buss@charite.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Buss
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000196:embryology / Q000254:growth & development; D003198:Computer Simulation; D056324:Diffusion Tensor Imaging; D005260:Female; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008953:Models, Anatomic; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000196:embryology / Q000254:growth & development; D066127:White Matter / Q000000981:diagnostic imaging / Q000196:embryology / Q000254:growth & development
keywords: Age; Birth; DTI; Gestational; Myelination; Non-linear; Ontology; Postnatal