Brain White Matter Development Over the First 13 Years in Very Preterm and Typically Developing Children Based on the T1-W/T2-W Ratio

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013250
Author(s):  
Deanne Thompson ◽  
Joseph Yuan-Mou Yang ◽  
Jian Chen ◽  
Claire Kelly ◽  
Christopher L Adamson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Memory ◽  
White Matter ◽  
Magnetic Resonance ◽  
Memory Function ◽  
Childhood And Adolescence ◽  
Perinatal Risk Factors ◽  
Longitudinal Changes ◽  
Very Preterm ◽  
White Matter Development

Objective:To investigate brain regional white matter development in full-term (FT) and very preterm (VP) children at term-equivalent, 7 and 13 years of age based on the ratio of T1-weighted and T2-weighted magnetic resonance images (T1-w/T2-w), including: (1) whether longitudinal changes differ between birth groups or sexes; (2) associations with perinatal risk factors in VP children, and; (3) relationships with neurodevelopmental outcomes at 13 years.Methods:Prospective longitudinal cohort study of VP (born <30 weeks’ gestation or <1250 g) and FT infants born between 2001-2004 and followed up at term-equivalent age, 7 years of age and 13 years of age, including magnetic resonance imaging studies and neurodevelopmental assessments. T1-w/T2-w images were parcellated into 48 white matter regions of interest.Results:Of 224 VP participants and 76 FT participants, 197 VP and 55 FT participants had usable T1-w/T2-w data from at least one timepoint. T1-w/T2-w values increased between term-equivalent and 13 years of age, with little evidence that longitudinal changes varied between birth groups or sexes. VP birth, neonatal brain abnormalities, being small for gestational age and postnatal infection were associated with reduced regional T1-w/T2-w values in childhood and adolescence. Increased T1-w/T2-w values across the white matter at 13 years were associated with better motor and working memory function for all children. Within the FT group only, larger increases in T1-w/T2-w values from term-equivalent to 7 years were associated with poorer attention and executive function, and higher T1-w/T2-w values at 7 years were associated with poorer mathematics.Conclusion:VP birth and multiple known perinatal risk factors are associated with long-term reductions in the T1-w/T2-w ratio in white matter regions in childhood and adolescence, which may relate to alterations in microstructure and myelin content. Furthermore, increased T1-w/T2-w ratio at 13 years appeared to be associated with better motor and working memory function, and there appeared to be developmental differences between VP and FT children in the associations for attention, executive functioning and mathematics.

scholarly journals Long-term development of white matter fibre density and morphology up to 13 years after preterm birth

2020 ◽  
Author(s):  
Claire E Kelly ◽  
Deanne K Thompson ◽  
Sila Genc ◽  
Jian Chen ◽  
Joseph YM Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Corpus Callosum ◽  
Childhood And Adolescence ◽  
Fibre Tract ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
Fibre Density ◽  
Individual Fibre

AbstractBackgroundIt is well documented that infants born very preterm (VP) are at risk of brain injury and altered brain development in the neonatal period, however there is a lack of long-term, longitudinal studies on the effects of VP birth on white matter development over childhood. Most previous studies were based on voxel-averaged, non-fibre-specific diffusion magnetic resonance imaging (MRI) measures, such as fractional anisotropy. In contrast, the novel diffusion MRI analysis framework, fixel-based analysis (FBA), enables whole-brain analysis of microstructural and macrostructural properties of individual fibre populations at a sub-voxel level. We applied FBA to investigate the long-term implications of VP birth and associated perinatal risk factors on fibre development in childhood and adolescence.MethodsDiffusion images were acquired for a cohort of VP (born <30 weeks’ gestation) and full-term (FT, ≥37 weeks’ gestation) children at two ages: mean (SD) 7.6 (0.2) years (n=138 VP and 32 FT children) and 13.3 (0.4) years (n=130 VP and 45 FT children). 103 VP and 21 FT children had images at both ages for longitudinal analysis. At every fixel (individual fibre population within an image voxel) across the white matter, we compared FBA metrics (fibre density (FD), cross-section (FC) and a combination of these properties (FDC)) between VP and FT groups cross-sectionally at each age, and longitudinally between ages. We also examined associations between perinatal risk factors and FBA metrics in the VP group.ResultsCompared with FT children, VP children had lower FD, FC and FDC throughout the white matter, particularly in the corpus callosum, tapetum, inferior fronto-occipital fasciculus, fornix and cingulum at ages 7 and 13 years, as well as the motor pathways at age 13 years. VP children also had slower FDC development in the corpus callosum and corticospinal tract between ages 7 and 13 years compared with FT children. Within VP children, earlier gestational age at birth, lower birth weight z-score, and neonatal brain abnormalities were associated with lower FD, FC and FDC throughout the white matter at both ages.ConclusionsVP birth and concomitant perinatal risk factors are associated with fibre tract-specific alterations to axonal development in childhood and adolescence.

scholarly journals Listening to Mom in the NICU: effects of increased maternal speech exposure on language outcomes and white matter development in infants born very preterm

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Edith Brignoni-Pérez ◽  
Maya Chan Morales ◽  
Virginia A. Marchman ◽  
Melissa Scala ◽  
Heidi M. Feldman ◽  
...  
Keyword(s):  
White Matter ◽  
Structural Connectivity ◽  
Receptive Language ◽  
Secondary Outcome ◽  
Language Outcomes ◽  
Theoretical Understanding ◽  
Very Preterm ◽  
White Matter Development ◽  
Maternal Speech

Abstract Background Infants born very preterm (< 32 weeks gestational age (GA)) are at risk for developmental language delays. Poor language outcomes in children born preterm have been linked to neurobiological factors, including impaired development of the brain’s structural connectivity (white matter), and environmental factors, including decreased exposure to maternal speech in the neonatal intensive care unit (NICU). Interventions that enhance preterm infants’ exposure to maternal speech show promise as potential strategies for improving short-term health outcomes. Intervention studies have yet to establish whether increased exposure to maternal speech in the NICU offers benefits beyond the newborn period for brain and language outcomes. Methods This randomized controlled trial assesses the long-term effects of increased maternal speech exposure on structural connectivity at 12 months of age (age adjusted for prematurity (AA)) and language outcomes between 12 and 18 months of age AA. Study participants (N = 42) will include infants born very preterm (24–31 weeks 6/7 days GA). Newborns are randomly assigned to the treatment (n = 21) or standard medical care (n = 21) group. Treatment consists of increased maternal speech exposure, accomplished by playing audio recordings of each baby’s own mother reading a children’s book via an iPod placed in their crib/incubator. Infants in the control group have the identical iPod setup but are not played recordings. The primary outcome will be measures of expressive and receptive language skills, obtained from a parent questionnaire collected at 12–18 months AA. The secondary outcome will be measures of white matter development, including the mean diffusivity and fractional anisotropy derived from diffusion magnetic resonance imaging scans performed at around 36 weeks postmenstrual age during the infants’ routine brain imaging session before hospital discharge and 12 months AA. Discussion The proposed study is expected to establish the potential impact of increased maternal speech exposure on long-term language outcomes and white matter development in infants born very preterm. If successful, the findings of this study may help to guide NICU clinical practice for promoting language and brain development. This clinical trial has the potential to advance theoretical understanding of how early language exposure directly changes brain structure for later language learning. Trial registration NIH Clinical Trials (ClinicalTrials.gov) NCT04193579. Retrospectively registered on 10 December 2019.

scholarly journals Postnatal Decrease in Circulating Insulin-Like Growth Factor-I and Low Brain Volumes in Very Preterm Infants

2011 ◽  
Vol 96 (4) ◽  
pp. 1129-1135 ◽  
Author(s):  
Ingrid Hansen-Pupp ◽  
Holger Hövel ◽  
Ann Hellström ◽  
Lena Hellström-Westas ◽  
Chatarina Löfqvist ◽  
...  
Keyword(s):  
White Matter ◽  
Magnetic Resonance ◽  
Preterm Infants ◽  
Brain Volumes ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Matter Volume ◽  
Total Brain ◽  
Igf I ◽  
Igfbp 3

Abstract Context: IGF-I and IGF binding protein-3 (IGFBP-3) are essential for growth and maturation of the developing brain. Objective: The aim of this study was to evaluate the association between postnatal serum concentrations of IGF-I and IGFBP-3 and brain volumes at term in very preterm infants. Design: Fifty-one infants with a mean (sd) gestational age (GA) of 26.4 (1.9) wk and birth weight (BW) of 888 (288) g were studied, with weekly blood sampling of IGF-I and IGFBP-3 from birth until 35 gestational weeks (GW) and daily calculation of protein and caloric intake. Magnetic resonance images obtained at 40 GW were segmented into total brain, cerebellar, cerebrospinal fluid, gray matter, and unmyelinated white matter volumes. Main Outcome Measures: We evaluated brain growth by measuring brain volumes using magnetic resonance imaging. Results: Mean IGF-I concentrations from birth to 35 GW correlated with total brain volume, unmyelinated white matter volume, gray matter volume, and cerebellar volume [r = 0.55 (P &lt; 0.001); r = 0.55 (P &lt; 0.001); r = 0.44 (P = 0.002); and r = 0.58 (P &lt; 0.001), respectively]. Similar correlations were observed for IGFBP-3 concentrations. Correlations remained after adjustment for GA, mean protein and caloric intakes, gender, severe brain damage, and steroid treatment. Protein and caloric intakes were not related to brain volumes. Infants with BW small for GA had lower mean concentrations of IGF-I (P = 0.006) and smaller brain volumes (P = 0.001–0.013) than infants with BW appropriate for GA. Conclusion: Postnatal IGF-I and IGFBP-3 concentrations are positively associated with brain volumes at 40 GW in very preterm infants. Normalization of the IGF-I axis, directly or indirectly, may support normal brain development in very preterm infants.

Diffusion imaging perspectives on brain development in childhood and adolescence

2021 ◽  
Author(s):  
Bryce L. Geeraert ◽  
Jess E. Reynolds ◽  
Catherine Lebel
Keyword(s):  
White Matter ◽  
Brain Development ◽  
Diffusion Imaging ◽  
Childhood And Adolescence ◽  
Tissue Properties ◽  
Versatile Tool ◽  
P Diffusion ◽  
White Matter Development ◽  
Brain Microstructure ◽  
Development Trajectories

Diffusion magnetic resonance imaging (dMRI) is a versatile tool which can be applied to investigate brain microstructure. This chapter outlines brain development trajectories from infancy to adulthood as described by dMRI. The chapter focuses on white matter development, as dMRI is particularly well suited to describing white matter tissue properties. The chapter also discusses sources of individual variation which are simultaneously fascinating and confounding to research efforts. Next, the chapter discusses links between white matter development and cognition, with specific examples drawn from reading research. Additional techniques which may complement future diffusion-based research are introduced in the chapter’s final section.

scholarly journals Regional white matter development in very preterm infants: perinatal predictors and early developmental outcomes

2015 ◽  
Vol 79 (1) ◽  
pp. 87-95 ◽  
Author(s):  
Cynthia E. Rogers ◽  
Tara Smyser ◽  
Christopher D. Smyser ◽  
Joshua Shimony ◽  
Terrie E. Inder ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
Developmental Outcomes ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
White Matter Development ◽  
Early Developmental

scholarly journals Magnetic Resonance Imaging (MRI) findings in patients with brain small vessel disease

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Mohsen Forughipur ◽  
Ahmad Saheb-Alam ◽  
Ahmad Pourrashidi-Boshrabadi ◽  
Zahra Tafakhori ◽  
Athena Sharifi-Razavi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
White Matter ◽  
Magnetic Resonance ◽  
Small Vessel Disease ◽  
Lacunar Infarct ◽  
Small Vessel ◽  
Vessel Disease ◽  
Ataxic Hemiparesis ◽  
Pure Motor

Background: Cerebral  small  vessel  disease  (SVD)  affects  small  perforating  arteries, causing  both  lacunar  infarction (LI) and  confluent white matter lesions (WML). Small vessel disease or lacunar infarct is one of the major stroke subgroups. Lacunar syndromes may be divided into two groups: the classic group (pure motor hemiplegia, pure sensory stroke, ataxic hemiparesis, dysarthria-clumsy hand syndrome, sensorimotor stroke) and the miscellaneous group, including all other lacunar syndromes. We have evaluated risk factors, clinical syndromes, topography, and laboratory findings of 101 consecutive patients with symptomatic lacunar infarcts diagnosed by magnetic resonance imaging.Methods: We analyzed 101 patients with clinical lacunar infarct   syndrome who were referred to the neurology department of Qa’em hospital, Mashhad in the northeast of Iran. We assessed clinical features, sex, age, risk factors, radiologic findings and laboratory data of these patients.Results: The pure motor hemiparesis (53.5%) constituted the most usual lacunar syndrome. Mean age of the patients was 63.7± 8.5%. Diabetes mellitus was seen in 14 (13.9%) and hypercholesterolemia in 41 (40.6%) of patients. There were significant differences among ataxic-hemiparesis syndrome and hypertriglyceridemia and CVA history. There was a significant difference between miscellaneous syndromes and valve disease history. Also, there was significant correlation between WML and smoking. Thirty percent of the lesions were detected by CT scan.Conclusion: Sixty percent of the cases were associated with white matter signal changes. Diabetes mellitus were found in 14% of patients.  Hypertriglyceridemia, CVA history and valve disease history were associated with some subgroups, but more investigations should be performed for precise assessment of other risk factors.

scholarly journals Association between homocysteine and white matter hyperintensities in asymptomatic intracranial arterial stenosis: results from a population-based study

2019 ◽  
Author(s):  
Hao Yin ◽  
Xiang Wang ◽  
Yuan-yuan Zhao ◽  
Xiao-kang Ji ◽  
Shao-wei Sang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
White Matter ◽  
Magnetic Resonance ◽  
White Matter Hyperintensities ◽  
Population Based ◽  
Arterial Stenosis ◽  
Chinese People ◽  
Intracranial Arterial Stenosis ◽  
Population Based Study

Abstract Background: Although homocysteine (Hcy) and white matter hyperintensities (WMH) have been proven to be correlated with increased risks of ischemic stroke, there have been few studies addressing the association between serum Hcy and WMH in a population with asymptomatic intracranial arterial stenosis (aICAS). Thus, the aim of the present study is to describe the association between Hcy and WMH in rural-dwelling Chinese people with aICAS. Methods: In this study, 150 participants diagnosed as aICAS by magnetic resonance angiography were recruited from the Kongcun Town Study, which was a population-based study aimed to investigate the prevalence of aICAS in general population aged 40 to 90 years old, free of ischemic stroke history, and living in the Kongcun town, Pingyin county, Shandong, China. Data on demographics, risk factors, and serum Hcy levels were collected via interview, clinical examination, and laboratory tests. The WMH volumes were calculated through the lesion segmentation tool system for the Statistical Parametric Mapping package based on magnetic resonance imaging. The association between Hcy and WMH volume was analyzed using both linear and logistic regression analysis. Results: After adjusting for all confounders, high Hcy (HHcy) (serum Hcy ≥15umol/L) was significantly associated with severe WMH (the highest quartile in WMH volume) (OR: 2.972, 95%CI: 1.017-7.979, P <0.05). However, with changing of WMH volumes, only trends towards association with HHcy were observed in all 3 models (P values only slightly exceeded 0.05). After being stratified by age, sex, or ever smoking, the association between HHcy and WMH became more significant in participants who were ≥60 years old, male, or ever smoker. Conclusions: HHcy is associated with severe WMH in rural-dwelling Chinese people with aICAS, especially in participants ≥60 years old, male participants, or ever smokers, indicating these may be risk factors that contribute to the association between HHcy and severe WMH.

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