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Zhou L, Liu X, He G, Chen M, Zeng S, Sun C. Alteration of fractional anisotropy in preterm-born individuals: a systematic review and meta-analysis. J OBSTET GYNAECOL 2024; 44:2371956. [PMID: 38984803 DOI: 10.1080/01443615.2024.2371956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 05/21/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUD Neurological disorders are common in preterm (PT) born individuals. Diffusion tensor imaging (DTI) studies using tract-based spatial statistics (TBSS) effectively detect microstructural white matter (WM) abnormalities in the brain. We conducted this systematic review to integrate the findings of TBSS studies to determine the most consistent WM alterations in PT born individuals. METHODS PubMed, Embase, Web of Science and Science Direct were searched. DTI studies using TBSS in PT born individuals were screened up to October 2022. The systematic review included studies reporting alterations in FA values for the entire brain in a stereotactic space, with three coordinates (x, y, z), according to the seed-based d mapping method. RESULTS The search strategy identified seventeen studies that fulfilled our inclusion criteria, with a total of 911 PT-born individuals and 563 matched controls were analysed. Of the seventeen studies, eight were dedicated to 650 adults, five to 411 children and four to 413 infants. Ten studies recruited 812 individuals born very prematurely (GA <29 weeks), six studies recruited 386 moderately premature individuals (GA = 29-32 weeks) and one study recruited 276 individuals born late prematurely (GA >32 weeks). This meta-analysis of six studies including 388 individuals highlighted four brain regions in which fractional anisotropy (FA) was lower in PT group than in people born at term. The quantitative meta-analysis found that the most robust WM alterations were located in the corpus callosum (CC), the bilateral thalamus and the left superior longitudinal fasciculus (SLF) II. Significant changes in FA reflect WM abnormalities in PT born individuals from infant to young adulthood. CONCLUSIONS Significant changes in FA reflect WM abnormalities in individuals born PT from infancy to young adulthood. The abnormal development of the CC, bilateral thalamus and left SLF may play a vital role in the neurodevelopment of PT individuals.
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Affiliation(s)
- Le Zhou
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Xinghui Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Guolin He
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Meng Chen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Shuai Zeng
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Beijing, China
| | - Chuntang Sun
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
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Deferm W, Tang T, Moerkerke M, Daniels N, Steyaert J, Alaerts K, Ortibus E, Naulaers G, Boets B. Subtle microstructural alterations in white matter tracts involved in socio-emotional processing after very preterm birth. Neuroimage Clin 2024; 41:103580. [PMID: 38401459 PMCID: PMC10944182 DOI: 10.1016/j.nicl.2024.103580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/10/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
Children born very preterm (VPT, < 32 weeks of gestation) have an increased risk of developing socio-emotional difficulties. Possible neural substrates for these socio-emotional difficulties are alterations in the structural connectivity of the social brain due to premature birth. The objective of the current study was to study microstructural white matter integrity in VPT versus full-term (FT) born school-aged children along twelve white matter tracts involved in socio-emotional processing. Diffusion MRI scans were obtained from a sample of 35 VPT and 38 FT 8-to-12-year-old children. Tractography was performed using TractSeg, a state-of-the-art neural network-based approach, which offers investigation of detailed tract profiles of fractional anisotropy (FA). Group differences in FA along the tracts were investigated using both a traditional and complementary functional data analysis approach. Exploratory correlations were performed between the Social Responsiveness Scale (SRS-2), a parent-report questionnaire assessing difficulties in social functioning, and FA along the tract. Both analyses showed significant reductions in FA for the VPT group along the middle portion of the right SLF I and an anterior portion of the left SLF II. These group differences possibly indicate altered white matter maturation due to premature birth and may contribute to altered functional connectivity in the Theory of Mind network which has been documented in earlier work with VPT samples. Apart from reduced social motivation in the VPT group, there were no significant group differences in reported social functioning, as assessed by SRS-2. We found that in the VPT group higher FA values in segments of the left SLF I and right SLF II were associated with better social functioning. Surprisingly, the opposite was found for segments in the right IFO, where higher FA values were associated with worse reported social functioning. Since no significant correlations were found for the FT group, this relationship may be specific for VPT children. The current study overcomes methodological limitations of previous studies by more accurately segmenting white matter tracts using constrained spherical deconvolution based tractography, by applying complementary tractometry analysis approaches to estimate changes in FA more accurately, and by investigating the FA profile along the three components of the SLF.
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Affiliation(s)
- Ward Deferm
- Center for Developmental Psychiatry, KU Leuven, Belgium.
| | - Tiffany Tang
- Center for Developmental Psychiatry, KU Leuven, Belgium
| | | | - Nicky Daniels
- Neuromotor Rehabilitation Research Group, KU Leuven, Belgium
| | - Jean Steyaert
- Center for Developmental Psychiatry, KU Leuven, Belgium; Child Psychiatry, UZ Leuven, Belgium
| | - Kaat Alaerts
- Neuromotor Rehabilitation Research Group, KU Leuven, Belgium
| | | | - Gunnar Naulaers
- Neonatal Intensive Care Unit - Neonatology, UZ Leuven, Belgium; UZ Leuven & Center for Developmental Disorders, Belgium
| | - Bart Boets
- Center for Developmental Psychiatry, KU Leuven, Belgium
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3
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Lapidaire W, Clayden JD, Fewtrell MS, Clark CA. Increased white matter fibre dispersion and lower IQ scores in adults born preterm. Hum Brain Mapp 2024; 45:e26545. [PMID: 38070181 PMCID: PMC10789207 DOI: 10.1002/hbm.26545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024] Open
Abstract
Preterm birth has been associated with altered microstructural properties of the white matter and lower cognitive ability in childhood and adulthood. Due to methodological limitations of the diffusion tensor model, it is not clear whether alterations in myelination or variation in fibre orientation are driving these differences. Novel models applied to multi-shell diffusion imaging have been used to disentangle these effects, but to date this has not been used to study the preterm brain in adulthood. This study investigated whether novel advanced diffusion MRI metrics such as microscopic anisotropy and orientation dispersion are altered in adults born preterm, and whether this was associated with cognitive performance. Seventy-two preterm born participants (<37 weeks gestational age) were recruited from a 1982-1984 cohort (33 males, mean age 33.5 ± 1.0 years). Seventy-two term born (>37 weeks gestational age) controls (34 males, mean age 30.9 ± 4.0 years) were recruited from the general population. Tensor FA was calculated with FSL, while microscopic FA and orientation dispersion entropy (ODE) were estimated using the Spherical Mean Technique (SMT). Estimated Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) were obtained from the WASI-II (abbreviated) IQ test. Voxel-wise comparisons using FSL's tract-based spatial statistics were performed to test between-group differences in diffusion MRI metrics as well as within-group associations of diffusion MRI metrics and IQ outcomes. The preterm group had significantly lower FSIQ, VCI and PRI scores. Preterm subjects demonstrated widespread decreases in ODE reflecting increased fibre dispersion, but no differences in microscopic FA. Tensor FA was increased in a small area in the anterior corona radiata. Lower FA values in the preterm population were associated with lower FSIQ and PRI scores. An increase in fibre dispersion in white matter and lower IQ scores after preterm birth exist in adulthood. Advanced diffusion MRI metrics such as the orientation dispersion entropy can be used to monitor white matter alterations across the lifespan in preterm born individuals. Although not significantly different between preterm and term groups, tensor FA values in the preterm group were associated with cognitive outcome.
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Affiliation(s)
- Winok Lapidaire
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of Oxford, John Radcliffe HospitalOxfordUK
| | - Jonathan D. Clayden
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Mary S. Fewtrell
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Christopher A. Clark
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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4
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Adrian J, Sawyer C, Bakeman R, Haist F, Akshoomoff N. Longitudinal Structural and Diffusion-Weighted Neuroimaging of Young Children Born Preterm. Pediatr Neurol 2023; 141:34-41. [PMID: 36773405 DOI: 10.1016/j.pediatrneurol.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 11/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Children born preterm are at risk for diffuse injury to subcortical gray and white matter. METHODS We used a longitudinal cohort study to examine the development of subcortical gray matter and white matter volumes, and diffusivity measures of white matter tracts following preterm birth. Our participants were 47 children born preterm (24 to 32 weeks gestational age) and 28 children born at term. None of the children born preterm had significant neonatal brain injury. Children received structural and diffusion weighted magnetic resonance imaging scans at ages five, six, and seven years. We examined volumes of amygdala, hippocampus, caudate nucleus, putamen, thalamus, brainstem, cerebellar white matter, intracranial space, and ventricles, and volumes, fractional anisotropy, and mean diffusivity of anterior thalamic radiation, cingulum, corticospinal tract, corpus callosum, inferior frontal occipital fasciculus, inferior longitudinal fasciculus, temporal and parietal superior longitudinal fasciculus, and uncinate fasciculus. RESULTS Children born preterm had smaller volumes of thalamus, brainstem, cerebellar white matter, cingulum, corticospinal tract, inferior frontal occipital fasciculus, uncinate fasciculus, and temporal superior longitudinal fasciculus, whereas their ventricles were larger compared with term-born controls. We found no significant effect of preterm birth on diffusivity measures. Despite developmental changes and growth, group differences were present and similarly strong at all three ages. CONCLUSION Even in the absence of significant neonatal brain injury, preterm birth has a persistent impact on early brain development. The lack of a significant term status by age interaction suggests a delayed developmental trajectory.
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Affiliation(s)
- Julia Adrian
- Department of Cognitive Science, University of California, San Diego, La Jolla, California; Center for Human Development, University of California, San Diego, La Jolla, California.
| | - Carolyn Sawyer
- Center for Human Development, University of California, San Diego, La Jolla, California; Department of Pediatrics, University of California, San Diego, La Jolla, California
| | - Roger Bakeman
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Frank Haist
- Center for Human Development, University of California, San Diego, La Jolla, California; Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Natacha Akshoomoff
- Center for Human Development, University of California, San Diego, La Jolla, California; Department of Psychiatry, University of California, San Diego, La Jolla, California
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5
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Lambert M, Wurz A, Smith AM, Fang Z, Brunet J. Preliminary Evidence of Improvement in Adolescent and Young Adult Cancer Survivors' Brain Health Following Physical Activity: A Proof-of-Concept Sub-Study. Brain Plast 2021; 7:97-109. [PMID: 34868876 PMCID: PMC8609486 DOI: 10.3233/bpl-210124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Cognitive impairment is common among adolescent and young adult (AYA) cancer survivors. Physical activity (PA) may help mitigate cognitive impairment post-treatment by positively impacting two indicators of general brain health: fractional anisotropy (FA) and functional connectivity (FC). As part of a two-arm, mixed-methods pilot randomized controlled trial (RCT), this sub-study was designed to provide preliminary proof-of-concept evidence for the effects of PA on FA and FC among AYA cancer survivors post-treatment to help inform decisions about proceeding to larger trials. Methods: AYA cancer survivors who had completed cancer treatment and who were enrolled in a larger pilot RCT comparing a 12-week PA intervention to a waitlist control group, were invited to participate in this sub-study. Sub-study participants completed diffusion tensor imaging and resting-state functional magnetic resonance imaging prior to randomization and post-intervention. Data were analyzed with descriptive statistics, independent component analysis, and paired sample t-tests. Results: Post-intervention, participants showed increases in FA of the bilateral hippocampal cingulum, left anterior corona radiata, middle cingulum, left anterior thalamic radiation, and left cerebellum. A decrease in overall FC of the default mode network and increases in the cerebellar and visual networks were also noted post-intervention (p < .05). Conclusion: Results provide preliminary evidence for the possible positive effects of PA on FA and FC among AYA cancer survivors post-treatment. On the basis of these results, larger trials assessing the effects of PA on specific brain health indicators, as captured by FA and FC, among AYA cancer survivors are appropriate and warranted.
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Affiliation(s)
- Maude Lambert
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Amanda Wurz
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Andra M Smith
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Zhuo Fang
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.,Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada
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6
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Sato J, Vandewouw MM, Bando N, Branson HM, O'Connor DL, Unger SL, Taylor MJ. White matter alterations and cognitive outcomes in children born very low birth weight. Neuroimage Clin 2021; 32:102843. [PMID: 34601309 PMCID: PMC8496319 DOI: 10.1016/j.nicl.2021.102843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Very low birth weight (VLBW) infants are at risk for disrupted white matter maturation, yet little is known about the contributing factors, particularly at preschool-age when cognitive difficulties begin to emerge. We examined white matter microstructure in five-year-old VLBW and full-term (FT) children, and its association with cognitive outcomes and birth weight. METHODS Multi-shell diffusion and MR images were obtained for 41 VLBW (mean birth weight: 1028.6 ± 256.8 g) and 26 FT (3295.4 ± 493.9 g) children. Fractional anisotropy (FA), radial diffusivity (RD), neurite orientation dispersion index (ODI) and density index (NDI) were estimated using diffusion tensor and neurite orientation dispersion and density imaging models. Between-group analyses used a general linear model with group and sex as explanatory variables. Within-group associations between white matter microstructure, cognitive outcomes and birth weight were also investigated. RESULTS VLBW compared to FT children showed lower FA and NDI across widespread white matter regions. Smaller clusters of atypical ODI were also found in VLBW children. Within-group analyses in FT children revealed that lower RD and higher NDI were associated with vocabulary acquisition and working memory. In VLBW children, higher FA and NDI, and lower RD and ODI, were associated with improved processing speed. In both groups, FA was positively associated with birth weight. CONCLUSIONS Our findings demonstrate white matter alterations in young VLBW children, including widespread reductions in axon density that may reflect sustained myelination disruptions. The associations with cognitive outcomes may also highlight which of the VLBW children are at higher risk for later cognitive difficulties.
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Affiliation(s)
- Julie Sato
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Psychology, University of Toronto, Toronto, Ontario, Canada; Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Marlee M Vandewouw
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada; Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Bando
- Translational Medicine, SickKids Research Institute, Toronto, Ontario, Canada
| | - Helen M Branson
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Medical Imaging, University of Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Translational Medicine, SickKids Research Institute, Toronto, Ontario, Canada; Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Paediatrics, Mount Sinai Health, Toronto, Ontario, Canada
| | - Sharon L Unger
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Paediatrics, University of Toronto, Toronto, Ontario, Canada; Paediatrics, Mount Sinai Health, Toronto, Ontario, Canada; Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Margot J Taylor
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Psychology, University of Toronto, Toronto, Ontario, Canada; Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada; Medical Imaging, University of Toronto, Ontario, Canada; Paediatrics, University of Toronto, Toronto, Ontario, Canada
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7
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Gosar D, Tretnjak V, Bregant T, Neubauer D, Derganc M. Reduced white-matter integrity and lower speed of information processing in adolescents with mild and moderate neonatal hypoxic-ischaemic encephalopathy. Eur J Paediatr Neurol 2020; 28:205-213. [PMID: 32665198 DOI: 10.1016/j.ejpn.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Studies have shown that adolescents with moderate hypoxic-ischaemic encephalopathy (HIE) may have specific cognitive deficits, especially reduced speed of information processing. The aim of our study was to confirm these earlier findings find out whether the degree of impairment in speed of information processing correlates with the degree of white-matter impairment as measured by diffusion tensor imaging (DTI). METHODS Thirty-three participants (mean age 18y 5mo, SD 12mo; 19 male) with mild or moderate HIE and 32 neurotypical adolescents (mean age 17y 10mo, SD 12mo, 18 male) completed a comprehensive neuropsychological battery measuring short-term memory, inhibition, speed of information processing, long-term visual and verbal memory. Fourteen participants also underwent structural MRI and DTI scans. RESULTS After controlling for age, gender and maternal education we found a significant effect of HIE on speed of information processing (F(2, 64) = 3.51, p < .037, η2 = 0.115), but not on other neuropsychological domains. Using tract-based spatial statistics we were also able to confirm a correlation between the degree of impairment in this cognitive domain and fractional anisotropy in several white-matter tracts. CONCLUSIONS The long-term cognitive outcome of moderate HIE includes reduced speed of information processing and is in part mediated by reduced integrity of major white-matter tracts.
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Affiliation(s)
- David Gosar
- University Children's Hospital, University Medical Centre Ljubljana, Department of Child, Adolescent and Developmental Neurology, Ljubljana, Slovenia.
| | - Vali Tretnjak
- University Children's Hospital, University Medical Centre Ljubljana, Department of Child, Adolescent and Developmental Neurology, Ljubljana, Slovenia
| | - Tina Bregant
- Centre for Education and Rehabilitation of Physically Handicapped Children and Adolescents - CIRIUS Kamnik, Slovenia
| | - David Neubauer
- University Children's Hospital, University Medical Centre Ljubljana, Department of Child, Adolescent and Developmental Neurology, Ljubljana, Slovenia
| | - Metka Derganc
- University Medical Centre Ljubljana, Department of Paediatric Surgery and Intensive Care, Ljubljana, Slovenia
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8
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Tokariev M, Vuontela V, Perkola J, Lönnberg P, Lano A, Andersson S, Metsäranta M, Carlson S. A protocol for the analysis of DTI data collected from young children. MethodsX 2020; 7:100878. [PMID: 32382519 PMCID: PMC7200313 DOI: 10.1016/j.mex.2020.100878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/19/2020] [Indexed: 01/01/2023] Open
Abstract
Software packages were applied to mitigate the effects of artifacts and to produce robust tensor estimation. Opposite phase-encoding directions were used in DTI acquisition to improve correction for EPI distortions. Advanced tensor-based registration of DTI images was obtained using a population-specific template.
Analysis of scalar maps obtained by diffusion tensor imaging (DTI) produce valuable information about the microstructure of the brain white matter. The DTI scanning of child populations, compared with adult groups, requires specifically designed data acquisition protocols that take into consideration the trade-off between the scanning time, diffusion strength, number of diffusion directions, and the applied analysis techniques. Furthermore, inadequate normalization of DTI images and non-robust tensor reconstruction have profound effects on data analyses and may produce biased statistical results. Here, we present an acquisition sequence that was specifically designed for pediatric populations, and describe the analysis steps of the DTI data collected from extremely preterm-born young school-aged children and their age- and gender-matched controls. The protocol utilizes multiple software packages to address the effects of artifacts and to produce robust tensor estimation. The computation of a population-specific template and the nonlinear registration of tensorial images with this template were implemented to improve alignment of brain images from the children.
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Affiliation(s)
- Maksym Tokariev
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland.,Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Virve Vuontela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland.,Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaana Perkola
- Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Piia Lönnberg
- Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aulikki Lano
- Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sture Andersson
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marjo Metsäranta
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Synnöve Carlson
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland.,Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Advanced Magnetic Imaging Centre, Aalto University School of Science, Espoo, Finland
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9
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Barnes-Davis ME, Williamson BJ, Merhar SL, Holland SK, Kadis DS. Rewiring the extremely preterm brain: Altered structural connectivity relates to language function. Neuroimage Clin 2020; 25:102194. [PMID: 32032818 PMCID: PMC7005506 DOI: 10.1016/j.nicl.2020.102194] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/26/2022]
Abstract
Children born preterm are at increased risk for cognitive impairment, with higher-order functions such as language being especially vulnerable. Previously, we and others have reported increased interhemispheric functional connectivity in children born extremely preterm; the finding appears at odds with literature showing decreased integrity of the corpus callosum, the primary commissural bundle, in preterm children. We address the apparent discrepancy by obtaining advanced measures of structural connectivity in twelve school-aged children born extremely preterm (<28 weeks) and ten term controls. We hypothesize increased extracallosal structural connectivity might support the functional hyperconnectivity we had previously observed. Participants were aged four to six years at time of study and groups did not differ in age, sex, race, ethnicity, or socioeconomic status. Whole-brain and language-network-specific (functionally-constrained) connectometry analyses were performed. At the whole-brain level, preterm children had decreased connectivity in the corpus callosum and increased connectivity in the cerebellum versus controls. Functionally-constrained analyses revealed significantly increased extracallosal connectivity between bilateral temporal regions in preterm children (FDRq <0.05). Connectivity within these extracallosal pathways was positively correlated with performance on standardized language assessments in children born preterm (FDRq <0.001), but unrelated to performance in controls. This is the first study to identify anatomical substrates for increased interhemispheric functional connectivity in children born preterm; increased reliance on an extracallosal pathway may represent a biomarker for resiliency following extremely preterm birth.
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Affiliation(s)
- Maria E Barnes-Davis
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, United States; Department of Pediatrics, University of Cincinnati College of Medicine, United States.
| | - Brady J Williamson
- Department of Psychology, University of Cincinnati, United States; Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, United States
| | - Stephanie L Merhar
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, United States; Department of Pediatrics, University of Cincinnati College of Medicine, United States
| | - Scott K Holland
- Department of Physics, University of Cincinnati, United States; Medpace Imaging Core Laboratory, Medpace Inc., United States
| | - Darren S Kadis
- Neurosciences and Mental Health Research Institute, Hospital for Sick Children, Canada; Department of Physiology, Faculty of Medicine, University of Toronto, Canada
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10
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Tokariev M, Vuontela V, Lönnberg P, Lano A, Perkola J, Wolford E, Andersson S, Metsäranta M, Carlson S. Altered working memory-related brain responses and white matter microstructure in extremely preterm-born children at school age. Brain Cogn 2019; 136:103615. [PMID: 31563082 DOI: 10.1016/j.bandc.2019.103615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/10/2019] [Accepted: 09/13/2019] [Indexed: 11/28/2022]
Abstract
Preterm birth poses a risk for neurocognitive and behavioral development. Preterm children, who have not been diagnosed with neurological or cognitive deficits, enter normal schools and are expected to succeed as their term-born peers. Here we tested the hypotheses that despite an uneventful development after preterm birth, these children might exhibit subtle abnormalities in brain function and white-matter microstructure at school-age. We recruited 7.5-year-old children born extremely prematurely (<28 weeks' gestation), and age- and gender-matched term-born controls (≥37 weeks' gestation). We applied fMRI during working-memory (WM) tasks, and investigated white-matter microstructure with diffusion tensor imaging. Compared with controls, preterm-born children performed WM tasks less accurately, had reduced activation in several right prefrontal areas, and weaker deactivation of right temporal lobe areas. The weaker prefrontal activation correlated with poorer WM performance. Preterm-born children had higher fractional anisotropy (FA) and lower diffusivity than controls in several white-matter areas, and in the posterior cerebellum, the higher FA associated with poorer visuospatial test scores. In controls, higher FA and lower diffusivity correlated with faster WM performance. Together these findings demonstrate weaker WM-related brain activations and altered white matter microstructure in children born extremely preterm, who had normal global cognitive ability.
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Affiliation(s)
- Maksym Tokariev
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Virve Vuontela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Piia Lönnberg
- Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aulikki Lano
- Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Perkola
- Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elina Wolford
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sture Andersson
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marjo Metsäranta
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Synnöve Carlson
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Advanced Magnetic Imaging Centre, Aalto University School of Science, Espoo, Finland.
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11
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White matter microstructure correlates with mathematics but not word reading performance in 13-year-old children born very preterm and full-term. NEUROIMAGE-CLINICAL 2019; 24:101944. [PMID: 31426019 PMCID: PMC6706654 DOI: 10.1016/j.nicl.2019.101944] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/04/2019] [Accepted: 07/17/2019] [Indexed: 01/24/2023]
Abstract
Individuals born very preterm (VPT; <32 weeks' gestational age) are at increased risk of impaired mathematics and word reading performance, as well as widespread white matter microstructural alterations compared with individuals born full term (FT; ≥37 weeks' gestational age). To date, the link between academic performance and white matter microstructure is not well understood. This study aimed to investigate the associations between mathematics and reading performance with white matter microstructure in 114 VPT and 36 FT 13-year-old children. Additionally, we aimed to investigate whether the association of mathematics and reading performance with white matter microstructure in VPT children varied as a function of impairment. To do this, we used diffusion tensor imaging and advanced diffusion modelling techniques (Neurite Orientation Dispersion and Density Imaging and the Spherical Mean Technique), combined with a whole-brain analysis approach (Tract-Based Spatial Statistics). Mathematics performance across VPT and FT groups was positively associated with white matter microstructural measurements of fractional anisotropy and neurite density, and negatively associated with radial and mean diffusivities in widespread, bilateral regions. Furthermore, VPT children with a mathematics impairment (>1 standard deviation below FT mean) had significantly reduced neurite density compared with VPT children without an impairment. Reading performance was not significantly associated with any of the white matter microstructure parameters. Additionally, the associations between white matter microstructure and mathematics and reading performance did not differ significantly between VPT and FT groups. Our findings suggest that alterations in white matter microstructure, and more specifically lower neurite density, are associated with poorer mathematics performance in 13-year-old VPT and FT children. More research is required to understand the association between reading performance and white matter microstructure in 13-year-old children. Diffusion tensor and neurite density metrics were associated with mathematics. Associations were present in very preterm and full-term children. Associations were widespread throughout the white matter microstructure. Decreased neurite density was evident in children with a mathematics impairment. Limited evidence of associations between white matter microstructure and reading.
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12
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Dubner SE, Dodson CK, Marchman VA, Ben-Shachar M, Feldman HM, Travis KE. White matter microstructure and cognitive outcomes in relation to neonatal inflammation in 6-year-old children born preterm. NEUROIMAGE-CLINICAL 2019; 23:101832. [PMID: 31075555 PMCID: PMC6603335 DOI: 10.1016/j.nicl.2019.101832] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/03/2019] [Accepted: 04/18/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cognitive outcomes in preterm (PT) children have been associated with microstructural properties of white matter. PT children who experienced neonatal inflammatory conditions have poorer cognitive outcomes than those who did not. The goal of this study was to contrast white matter microstructure and cognitive outcomes after preterm birth in relation to the presence or absence of severe inflammatory conditions in the neonatal period. METHODS PT children (n = 35), born at gestational age 22-32 weeks, were classified as either PT+ (n = 12) based on a neonatal history of inflammatory conditions, including bronchopulmonary dysplasia, necrotizing enterocolitis or culture positive sepsis, or PT- (n = 23) based on the absence of the three inflammatory conditions. Full term (FT) children (n = 43) served as controls. Participants underwent diffusion MRI and cognitive testing (intelligence, reading, and executive function) at age 6 years. The corpus callosum was segmented into 7 regions using deterministic tractography and based on the cortical projection zones of the callosal fibers. Mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated for each segment. General linear models with planned contrasts assessed group differences in FA, MD and cognitive outcomes. Pearson correlations assessed associations of white matter metrics and cognitive outcome measures. RESULTS FA was significantly lower and MD was significantly higher in PT+ compared to PT- or FT groups in multiple callosal segments, even after adjusting for gestational age. Executive function scores, but not intelligence or reading scores, were less favorable in PT+ than in PT- groups. Among the entire sample, occipital FA was significantly correlated with IQ (r = 0.25, p < 0.05), reading (r = 0.32, p < 0.01), and executive function (r = -0.28, p < 0.05) measures. Anterior frontal FA and superior parietal FA were significantly correlated with executive function (r = -0.25, r = 0.23, respectively, p < 0.05). CONCLUSIONS We observed differences in the white matter microstructure of the corpus callosum and in the cognitive skills of 6-year-old PT children based on their history of neonatal inflammation. Neonatal inflammation is one medical factor that may contribute to variation in long-term neurobiological and neuropsychological outcomes in PT samples.
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Affiliation(s)
- Sarah E Dubner
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Cory K Dodson
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Michal Ben-Shachar
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel; Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan, Israel
| | - Heidi M Feldman
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Katherine E Travis
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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13
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Jurcoane A, Daamen M, Keil VC, Scheef L, Bäuml JG, Meng C, Wohlschläger AM, Sorg C, Busch B, Baumann N, Wolke D, Bartmann P, Boecker H, Lüchters G, Marinova M, Hattingen E. Automated quantitative evaluation of brain MRI may be more accurate for discriminating preterm born adults. Eur Radiol 2019; 29:3533-3542. [PMID: 30903339 DOI: 10.1007/s00330-019-06099-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/01/2019] [Accepted: 02/11/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the structural brain abnormalities and their diagnostic accuracy through qualitative and quantitative analysis in term born and very preterm birth or with very low birth weight (VP/VLBW) adults. METHODS We analyzed 3-T MRIs acquired in 2011-2013 from 67 adults (27 term born controls, mean age 26.4 years, 8 females; 40 VP/VLBWs, mean age 26.6 years, 16 females). We compared automatic segmentations of the white matter, deep gray matter and cortical gray matter, manual corpus callosum measurements and visual ratings of the ventricles and white matter with t tests, logistic regression, and receiver operator characteristic (ROC) curves. RESULTS Automatic segmentation correctly classified 84% of cases; visual ratings correctly classified 63%. Quantitative volumetry based on automatic segmentation revealed higher ventricular volume, lower posterior corpus callosum, and deep gray matter volumes in VP/VLBW subjects compared to controls (p < 0.01). Visual rating and manual measurement revealed a thinner corpus callosum in VP/VLBW adults (p = 0.04) and deformed lateral ventricles (p = 0.03) and tendency towards more "dirty" white matter (p = 0.06). Automatic/manual measures combined with visual ratings correctly classified 87% of cases. Stepwise logistic regression identified three independent features that correctly classify 81% of cases: ventricular volume, deep gray matter volume, and white matter aspect. CONCLUSION Enlarged and deformed lateral ventricles, thinner corpus callosum, and "dirty" white matter are prevalent in preterm born adults. Their visual evaluation has low diagnostic accuracy. Automatic volume quantification is more accurate but time consuming. It may be useful to ask for prematurity before initiating further diagnostics in subjects with these alterations. KEY POINTS • Our study confirms prior reports showing that structural brain abnormalities related to preterm birth persist into adulthood. • In the clinical practice, if large and deformed lateral ventricles, small and thin corpus callosum, and "dirty" white matter are visible on MRI, ask for prematurity before considering other diagnoses. • Although prevalent, visual findings have low accuracy; adding automatic segmentation of lateral ventricles and deep gray matter nuclei improves the diagnostic accuracy.
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Affiliation(s)
- Alina Jurcoane
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany.
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany.
- Department of Neonatology, University Hospital Bonn, Bonn, Germany.
- Institute for Neuroradiology, University Hospital Frankfurt, Frankfurt, Germany.
| | - Marcel Daamen
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Vera C Keil
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
| | - Lukas Scheef
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Josef G Bäuml
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Chun Meng
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Afra M Wohlschläger
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Christian Sorg
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
- Department of Psychiatry, Klinikum rechts der Isar, Munich, Germany
| | - Barbara Busch
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Henning Boecker
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Guido Lüchters
- Center for Development Research, University of Bonn, Bonn, Germany
| | - Milka Marinova
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
| | - Elke Hattingen
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
- Institute for Neuroradiology, University Hospital Frankfurt, Frankfurt, Germany
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14
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Pascoe MJ, Melzer TR, Horwood LJ, Woodward LJ, Darlow BA. Altered grey matter volume, perfusion and white matter integrity in very low birthweight adults. NEUROIMAGE-CLINICAL 2019; 22:101780. [PMID: 30925384 PMCID: PMC6438988 DOI: 10.1016/j.nicl.2019.101780] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/11/2019] [Accepted: 03/14/2019] [Indexed: 11/26/2022]
Abstract
This study examined the long-term effects of being born very-low-birth-weight (VLBW, <1500 g) on adult cerebral structural development using a multi-method neuroimaging approach. The New Zealand VLBW study cohort comprised 413 individuals born VLBW in 1986. Of the 338 who survived to discharge, 229 were assessed at age 27–29 years. Of these, 150 had a 3 T MRI scan alongside 50 healthy term-born controls. The VLBW group included 53/57 participants born <28 weeks gestation. MRI analyses included: a) structural MRI to assess grey matter (GM) volume and cortical thickness; b) arterial spin labelling (ASL) to quantify GM perfusion; and c) diffusion tensor imaging (DTI) to measure white matter (WM) integrity. Compared to controls, VLBW adults had smaller GM volumes within frontal, temporal, parietal and occipital cortices, bilateral cingulate gyri and left caudate, as well as greater GM volumes in frontal, temporal and occipital areas. Thinner cortex was observed within frontal, temporal and parietal cortices. VLBW adults also had less GM perfusion within limited temporal areas, bilateral hippocampi and thalami. Finally, lower fractional anisotropy (FA) and axial diffusivity (AD) within principal WM tracts was observed in VLBW subjects. Within the VLBW group, birthweight was positively correlated with GM volume and perfusion in cortical and subcortical regions, as well as FA and AD across numerous principal WM tracts. Between group differences within temporal cortices were evident across all imaging modalities, suggesting that the temporal lobe may be particularly susceptible to disruption in development following preterm birth. Overall, findings reveal enduring and pervasive effects of preterm birth on brain structural development, with individuals born at lower birthweights having greater long-term neuropathology. Very-low-birth-weight adults had smaller GM volumes and thinner cortex than controls. VLBW adults also showed regions of larger grey matter volumes and thicker cortex. Several small regions showed lower cerebral perfusion in VLBW adults than in controls. Diffusion tensor MRI suggested poorer WM integrity in VLBW adults than in controls. Within VLBW adults, all MRI measures showed positive associations with birthweight.
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Affiliation(s)
- Maddie J Pascoe
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand.
| | - Tracy R Melzer
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand; Department of Medicine, University of Otago, Christchurch 8011, New Zealand.
| | - L John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch 8011, New Zealand.
| | - Lianne J Woodward
- School of Health Sciences, University of Canterbury, Christchurch 8041, New Zealand.
| | - Brian A Darlow
- Department of Paediatrics, University of Otago, Christchurch 8011, New Zealand.
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15
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Loe IM, Adams JN, Feldman HM. Executive Function in Relation to White Matter in Preterm and Full Term Children. Front Pediatr 2019; 6:418. [PMID: 30697535 PMCID: PMC6341022 DOI: 10.3389/fped.2018.00418] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/18/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Executive function (EF) refers to cognitive abilities used to guide goal-directed behavior. Diffusion Tensor Imaging (DTI) provides quantitative characterization of white matter tracts in the brain. Children with preterm birth often have EF impairments and white matter injury. Aim: To examine the degree of association between EF scores and white matter fractional anisotropy (FA) as measured by DTI in children born preterm and term Study design: Cross-sectional study Subjects: Participants, 9-16 years of age, born preterm (n = 25; mean gestational age 28.6 weeks; mean birth weight 1,191 grams), and full term (n = 20) Outcome measures: White matter FA analyzed with Tract-Based Spatial Statistics, a technique that generates a skeleton representing the core of white matter tracts throughout the brain. Behavioral scores from EF tasks examining working memory, spatial memory capacity, and multiple skills from the Stockings of Cambridge. Results: The groups performed comparably on all tasks. In both groups, unfavorable working memory strategy scores were associated with lower FA. Other measures of EF were not associated with whole skeleton FA in either group in either direction. Conclusions: Strategy score on a spatial working memory task was associated with FA in preterm and full term children, suggesting common underlying neurobiology in both groups. Associations were found in frontal-parietal connections and other major tracts. Lack of associations between other EF tasks and FA may be due to variation in how children accomplish these EF tasks. Future research is required to fully understand the neurobiology of EF in children born preterm.
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Affiliation(s)
- Irene M. Loe
- Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Jenna N. Adams
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - Heidi M. Feldman
- Department of Pediatrics, Stanford University, Stanford, CA, United States
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16
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Young JM, Morgan BR, Whyte HEA, Lee W, Smith ML, Raybaud C, Shroff MM, Sled JG, Taylor MJ. Longitudinal Study of White Matter Development and Outcomes in Children Born Very Preterm. Cereb Cortex 2018; 27:4094-4105. [PMID: 27600850 DOI: 10.1093/cercor/bhw221] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/14/2016] [Indexed: 12/24/2022] Open
Abstract
Identifying trajectories of early white matter development is important for understanding atypical brain development and impaired functional outcomes in children born very preterm (<32 weeks gestational age [GA]). In this study, 161 diffusion images were acquired in children born very preterm (median GA: 29 weeks) shortly following birth (75), term-equivalent (39), 2 years (18), and 4 years of age (29). Diffusion tensors were computed to obtain measures of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), which were aligned and averaged. A paediatric atlas was applied to obtain diffusion metrics within 12 white matter tracts. Developmental trajectories across time points demonstrated age-related changes which plateaued between term-equivalent and 2 years of age in the majority of posterior tracts and between 2 and 4 years of age in anterior tracts. Between preterm and term-equivalent scans, FA rates of change were slower in anterior than posterior tracts. Partial least squares analyses revealed associations between slower MD and RD rates of change within the external and internal capsule with lower intelligence quotients and language scores at 4 years of age. These results uniquely demonstrate early white matter development and its linkage to cognitive functions.
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Affiliation(s)
- Julia M Young
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin R Morgan
- 1Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Hilary E A Whyte
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Neonatology, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Wayne Lee
- 1Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Mary Lou Smith
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Charles Raybaud
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Manohar M Shroff
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - John G Sled
- Program in Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Margot J Taylor
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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17
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Bradfield C, Vavalle N, DeVincentis B, Wong E, Luong Q, Voo L, Carneal C. Combat Helmet Suspension System Stiffness Influences Linear Head Acceleration and White Matter Tissue Strains: Implications for Future Helmet Design. Mil Med 2018; 183:276-286. [PMID: 29635587 DOI: 10.1093/milmed/usx181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Indexed: 11/13/2022] Open
Abstract
Combat helmets are expected to protect the warfighter from a variety of blunt, blast, and ballistic threats. Their blunt impact performance is evaluated by measuring linear headform acceleration in drop tower tests, which may be indicative of skull fracture, but not necessarily brain injury. The current study leverages a blunt impact biomechanics model consisting of a head, neck, and helmet with a suspension system to predict how pad stiffness affects both (1) linear acceleration alone and (2) brain tissue response induced by both linear and rotational acceleration. The approach leverages diffusion tensor imaging information to estimate how pad stiffness influences white matter tissue strains, which may be representative of diffuse axonal injury. Simulation results demonstrate that a softer pad material reduces linear head accelerations for mild and moderate impact velocities, but a stiffer pad design minimizes linear head accelerations at high velocities. Conversely, white matter tract-oriented strains were found to be smallest with the softer pads at the severe impact velocity. The results demonstrate that the current helmet blunt impact testing standards' standalone measurement of linear acceleration does not always convey how the brain tissue responds to changes in helmet design. Consequently, future helmet testing should consider the brain's mechanical response when evaluating new designs.
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Affiliation(s)
- Connor Bradfield
- Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723
| | - Nicholas Vavalle
- Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723
| | - Brian DeVincentis
- Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723
| | - Edna Wong
- Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723
| | - Quang Luong
- Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723
| | - Liming Voo
- Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723
| | - Catherine Carneal
- Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723
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18
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Glozman T, Bruckert L, Pestilli F, Yecies DW, Guibas LJ, Yeom KW. Framework for shape analysis of white matter fiber bundles. Neuroimage 2018; 167:466-477. [PMID: 29203454 PMCID: PMC5845796 DOI: 10.1016/j.neuroimage.2017.11.052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/26/2017] [Accepted: 11/22/2017] [Indexed: 12/24/2022] Open
Abstract
Diffusion imaging coupled with tractography algorithms allows researchers to image human white matter fiber bundles in-vivo. These bundles are three-dimensional structures with shapes that change over time during the course of development as well as in pathologic states. While most studies on white matter variability focus on analysis of tissue properties estimated from the diffusion data, e.g. fractional anisotropy, the shape variability of white matter fiber bundle is much less explored. In this paper, we present a set of tools for shape analysis of white matter fiber bundles, namely: (1) a concise geometric model of bundle shapes; (2) a method for bundle registration between subjects; (3) a method for deformation estimation. Our framework is useful for analysis of shape variability in white matter fiber bundles. We demonstrate our framework by applying our methods on two datasets: one consisting of data for 6 normal adults and another consisting of data for 38 normal children of age 11 days to 8.5 years. We suggest a robust and reproducible method to measure changes in the shape of white matter fiber bundles. We demonstrate how this method can be used to create a model to assess age-dependent changes in the shape of specific fiber bundles. We derive such models for an ensemble of white matter fiber bundles on our pediatric dataset and show that our results agree with normative human head and brain growth data. Creating these models for a large pediatric longitudinal dataset may improve understanding of both normal development and pathologic states and propose novel parameters for the examination of the pediatric brain.
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Affiliation(s)
- Tanya Glozman
- Electrical Engineering, Stanford University, Stanford, CA, USA.
| | | | - Franco Pestilli
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Derek W Yecies
- Pediatric Neurosurgery, Stanford University, Stanford, CA, USA
| | | | - Kristen W Yeom
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA
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19
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Young JM, Vandewouw MM, Morgan BR, Smith ML, Sled JG, Taylor MJ. Altered white matter development in children born very preterm. Brain Struct Funct 2018; 223:2129-2141. [PMID: 29380120 DOI: 10.1007/s00429-018-1614-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/17/2018] [Indexed: 12/31/2022]
Abstract
Children born very preterm (VPT) at less than 32 weeks' gestational age (GA) are prone to disrupted white matter maturation and impaired cognitive development. The aims of the present study were to identify differences in white matter microstructure and connectivity of children born VPT compared to term-born children, as well as relations between white matter measures with cognitive outcomes and early brain injury. Diffusion images and T1-weighted anatomical MR images were acquired along with developmental assessments in 31 VPT children (mean GA: 28.76 weeks) and 28 term-born children at 4 years of age. FSL's tract-based spatial statistics was used to create a cohort-specific template and mean fractional anisotropy (FA) skeleton that was applied to each child's DTI data. Whole brain deterministic tractography was performed and graph theoretical measures of connectivity were calculated based on the number of streamlines between cortical and subcortical nodes derived from the Desikan-Killiany atlas. Between-group analyses included FSL Randomise for voxel-wise statistics and permutation testing for connectivity analyses. Within-group analyses between FA values and graph measures with IQ, language and visual-motor scores as well as history of white matter injury (WMI) and germinal matrix/intraventricular haemorrhage (GMH/IVH) were performed. In the children born VPT, FA values within major white matter tracts were reduced compared to term-born children. Reduced measures of local strength, clustering coefficient, local and global efficiency were present in the children born VPT within nodes in the lateral frontal, middle and superior temporal, cingulate, precuneus and lateral occipital regions. Within-group analyses revealed associations in term-born children between FA, Verbal IQ, Performance IQ and Full scale IQ within regions of the superior longitudinal fasciculus, inferior fronto-occipital fasciculus, forceps minor and forceps major. No associations with outcome were found in the VPT group. Global efficiency was reduced in the children born VPT with a history of WMI and GMH/IVH. These findings are evidence for under-developed and less connected white matter in children born VPT, contributing to our understanding of white matter development within this population.
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Affiliation(s)
- Julia M Young
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada. .,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada. .,Department of Psychology, University of Toronto, Toronto, ON, Canada.
| | - Marlee M Vandewouw
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Benjamin R Morgan
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Mary Lou Smith
- Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - John G Sled
- Translational Medicine, SickKids Research Institute, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Margot J Taylor
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
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20
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Saunavaara V, Kallankari H, Parkkola R, Haataja L, Olsén P, Hallman M, Kaukola T. Very preterm children with fetal growth restriction demonstrated altered white matter maturation at nine years of age. Acta Paediatr 2017. [PMID: 28626859 DOI: 10.1111/apa.13954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
AIM This study evaluated the role of preterm birth and fetal growth restriction on white matter maturation in schoolchildren without any severe neurodevelopmental impairment. METHODS The study group comprised 56 very preterm children and 21 term children born between November 1998 and November 2002 at Oulu University Hospital, Finland. The mean gestational age of the preterm children was 28.7 (24.1-31.9) weeks. All children underwent diffusion tensor imaging at a mean age of 9.0 (8.6-9.6) years. Voxel-wise statistical analyses of the imaging data were carried out using tract-based spatial statistics. RESULTS Preterm children with fetal growth restriction had lower fractional anisotropy and higher radial diffusivity than term controls (p < 0.05), bilaterally in several white matter areas. Preterm children without fetal growth restriction had higher mean diffusivity and axial diffusivity than term controls (p < 0.05) in analogous areas, but more asymmetrically. CONCLUSION Preterm children had microstructural differences in white matter, compared to term-born children at a mean age of nine, and those with poor fetal growth showed widespread changes in white matter maturation compared to term-born children. Fetal growth and prematurity seemed to affect white matter maturation in a way that was still visible at that age.
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Affiliation(s)
- Virva Saunavaara
- PET Center; Turku University Hospital; Turku Finland
- Department of Medical physics; Turku University Hospital; Turku Finland
| | - Hanna Kallankari
- Department of Child Neurology; PEDEGO Research Unit; University of Oulu and Oulu University Hospital; Oulu Finland
| | | | - Leena Haataja
- Department of Child Neurology, Children and adolescents; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Päivi Olsén
- Department of Child Neurology; PEDEGO Research Unit; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Mikko Hallman
- PEDEGO Research Unit; Medical Research Center Oulu; Oulu Finland
| | - Tuula Kaukola
- Department of Neonatology; PEDEGO Research Unit; University of Oulu and Oulu University Hospital; Oulu Finland
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21
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Weeke LC, Brilstra E, Braun KP, Zonneveld-Huijssoon E, Salomons GS, Koeleman BP, van Gassen KL, van Straaten HL, Craiu D, de Vries LS. Punctate white matter lesions in full-term infants with neonatal seizures associated with SLC13A5 mutations. Eur J Paediatr Neurol 2017; 21:396-403. [PMID: 27913086 DOI: 10.1016/j.ejpn.2016.11.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 11/13/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Early-onset epileptic encephalopathy caused by biallelic SLC13A5 mutations is characterized by seizure onset in the first days of life, refractory epilepsy and developmental delay. Little detailed information about the brain MRI features is available in these patients. METHODS Observational study describing the neuro-imaging findings in eight patients (five families) with mutations in the SLC13A5 gene. Seven infants had an MRI in the neonatal period, two had a follow-up MRI at the age of 6 and 18 months and one only at 13 months. One patient had follow-up MRIs at 11 and 16 months and 3 and 6 years of age, but no neonatal MRI. RESULTS All patients presented with refractory neonatal seizures on the first day of life after an uncomplicated pregnancy and term delivery. Six out of seven infants with a neonatal MRI had a characteristic MRI pattern, with punctate white matter lesions (PWML), which were no longer visible at the age of 6 months, but led to gliotic scarring visible on MRI at the age of 18 months. The same pattern of gliotic scarring was seen on the MRIs of the infant without a neonatal scan. One infant had signal abnormalities in the white matter suspected of PWML on T2WI, but these could not be confirmed on other sequences. CONCLUSION In infants presenting with therapy resistant seizures in the first days after birth, without a clear history of hypoxic-ischemic encephalopathy, but with PWML on their neonatal MRI, a diagnosis of SCL13A5 related epileptic encephalopathy should be considered.
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Affiliation(s)
- Lauren C Weeke
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eva Brilstra
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kees P Braun
- Department of Pediatric Neurology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Gajja S Salomons
- Metabolic Unit, Department of Clinical Chemistry, VU University Medical Center/Neuroscience Campus, Amsterdam, The Netherlands
| | - Bobby P Koeleman
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Koen L van Gassen
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Dana Craiu
- Pediatric Neurology Discipline, Department of Clinical Neurosciences, "Carol Davila" University of Medicine, Bucharest, Romania; Pediatric Neurology Clinic, Alexandru Obregia Hospital, Bucharest, Romania
| | - Linda S de Vries
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
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22
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Ramu J, Konak T, Paule MG, Hanig JP, Liachenko S. Longitudinal diffusion tensor imaging of the rat brain after hexachlorophene exposure. Neurotoxicology 2016; 56:225-232. [PMID: 27555423 DOI: 10.1016/j.neuro.2016.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 08/17/2016] [Accepted: 08/17/2016] [Indexed: 12/28/2022]
Abstract
Longitudinal MRI employing diffusion tensor imaging and T2 mapping approaches has been applied to investigate the mechanisms of white matter damage caused by acute hexachlorophene neurotoxicity in rats in vivo. Male Sprague-Dawley rats were administered hexachlorophene orally once a day for five consecutive days at a dose of 30mg/kg and were monitored in 7T MRI scanner at days 0 (baseline), 3, 6, 13, and 20 following the first hexachlorophene dose. Quantitative T2 maps as well as a number of diffusion tensor parameters (fractional anisotropy, radial and axial diffusivity, apparent diffusion coefficient, and trace) were calculated from corresponding MR images. T2, as well as all diffusion tensor derived parameters (except fractional anisotropy) showed significant changes during the course of neurotoxicity development. These changes peaked at 6days after the first dose of hexachlorophene (one day after the last dose) and recovered to practically baseline levels at the end of observation (20days from the first dose). While such changes in diffusivity and T2 relaxation clearly demonstrate myelin perturbations consistent with edema, the lack of changes of fractional anisotropy suggests that the structure of the myelin sheath was not disrupted significantly by hexachlorophene in this study. This is also confirmed by the rapid recovery of all observed MRI parameters after cessation of hexachlorophene exposure.
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Affiliation(s)
- Jaivijay Ramu
- Division of Neurotoxicology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States.
| | - Tetyana Konak
- Division of Neurotoxicology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States.
| | - Merle G Paule
- Division of Neurotoxicology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States.
| | - Joseph P Hanig
- Center for Drug Evaluation and Research, Food and Drug Administration, White Oak, MD, United States.
| | - Serguei Liachenko
- Division of Neurotoxicology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States.
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23
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Leitner Y, Travis KE, Ben-Shachar M, Yeom KW, Feldman HM. Tract Profiles of the Cerebellar White Matter Pathways in Children and Adolescents. THE CEREBELLUM 2016; 14:613-623. [PMID: 25648754 DOI: 10.1007/s12311-015-0652-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Intact development of cerebellar connectivity is essential for healthy neuromotor and neurocognitive development. To date, limited knowledge about the microstructural properties of the cerebellar peduncles, the major white matter tracts of the cerebellum, is available for children and adolescents. Such information would be useful as a comparison for studies of normal development, clinical conditions, or associations of cerebellar structures with cognitive and motor functions. The goal of the present study was to evaluate the variability in diffusion measures of the cerebellar peduncles within individuals and within a normative sample of healthy children. Participants were 19 healthy children and adolescents, aged 9-17 years, mean age 13.0 ± 2.3. We analyzed diffusion magnetic resonance imaging (dMRI) data with deterministic tractography. We generated tract profiles for each of the cerebellar peduncles by extracting four diffusion properties (fractional anisotropy (FA) and mean, radial, and axial diffusivity) at 30 equidistant points along each tract. We were able to identify the middle cerebellar peduncle and the bilateral inferior and superior cerebellar peduncles in all participants. The results showed that within each of the peduncles, the diffusion properties varied along the trajectory of the tracts. However, the tracts showed consistent patterns of variation across individuals; the coefficient of variation for FA across individual profiles was low (≤20%) for each tract. We observed no systematic variation of the diffusion properties with age. These cerebellar tract profiles of the cerebellar peduncles can serve as a reference for future studies of children across the age range and for children and adolescents with clinical conditions that affect the cerebellum.
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Affiliation(s)
- Yael Leitner
- Child Development Center, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Katherine E Travis
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto CA USA
| | - Michal Ben-Shachar
- The Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel.,The English Department, Linguistics Division, Bar Ilan University, Ramat Gan, Israel
| | - Kristen W Yeom
- Department of Radiology, Stanford University School of Medicine, Palo Alto CA USA
| | - Heidi M Feldman
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto CA USA
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24
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Thompson DK, Chen J, Beare R, Adamson CL, Ellis R, Ahmadzai ZM, Kelly CE, Lee KJ, Zalesky A, Yang JYM, Hunt RW, Cheong JLY, Inder TE, Doyle LW, Seal ML, Anderson PJ. Structural connectivity relates to perinatal factors and functional impairment at 7years in children born very preterm. Neuroimage 2016; 134:328-337. [PMID: 27046108 PMCID: PMC4912891 DOI: 10.1016/j.neuroimage.2016.03.070] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/17/2016] [Accepted: 03/26/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To use structural connectivity to (1) compare brain networks between typically and atypically developing (very preterm) children, (2) explore associations between potential perinatal developmental disturbances and brain networks, and (3) describe associations between brain networks and functional impairments in very preterm children. METHODS 26 full-term and 107 very preterm 7-year-old children (born <30weeks' gestational age and/or <1250g) underwent T1- and diffusion-weighted imaging. Global white matter fibre networks were produced using 80 cortical and subcortical nodes, and edges were created using constrained spherical deconvolution-based tractography. Global graph theory metrics were analysed, and regional networks were identified using network-based statistics. Cognitive and motor function were assessed at 7years of age. RESULTS Compared with full-term children, very preterm children had reduced density, lower global efficiency and higher local efficiency. Those with lower gestational age at birth, infection or higher neonatal brain abnormality score had reduced connectivity. Reduced connectivity within a widespread network was predictive of impaired IQ, while reduced connectivity within the right parietal and temporal lobes was associated with motor impairment in very preterm children. CONCLUSIONS This study utilised an innovative structural connectivity pipeline to reveal that children born very preterm have less connected and less complex brain networks compared with typically developing term-born children. Adverse perinatal factors led to disturbances in white matter connectivity, which in turn are associated with impaired functional outcomes, highlighting novel structure-function relationships.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, VIC 3052, Australia.
| | - Jian Chen
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Medicine, Monash Medical Centre, Monash University, 246 Clayton Rd, Melbourne, VIC 3168, Australia
| | - Richard Beare
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Medicine, Monash Medical Centre, Monash University, 246 Clayton Rd, Melbourne, VIC 3168, Australia
| | - Christopher L Adamson
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Rachel Ellis
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Zohra M Ahmadzai
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Claire E Kelly
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Katherine J Lee
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Andrew Zalesky
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, 161 Barry St, Carlton, VIC 3053, Australia; Melbourne School of Engineering, Building 173, University of Melbourne, Parkville, VIC 3010, Australia
| | - Joseph Y M Yang
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Neurosurgery, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Rodney W Hunt
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Jeanie L Y Cheong
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Women's Newborn Research Centre, Royal Women's Hospital, 20 Flemington Rd, Parkville, VIC 3052, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, 20 Flemington Rd, Parkville, VIC 3052, Australia
| | - Terrie E Inder
- Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Lex W Doyle
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, VIC 3052, Australia; Women's Newborn Research Centre, Royal Women's Hospital, 20 Flemington Rd, Parkville, VIC 3052, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, 20 Flemington Rd, Parkville, VIC 3052, Australia
| | - Marc L Seal
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, VIC 3052, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, VIC 3052, Australia
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25
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Kelly CE, Thompson DK, Chen J, Leemans A, Adamson CL, Inder TE, Cheong JLY, Doyle LW, Anderson PJ. Axon density and axon orientation dispersion in children born preterm. Hum Brain Mapp 2016; 37:3080-102. [PMID: 27133221 DOI: 10.1002/hbm.23227] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 04/12/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Very preterm birth (VPT, <32 weeks' gestation) is associated with altered white matter fractional anisotropy (FA), the biological basis of which is uncertain but may relate to changes in axon density and/or dispersion, which can be measured using Neurite Orientation Dispersion and Density Imaging (NODDI). This study aimed to compare whole brain white matter FA, axon dispersion, and axon density between VPT children and controls (born ≥37 weeks' gestation), and to investigate associations with perinatal factors and neurodevelopmental outcomes. METHODS FA, neurite dispersion, and neurite density were estimated from multishell diffusion magnetic resonance images for 145 VPT and 33 control 7-year-olds. Diffusion values were compared between groups and correlated with perinatal factors (gestational age, birthweight, and neonatal brain abnormalities) and neurodevelopmental outcomes (IQ, motor, academic, and behavioral outcomes) using Tract-Based Spatial Statistics. RESULTS Compared with controls, VPT children had lower FA and higher axon dispersion within many major white matter fiber tracts. Neonatal brain abnormalities predicted lower FA and higher axon dispersion in many major tracts in VPT children. Lower FA, higher axon dispersion, and lower axon density in various tracts correlated with poorer neurodevelopmental outcomes in VPT children. CONCLUSIONS FA and NODDI measures distinguished VPT children from controls and were associated with neonatal brain abnormalities and neurodevelopmental outcomes. This study provides a more detailed and biologically meaningful interpretation of white matter microstructure changes associated with prematurity. Hum Brain Mapp 37:3080-3102, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Claire E Kelly
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Jian Chen
- Murdoch Childrens Research Institute, Melbourne, Australia.,Department of Medicine, Monash Medical Centre, Monash University, Melbourne, Australia
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Jeanie L Y Cheong
- Murdoch Childrens Research Institute, Melbourne, Australia.,Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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26
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Travis KE, Ben-Shachar M, Myall NJ, Feldman HM. Variations in the neurobiology of reading in children and adolescents born full term and preterm. Neuroimage Clin 2016; 11:555-565. [PMID: 27158588 PMCID: PMC4845391 DOI: 10.1016/j.nicl.2016.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/05/2016] [Accepted: 04/06/2016] [Indexed: 01/18/2023]
Abstract
Diffusion properties of white matter tracts have been associated with individual differences in reading. Individuals born preterm are at risk of injury to white matter. In this study we compared the associations between diffusion properties of white matter and reading skills in children and adolescents born full term and preterm. 45 participants, aged 9-17 years, included 26 preterms (born < 36 weeks' gestation) and 19 full-terms. Tract fractional anisotropy (FA) profiles were generated for five bilateral white matter tracts previously associated with reading: anterior superior longitudinal fasciculus (aSLF), arcuate fasciculus (Arc), corticospinal tract (CST), uncinate fasciculus (UF) and inferior longitudinal fasciculus (ILF). Mean scores on reading for the two groups were in the normal range and were not statistically different. In both groups, FA was associated with measures of single word reading and comprehension in the aSLF, AF, CST, and UF. However, correlations were negative in the full term group and positive in the preterm group. These results demonstrate variations in the neurobiology of reading in children born full term and preterm despite comparable reading skills. Findings suggest that efficient information exchange required for strong reading abilities may be accomplished via a different balance of neurobiological mechanisms in different groups of readers.
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Affiliation(s)
- Katherine E Travis
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304, United States
| | - Michal Ben-Shachar
- The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel; Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Nathaniel J Myall
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Heidi M Feldman
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304, United States.
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27
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Travis KE, Leitner Y, Ben-Shachar M, Yeom KW, Feldman HM. Case Series: Fractional Anisotropy Profiles of the Cerebellar Peduncles in Adolescents Born Preterm With Ventricular Dilation. J Child Neurol 2016; 31:321-7. [PMID: 26116381 PMCID: PMC4691425 DOI: 10.1177/0883073815592223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/06/2015] [Indexed: 11/17/2022]
Abstract
This case series assesses white matter microstructure of the cerebellar peduncles in 4 adolescents born preterm with enlarged ventricles and reduced white matter volume in the cerebrum but no apparent injury to the cerebellum. Subjects (ages 12-17 years, gestational age 26-32 weeks, birth weight 825-2211 g) were compared to a normative sample of 19 full-term controls (9-17 years, mean gestational age 39 weeks, mean birth weight 3154 g). Tract profiles for each of the cerebellar peduncles were generated by calculating fractional anisotropy at 30 points along the central portion of each tract. One or more case subjects exhibited higher fractional anisotropy beyond the 90th percentile in the inferior, middle, and superior cerebellar peduncles. Findings demonstrate that differences in cerebellar white matter microstructure can be detected in the absence of macrostructural cerebellar abnormalities.
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Affiliation(s)
- Katherine E Travis
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Yael Leitner
- Child Development Center, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Ben-Shachar
- The Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan, Israel
| | - Kristen W Yeom
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Heidi M Feldman
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
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28
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Sølsnes AE, Sripada K, Yendiki A, Bjuland KJ, Østgård HF, Aanes S, Grunewaldt KH, Løhaugen GC, Eikenes L, Håberg AK, Rimol LM, Skranes J. Limited microstructural and connectivity deficits despite subcortical volume reductions in school-aged children born preterm with very low birth weight. Neuroimage 2015; 130:24-34. [PMID: 26712340 DOI: 10.1016/j.neuroimage.2015.12.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/24/2015] [Accepted: 12/16/2015] [Indexed: 12/14/2022] Open
Abstract
Preterm birth and very low birth weight (VLBW, ≤1500 g) are worldwide problems that burden survivors with lifelong cognitive, psychological, and physical challenges. In this multimodal structural magnetic resonance imaging (MRI) and diffusion MRI (dMRI) study, we investigated differences in subcortical brain volumes and white matter tract properties in children born preterm with VLBW compared to term-born controls (mean age=8 years). Subcortical brain structure volumes and cortical thickness estimates were obtained, and fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were generated for 18 white matter tracts. We also assessed structural relationships between white matter tracts and cortical thickness of the tract endpoints. Compared to controls, the VLBW group had reduced volumes of thalamus, globus pallidus, corpus callosum, cerebral white matter, ventral diencephalon, and brain stem, while the ventricular system was larger in VLBW subjects, after controlling for age, sex, IQ, and estimated total intracranial volume. For the dMRI parameters, group differences were not significant at the whole-tract level, though pointwise analysis found shorter segments affected in forceps minor and left superior longitudinal fasciculus - temporal bundle. IQ did not correlate with subcortical volumes or dMRI measures in the VLBW group. While the deviations in subcortical volumes were substantial, there were few differences in dMRI measures between the two groups, which may reflect the influence of advances in perinatal care on white matter development.
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Affiliation(s)
- Anne Elisabeth Sølsnes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kam Sripada
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Anastasia Yendiki
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Knut Jørgen Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Heidi Furre Østgård
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Synne Aanes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristine Hermansen Grunewaldt
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olav's Hospital, Trondheim, Norway
| | - Gro C Løhaugen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Live Eikenes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asta K Håberg
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Imaging, St. Olav's Hospital, Trondheim, Norway
| | - Lars M Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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29
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Travis KE, Adams JN, Ben-Shachar M, Feldman HM. Decreased and Increased Anisotropy along Major Cerebral White Matter Tracts in Preterm Children and Adolescents. PLoS One 2015; 10:e0142860. [PMID: 26560745 PMCID: PMC4641645 DOI: 10.1371/journal.pone.0142860] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/26/2015] [Indexed: 12/15/2022] Open
Abstract
Premature birth is highly prevalent and associated with neurodevelopmental delays and disorders. Adverse outcomes, particularly in children born before 32 weeks of gestation, have been attributed in large part to white matter injuries, often found in periventricular regions using conventional imaging. To date, tractography studies of white matter pathways in children and adolescents born preterm have evaluated only a limited number of tracts simultaneously. The current study compares diffusion properties along 18 major cerebral white matter pathways in children and adolescents born preterm (n = 27) and full term (n = 19), using diffusion magnetic resonance imaging and tractography. We found that compared to the full term group, the preterm group had significantly decreased FA in segments of the bilateral uncinate fasciculus and anterior segments of the right inferior fronto-occipital fasciculus. Additionally, the preterm group had significantly increased FA in segments of the right and left anterior thalamic radiations, posterior segments of the right inferior fronto-occipital fasciculus, and the right and left inferior longitudinal fasciculus. Increased FA in the preterm group was generally associated with decreased radial diffusivity. These findings indicate that prematurity-related white matter differences in later childhood and adolescence do not affect all tracts in the periventricular zone and can involve both decreased and increased FA. Differences in the patterns of radial diffusivity and axial diffusivity suggest that the tissue properties underlying group FA differences may vary within and across white matter tracts. Distinctive diffusion properties may relate to variations in the timing of injury in the neonatal period, extent of white matter dysmaturity and/or compensatory processes in childhood.
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Affiliation(s)
- Katherine E. Travis
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94303, United States of America
| | - Jenna N. Adams
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94303, United States of America
| | - Michal Ben-Shachar
- The Gonda Brain Research Center, Bar Ilan University, Ramat Gan, 5290002, Israel
- Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan, 5290002, Israel
| | - Heidi M. Feldman
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94303, United States of America
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Murray AL, Thompson DK, Pascoe L, Leemans A, Inder TE, Doyle LW, Anderson JFI, Anderson PJ. White matter abnormalities and impaired attention abilities in children born very preterm. Neuroimage 2015; 124:75-84. [PMID: 26318524 DOI: 10.1016/j.neuroimage.2015.08.044] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/16/2015] [Accepted: 08/20/2015] [Indexed: 12/23/2022] Open
Abstract
While attention impairments are commonly observed in very preterm (<32weeks' gestational age) children, neuroanatomical correlates of these difficulties are unclear. We aimed to determine whether the microstructural organization of key white matter tracts thought to be involved in attention (cingulum bundle, superior longitudinal fasciculi, reticular activating system, and corpus callosum) were altered in very preterm children compared with term-born controls. We also aimed to determine whether alterations in microstructural organization of these tracts were associated with attention functioning in very preterm children. One hundred and forty-nine very preterm children and 36 term-born controls underwent neuroimaging and assessment of their attention abilities at 7years. Constrained spherical deconvolution and probabilistic tractography was used to identify the key white matter tracts. Altered microstructural organization and reduced tract volume within reticular activating system and corpus callosum were found in the very preterm group compared with the control group. Diffusion and volume changes in the cingulum bundle, superior longitudinal fasciculi, reticular activating system, and corpus callosum were related to variations in attention functioning in the very preterm children. These findings emphasize that white matter tract integrity is associated with later attentional abilities in very preterm children.
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Affiliation(s)
- Andrea L Murray
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Leona Pascoe
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center, Utrecht, The Netherlands
| | - Terrie E Inder
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Research Office, The Royal Women's Hospital, Grattan Street, Melbourne, Australia; Department of Obstetrics & Gynaecology, The University of Melbourne, Royal Women's Hospital, Melbourne, Australia
| | - Jacqueline F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Department of Psychology, The Alfred, Alfred Health, Melbourne, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Australia.
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Thompson DK, Lee KJ, van Bijnen L, Leemans A, Pascoe L, Scratch SE, Cheong J, Egan GF, Inder TE, Doyle LW, Anderson PJ. Accelerated corpus callosum development in prematurity predicts improved outcome. Hum Brain Mapp 2015; 36:3733-48. [PMID: 26108187 DOI: 10.1002/hbm.22874] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/01/2015] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To determine: (1) whether corpus callosum (CC) size and microstructure at 7 years of age or their change from infancy to 7 years differed between very preterm (VP) and full-term (FT) children; (2) perinatal predictors of CC size and microstructure at 7 years; and (3) associations between CC measures at 7 years or trajectories from infancy to 7 years and neurodevelopmental outcomes. EXPERIMENTAL DESIGN One hundred and thirty-six VP (gestational age [GA] <30 weeks and/or birth weight <1,250 g) and 33 FT children had usable magnetic resonance images at 7 years of age, and of these, 76 VP and 16 FT infants had usable data at term equivalent age. The CC was traced and divided into six sub-regions. Fractional anisotropy, mean, axial, radial diffusivity and volume were measured from tractography. Perinatal data were collected, and neurodevelopmental tests administered at 7 years' corrected age. PRINCIPAL OBSERVATIONS VP children had smaller posterior CC regions, higher diffusivity and lower fractional anisotropy compared with FT 7-year-olds. Reduction in diffusivity over time occurred faster in VP than FT children (P ≤ 0.002). Perinatal brain abnormality and earlier GA were associated with CC abnormalities. Microstructural abnormalities at 7 years or slower development of the CC were associated with motor dysfunction, poorer mathematics and visual perception. CONCLUSIONS This study is the first to demonstrate an accelerated trajectory of CC white matter diffusion following VP birth, associated with improved neurodevelopmental functioning. Findings suggest there is a window of opportunity for neurorestorative intervention to improve outcomes. Hum Brain Mapp 36:3733-3748, 2015. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine J Lee
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Loeka van Bijnen
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Alexander Leemans
- Imaging Science Institute, University Medical Center, Utrecht, Netherlands
| | - Leona Pascoe
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Shannon E Scratch
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Jeanie Cheong
- Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Gary F Egan
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Terrie E Inder
- Brigham and Women's Hospital, Boston, Massachusetts.,Department of Pediatrics, Washington University in St Louis Medical School, St Louis, Missouri
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Pediatrics, Washington University in St Louis Medical School, St Louis, Missouri
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Degnan AJ, Wisnowski JL, Choi S, Ceschin R, Bhushan C, Leahy RM, Corby P, Schmithorst VJ, Panigrahy A. Altered Structural and Functional Connectivity in Late Preterm Preadolescence: An Anatomic Seed-Based Study of Resting State Networks Related to the Posteromedial and Lateral Parietal Cortex. PLoS One 2015; 10:e0130686. [PMID: 26098888 PMCID: PMC4476681 DOI: 10.1371/journal.pone.0130686] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/22/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Late preterm birth confers increased risk of developmental delay, academic difficulties and social deficits. The late third trimester may represent a critical period of development of neural networks including the default mode network (DMN), which is essential to normal cognition. Our objective is to identify functional and structural connectivity differences in the posteromedial cortex related to late preterm birth. METHODS Thirty-eight preadolescents (ages 9-13; 19 born in the late preterm period (≥32 weeks gestational age) and 19 at term) without access to advanced neonatal care were recruited from a low socioeconomic status community in Brazil. Participants underwent neurocognitive testing, 3-dimensional T1-weighted imaging, diffusion-weighted imaging and resting state functional MRI (RS-fMRI). Seed-based probabilistic diffusion tractography and RS-fMRI analyses were performed using unilateral seeds within the posterior DMN (posterior cingulate cortex, precuneus) and lateral parietal DMN (superior marginal and angular gyri). RESULTS Late preterm children demonstrated increased functional connectivity within the posterior default mode networks and increased anti-correlation with the central-executive network when seeded from the posteromedial cortex (PMC). Key differences were demonstrated between PMC components with increased anti-correlation with the salience network seen only with posterior cingulate cortex seeding but not with precuneus seeding. Probabilistic tractography showed increased streamlines within the right inferior longitudinal fasciculus and inferior fronto-occipital fasciculus within late preterm children while decreased intrahemispheric streamlines were also observed. No significant differences in neurocognitive testing were demonstrated between groups. CONCLUSION Late preterm preadolescence is associated with altered functional connectivity from the PMC and lateral parietal cortex to known distributed functional cortical networks despite no significant executive neurocognitive differences. Selective increased structural connectivity was observed in the setting of decreased posterior interhemispheric connections. Future work is needed to determine if these findings represent a compensatory adaptation employing alternate neural circuitry or could reflect subtle pathology resulting in emotional processing deficits not seen with neurocognitive testing.
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Affiliation(s)
- Andrew J. Degnan
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Radiology, University of Pittsburgh Medical Center (UPMC), 3950 Presby South Tower, 200 Lothrop Street, Pittsburgh, PA 15213, United States of America
| | - Jessica L. Wisnowski
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
| | - SoYoung Choi
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
| | - Rafael Ceschin
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Chitresh Bhushan
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Richard M. Leahy
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Patricia Corby
- Twins Institute for Genetics Research, Montes Claros, Minas Gerais 39400–115, Brazil
- New York University Bluestone Center for Clinical Research, 421 1st Ave, New York, NY 10010, United States of America
| | - Vincent J. Schmithorst
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
| | - Ashok Panigrahy
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
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Travis KE, Leitner Y, Feldman HM, Ben-Shachar M. Cerebellar white matter pathways are associated with reading skills in children and adolescents. Hum Brain Mapp 2014; 36:1536-53. [PMID: 25504986 DOI: 10.1002/hbm.22721] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 11/10/2014] [Accepted: 12/04/2014] [Indexed: 01/18/2023] Open
Abstract
Reading is a critical life skill in the modern world. The neural basis of reading incorporates a distributed network of cortical areas and their white matter connections. The cerebellum has also been implicated in reading and reading disabilities. However, little is known about the contribution of cerebellar white matter pathways to major component skills of reading. We used diffusion magnetic resonance imaging (dMRI) with tractography to identify the cerebellar peduncles in a group of 9- to 17-year-old children and adolescents born full term (FT, n = 19) or preterm (PT, n = 26). In this cohort, no significant differences were found between fractional anisotropy (FA) measures of the peduncles in the PT and FT groups. FA of the cerebellar peduncles correlated significantly with measures of decoding and reading comprehension in the combined sample of FT and PT subjects. Correlations were negative in the superior and inferior cerebellar peduncles and positive in the middle cerebellar peduncle. Additional analyses revealed that FT and PT groups demonstrated similar patterns of reading associations within the left superior cerebellar peduncle, middle cerebellar peduncle, and left inferior cerebellar peduncle. Partial correlation analyses showed that distinct sub-skills of reading were associated with FA in segments of different cerebellar peduncles. Overall, the present findings are the first to document associations of microstructure of the cerebellar peduncles and the component skills of reading.
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Affiliation(s)
- Katherine E Travis
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
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Eskandari R, Abdullah O, Mason C, Lloyd KE, Oeschle AN, McAllister JP. Differential vulnerability of white matter structures to experimental infantile hydrocephalus detected by diffusion tensor imaging. Childs Nerv Syst 2014; 30:1651-61. [PMID: 25070594 DOI: 10.1007/s00381-014-2500-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 07/14/2014] [Indexed: 12/22/2022]
Abstract
PURPOSE The differential vulnerability of white matter (WM) to acute and chronic infantile hydrocephalus and the related effects of early and late reservoir treatment are unknown, but diffusion tensor imaging (DTI) could provide this information. Thus, we characterized WM integrity using DTI in a clinically relevant model. METHODS Obstructive hydrocephalus was induced in 2-week-old felines by intracisternal kaolin injection. Ventricular reservoirs were placed 1 (early) or 2 (late) weeks post-kaolin and tapped frequently based solely on neurological deficit. Hydrocephalic and age-matched control animals were sacrificed 12 weeks postreservoir. WM integrity was evaluated in the optic system, corpus callosum, and internal capsule prereservoir and every 3 weeks using DTI. Analyses were grouped as acute (<6 weeks) or chronic (≥6 weeks). RESULTS In the corpus callosum during acute stages, fractional anisotropy (FA) decreased significantly with early and late reservoir placement (p = 0.0008 and 0.0008, respectively), and diffusivity increased significantly in early (axial, radial, and mean diffusivity, p = 0.0026, 0.0012, and 0.0002, respectively) and late (radial and mean diffusivity, p = 0.01 and 0.0038, respectively) groups. Chronically, the corpus callosum was thinned and not detectable by DTI. FA was significantly lower in the optic chiasm and tracts (p = 0.0496 and 0.0052, respectively) with late but not early reservoir placement. In the internal capsule, FA in both reservoir groups increased significantly with age (p < 0.05) but diffusivity remained unchanged. CONCLUSIONS All hydrocephalic animals treated with intermittent ventricular reservoir tapping demonstrated progressive ventriculomegaly. Both reservoir groups demonstrated WM integrity loss, with the CC the most vulnerable and the optic system the most resilient.
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Affiliation(s)
- Ramin Eskandari
- Stanford Children's Health, Lucile Packard Children's Hospital, 725 Welch Road, Palo Alto, CA, USA,
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35
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A crucial role for white matter alterations in interference control problems of very preterm children. Pediatr Res 2014; 75:731-7. [PMID: 24695275 DOI: 10.1038/pr.2014.31] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 11/22/2013] [Indexed: 01/15/2023]
Abstract
BACKGROUND Attention problems are among the most prominent behavioral deficits reported in very preterm children (below 32 wk of gestation) at school age. In this study, we aimed to elucidate the brain abnormalities underlying attention problems in very preterm children by investigating the role of abnormalities in white and gray brain matter during interference control, using functional magnetic resonance imaging (fMRI)-guided probabilistic diffusion tensor tractography. METHODS Twenty-nine very preterm children (mean (SD) age: 8.6 (0.3) y), and 47 term controls (mean (SD) age: 8.7 (0.5) y), performed a fMRI version of the Eriksen Flanker task measuring interference control. RESULTS Very preterm children showed slower reaction times than term controls when interfering stimuli were presented, indicating poorer interference control. Very preterm children and term controls did not differ in mean activation of the cortical regions involved in interference control. However, impaired fractional anisotropy (FA) was found in very preterm children in specifically those fiber tracts that innervate the cortical regions involved in interference control. Lower FA was related to poorer interference control in very preterm children. CONCLUSION White matter alterations have a crucial role in the interference control problems of very preterm children at school age.
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Vinall J, Miller SP, Bjornson BH, Fitzpatrick KP, Poskitt KJ, Brant R, Synnes AR, Cepeda IL, Grunau RE. Invasive procedures in preterm children: brain and cognitive development at school age. Pediatrics 2014; 133:412-21. [PMID: 24534406 PMCID: PMC3934331 DOI: 10.1542/peds.2013-1863] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Very preterm infants (born 24-32 weeks' gestation) undergo numerous invasive procedures during neonatal care. Repeated skin-breaking procedures in rodents cause neuronal cell death, and in human preterm neonates higher numbers of invasive procedures from birth to term-equivalent age are associated with abnormal brain development, even after controlling for other clinical risk factors. It is unknown whether higher numbers of invasive procedures are associated with long-term alterations in brain microstructure and cognitive outcome at school age in children born very preterm. METHODS Fifty children born very preterm underwent MRI and cognitive testing at median age 7.6 years (interquartile range, 7.5-7.7). T1- and T2-weighted images were assessed for the severity of brain injury. Magnetic resonance diffusion tensor sequences were used to measure fractional anisotropy (FA), an index of white matter (WM) maturation, from 7 anatomically defined WM regions. Child cognition was assessed using the Wechsler Intelligence Scale for Children-IV. Multivariate modeling was used to examine relationships between invasive procedures, brain microstructure, and cognition, adjusting for clinical confounders (eg, infection, ventilation, brain injury). RESULTS Greater numbers of invasive procedures were associated with lower FA values of the WM at age 7 years (P = .01). The interaction between the number of procedures and FA was associated with IQ (P = .02), such that greater numbers of invasive procedures and lower FA of the superior WM were related to lower IQ. CONCLUSIONS Invasive procedures during neonatal care contribute to long-term abnormalities in WM microstructure and lower IQ.
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Affiliation(s)
- Jillian Vinall
- Departments of Neuroscience,,Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Steven P. Miller
- Pediatrics,,Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | - Bruce H. Bjornson
- Pediatrics,,Developmental Neurosciences and Child Health, Child & Family Research Institute,,British Columbia Children’s and Women’s Hospitals, Vancouver, British Columbia, Canada
| | | | - Kenneth J. Poskitt
- Pediatrics,,Radiology, and,Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Rollin Brant
- Statistics, University of British Columbia, Vancouver, British Columbia, Canada;,Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Anne R. Synnes
- Pediatrics,,Developmental Neurosciences and Child Health, Child & Family Research Institute,,British Columbia Children’s and Women’s Hospitals, Vancouver, British Columbia, Canada
| | - Ivan L. Cepeda
- Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Ruth E. Grunau
- Departments of Neuroscience,,Pediatrics,,Developmental Neurosciences and Child Health, Child & Family Research Institute,,British Columbia Children’s and Women’s Hospitals, Vancouver, British Columbia, Canada;,School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland; and
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37
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Schmitz T, Krabbe G, Weikert G, Scheuer T, Matheus F, Wang Y, Mueller S, Kettenmann H, Matyash V, Bührer C, Endesfelder S. Minocycline protects the immature white matter against hyperoxia. Exp Neurol 2014; 254:153-65. [PMID: 24491957 DOI: 10.1016/j.expneurol.2014.01.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 12/21/2013] [Accepted: 01/23/2014] [Indexed: 01/06/2023]
Abstract
Poor neurological outcome in preterm infants is associated with periventricular white matter damage and hypomyelination, often caused by perinatal inflammation, hypoxia-ischemia, and hyperoxia. Minocycline has been demonstrated in animal models to protect the immature brain against inflammation and hypoxia-ischemia by microglial inhibition. Here we studied the effect of minocycline on white matter damage caused by hyperoxia. To mimic the 3- to 4-fold increase of oxygen tension caused by preterm birth, we have used the hyperoxia model in neonatal rats providing 24h exposure to 4-fold increased oxygen concentration (80% instead of 21% O2) from P6 to P7. We analyzed whether minocycline prevents activation of microglia and damage of oligodendroglial precursor cell development, and whether acute treatment of hyperoxia-exposed rats with minocycline improves long term white matter integrity. Minocycline administration during exposure to hyperoxia resulted in decreased apoptotic cell death and in improved proliferation and maturation of oligodendroglial precursor cells (OPC). Minocycline blocked changes in microglial morphology and IL-1β release induced by hyperoxia. In primary microglial cell cultures, minocycline inhibited cytokine release while in mono-cultures of OPCs, it improved survival and proliferation. Long term impairment of white matter diffusivity in MRI/DTI in P30 and P60 animals after neonatal hyperoxia was attenuated by minocycline. Minocycline protects white matter development against oxygen toxicity through direct protection of oligodendroglia and by microglial inhibition. This study moreover demonstrates long term benefits of minocycline on white matter integrity.
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Affiliation(s)
- Thomas Schmitz
- Department for Neonatology, Charité University Medical Center, Berlin, Germany.
| | - Grietje Krabbe
- Cellular Neuroscience, Max-Delbrück-Center for Molecular Medicine, Robert-Rössle-Straße 10, Berlin, Germany
| | - Georg Weikert
- Department for Neonatology, Charité University Medical Center, Berlin, Germany
| | - Till Scheuer
- Department for Neonatology, Charité University Medical Center, Berlin, Germany
| | - Friederike Matheus
- Department for Neonatology, Charité University Medical Center, Berlin, Germany
| | - Yan Wang
- Department for Neonatology, Charité University Medical Center, Berlin, Germany
| | - Susanne Mueller
- Berlin Center for Stroke Research, Charité University Medical Center, Berlin, Germany
| | - Helmut Kettenmann
- Cellular Neuroscience, Max-Delbrück-Center for Molecular Medicine, Robert-Rössle-Straße 10, Berlin, Germany
| | - Vitali Matyash
- Cellular Neuroscience, Max-Delbrück-Center for Molecular Medicine, Robert-Rössle-Straße 10, Berlin, Germany
| | - Christoph Bührer
- Department for Neonatology, Charité University Medical Center, Berlin, Germany
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Thompson DK, Lee KJ, Egan GF, Warfield SK, Doyle LW, Anderson PJ, Inder TE. Regional white matter microstructure in very preterm infants: predictors and 7 year outcomes. Cortex 2013; 52:60-74. [PMID: 24405815 DOI: 10.1016/j.cortex.2013.11.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 10/18/2013] [Accepted: 11/27/2013] [Indexed: 02/01/2023]
Abstract
The aims of this study were to investigate regional white matter microstructural differences between very preterm (VPT) (<30 weeks' gestational age and/or <1250 g) and full term (FT) (≥37 weeks' gestational age) infants at term corrected age with diffusion tensor imaging, and to explore perinatal predictors of diffusion measures, and the relationship between regional diffusion measures and neurodevelopmental outcomes at age 7 years in VPT children. Mean (MD) (p = .003), axial (AD) (p = .008), and radial diffusivity (RD) (p = .003) in total white matter were increased in VPT compared with FT infants, with similar fractional anisotropy (FA) in the two groups. There was little evidence that group-wise differences were specific to any of the 8 regions studied for each hemisphere. Perinatal white matter abnormality and intraventricular hemorrhage (grade III or IV) were associated with increased diffusivity in the white matter of VPT infants. Higher white matter diffusivity measures of the inferior occipital and cerebellar region at term-equivalent age were associated with increased risk of impairments in motor and executive function at 7 years in VPT children, but there was little evidence for associations with IQ or memory impairment. In conclusion, myelination is likely disrupted or delayed in VPT infants, especially those with perinatal brain abnormality (BA). Altered diffusivity at term-equivalent age helps explain impaired functioning at 7 years. This study defines the nature of microstructural alterations in VPT infant white matter, assists in understanding the associated risk factors, and is the first study to reveal an important link between inferior occipital and cerebellar white matter disorganization in infancy, and executive and motor functioning 7 years later.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Carlton, Vic, Australia.
| | - Katherine J Lee
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Carlton, Vic, Australia
| | - Gary F Egan
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Carlton, Vic, Australia; Monash Biomedical Imaging, Monash University, Clayton, Vic, Australia
| | - Simon K Warfield
- Department of Radiology, Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, The University of Melbourne, Carlton, Vic, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Carlton, Vic, Australia
| | - Terrie E Inder
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Pediatrics, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO, USA
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39
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Thompson DK, Thai D, Kelly CE, Leemans A, Tournier JD, Kean MJ, Lee KJ, Inder TE, Doyle LW, Anderson PJ, Hunt RW. Alterations in the optic radiations of very preterm children-Perinatal predictors and relationships with visual outcomes. NEUROIMAGE-CLINICAL 2013; 4:145-53. [PMID: 24371797 PMCID: PMC3871291 DOI: 10.1016/j.nicl.2013.11.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 11/01/2013] [Accepted: 11/20/2013] [Indexed: 12/13/2022]
Abstract
Children born very preterm (VPT) are at risk for visual impairments, the main risk factors being retinopathy of prematurity and cerebral white matter injury, however these only partially account for visual impairments in VPT children. This study aimed to compare optic radiation microstructure and volume between VPT and term-born children, and to investigate associations between 1) perinatal variables and optic radiations; 2) optic radiations and visual function in VPT children. We hypothesized that optic radiation microstructure would be altered in VPT children, predicted by neonatal cerebral white matter abnormality and retinopathy of prematurity, and associated with visual impairments. 142 VPT children and 32 controls underwent diffusion-weighted magnetic resonance imaging at 7 years of age. Optic radiations were delineated using constrained spherical deconvolution tractography. Tract volume and average diffusion tensor values for the whole optic radiations and three sub-regions were compared between the VPT and control groups, and correlated with perinatal variables and 7-year visual outcome data. Total tract volumes and average diffusion values were similar between VPT and control groups. On regional analysis of the optic radiation, mean and radial diffusivity were higher within the middle sub-regions in VPT compared with control children. Neonatal white matter abnormalities and retinopathy of prematurity were associated with optic radiation diffusion values. Lower fractional anisotropy in the anterior sub-regions was associated with poor visual acuity and increased likelihood of other visual defects. This study presents evidence for microstructural alterations in the optic radiations of VPT children, which are largely predicted by white matter abnormality or severe retinopathy of prematurity, and may partially explain the higher rate of visual impairments in VPT children. This study compares optic radiations between very preterm and control 7-year-olds. There are microstructural alterations in the optic radiations of VPT children. The main risk factors are retinopathy of prematurity and white matter injury. Microstructural alterations associate with poor visual acuity and visual defects. This study elucidates neuroanatomical correlates of visual impairment in prematurity.
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Key Words
- AD, Axial diffusivity
- BWSDS, Birth weight standard deviation score
- CI, Confidence interval
- CSD, Constrained spherical deconvolution
- Diffusion weighted imaging
- FA, Fractional anisotropy
- GA, Gestational age
- MD, Mean diffusivity
- MRI, Magnetic resonance imaging
- Magnetic resonance imaging
- Prematurity
- RD, Radial diffusivity
- ROP, Retinopathy of prematurity
- Tractography
- VPT, Very preterm
- Visual system
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Australia ; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Dolly Thai
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Claire E Kelly
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, The Netherlands
| | | | - Michael J Kean
- Department of Medical Imaging, Royal Children's Hospital, Melbourne, Australia
| | - Katherine J Lee
- Murdoch Childrens Research Institute, Melbourne, Australia ; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Terrie E Inder
- St. Louis Children's Hospital, Washington University in St. Louis, St. Louis, USA
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Melbourne, Australia ; Royal Women's Hospital, Melbourne, Australia ; Department of Obstetrics and Gynaecology, The University of Melbourne, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Melbourne, Australia ; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Rodney W Hunt
- Murdoch Childrens Research Institute, Melbourne, Australia ; Department of Paediatrics, The University of Melbourne, Melbourne, Australia ; Department of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia
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Pogribna U, Burson K, Lasky RE, Narayana PA, Evans PW, Parikh NA. Role of diffusion tensor imaging as an independent predictor of cognitive and language development in extremely low-birth-weight infants. AJNR Am J Neuroradiol 2013; 35:790-6. [PMID: 24052505 DOI: 10.3174/ajnr.a3725] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Diffusion tensor imaging at term can predict later development of cerebral palsy. Less is known about its ability to independently predict cognitive and language development in extremely preterm infants. The goals of the study were to investigate the following: 1) whether regional DTI measures at term-equivalent age in extremely low-birth-weight infants (birth weight, ≤1000 g) are predictive of Bayley III developmental scores at 18- to 22-months' corrected age, and 2) to compare white matter microstructural development at term and neurodevelopmental outcomes of extremely low-birth-weight infants with healthy term controls. MATERIALS AND METHODS Fractional anisotropy and mean diffusivity in 7 vulnerable cerebral regions were measured in 42 extremely low-birth-weight and 16 term infants with high-quality DTI scans. The Bayley mental scale score (average of cognitive and language scale scores) was the primary outcome of interest with individual scores serving as secondary outcomes. Multiple linear regression modeling was used to identify the incremental ability of DTI measures to predict Bayley scores over known predictors. RESULTS Compared with healthy term infants, extremely low-birth-weight infants exhibited significantly higher mean diffusivity and lower fractional anisotropy in 6 of 7 regions. At 18- to 22-months' corrected age, 39 extremely low-birth-weight infants (93%) and 14 term infants (88%) had undergone neurodevelopmental assessments. Although not statistically significant, extremely low-birth-weight infants averaged 7-9 points lower on Bayley subtests than term controls. In multivariable analyses, centrum semiovale mean diffusivity was a significant predictor of mental and language scale scores, and subventricular zone fractional anisotropy was a significant predictor of cognitive scale scores. A 10% increase in centrum semiovale mean diffusivity was associated with a 4.6 (95% CI, 1.6-7.6) point lower mental scale score (adjusted R(2) = 0.341, P = .001). CONCLUSIONS In our extremely low-birth-weight cohort, DTI was an independent predictor of later cognitive and language development.
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Affiliation(s)
- U Pogribna
- From the Division of Neonatology (U.P., K.B., R.E.L., P.W.E., N.A.P.)
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Pandit AS, Ball G, Edwards AD, Counsell SJ. Diffusion magnetic resonance imaging in preterm brain injury. Neuroradiology 2013; 55 Suppl 2:65-95. [PMID: 23942765 DOI: 10.1007/s00234-013-1242-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 07/09/2013] [Indexed: 01/01/2023]
Abstract
INTRODUCTION White matter injury and abnormal maturation are thought to be major contributors to the neurodevelopmental disabilities observed in children and adolescents who were born preterm. Early detection of abnormal white matter maturation is important in the design of preventive, protective, and rehabilitative strategies for the management of the preterm infant. Diffusion-weighted magnetic resonance imaging (d-MRI) has become a valuable tool in assessing white matter maturation and injury in survivors of preterm birth. In this review, we aim to (1) describe the basic concepts of d-MRI; (2) evaluate the methods that are currently used to analyse d-MRI; (3) discuss neuroimaging correlates of preterm brain injury observed at term corrected age; during infancy, adolescence and in early adulthood; and (4) explore the relationship between d-MRI measures and subsequent neurodevelopmental performance. METHODS References for this review were identified through searches of PubMed and Google Scholar before March 2013. RESULTS The impact of premature birth on cerebral white matter can be observed from term-equivalent age through to adulthood. Disruptions to white matter development, identified by d-MRI, are related to diminished performance in functional domains including motor performance, cognition and behaviour in early childhood and in later life. CONCLUSION d-MRI is an effective tool for investigating preterm white matter injury. With advances in image acquisition and analysis approaches, d-MRI has the potential to be a biomarker of subsequent outcome and to evaluate efficacy of clinical interventions in this population.
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Affiliation(s)
- Anand S Pandit
- Centre for the Developing Brain, Department of Perinatal Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College London, First Floor, South Wing, St Thomas' Hospital, London, UK
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Abstract
OBJECTIVE Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique that provides quantitative characterization of white matter tracts in the brain. This study used DTI to examine the degree of association between parent-rated scores of attention, internalizing behaviors including anxiety symptoms, and externalizing behaviors and white matter fractional anisotropy (FA) in children born preterm. METHODS Participants were aged 9 to 16 years; 25 were born at <36 weeks of gestation (mean = 28.6 wk, birth weight = 1191 g) and 20 were full term. The authors analyzed the results using Tract-Based Spatial Statistics, a technique that generates a skeleton representing the core of white matter tracts throughout the brain. The authors examined the correlations between behavior scores and FA of (1) the whole skeleton and (2) the specific regions of interest. RESULTS In preterm children, scores on attention and internalizing behavior scales were each associated with whole skeleton FA and several regions of interest; unfavorable scores were consistently associated with lower FA. Externalizing behaviors were not associated with whole skeleton FA, but significant associations were found within a few regions of interest. The network of significant regions for attention and internalizing symptoms was widely distributed and overlapping. In full-term children, no associations of FA and behavior were significant. CONCLUSIONS Attention and internalizing behaviors in preterm children were associated with FA in a widely distributed overlapping network of white matter tracts, suggesting common underlying neurobiology. DTI contributes to understanding individual differences in attention and behavior characteristics in children born preterm.
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Affiliation(s)
- Irene M Loe
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94304, USA.
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Feldman HM, Lee ES, Yeatman JD, Yeom KW. Language and reading skills in school-aged children and adolescents born preterm are associated with white matter properties on diffusion tensor imaging. Neuropsychologia 2012; 50:3348-62. [PMID: 23088817 DOI: 10.1016/j.neuropsychologia.2012.10.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 10/12/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
Abstract
Children born preterm are at risk for deficits in language and reading. They are also at risk for injury to the white matter of the brain. The goal of this study was to determine whether performance in language and reading skills would be associated with white matter properties in children born preterm and full-term. Children born before 36 weeks gestation (n=23, mean±SD age 12.5±2.0 years, gestational age 28.7±2.5 weeks, birth weight 1184±431 g) and controls born after 37 weeks gestation (n=19, 13.1±2.1 years, 39.3±1.0 weeks, 3178±413 g) underwent a battery of language and reading tests. Diffusion tensor imaging (DTI) scans were processed using tract-based spatial statistics to generate a core white matter skeleton that was anatomically comparable across participants. Fractional anisotropy (FA) was the diffusion property used in analyses. In the full-term group, no regions of the whole FA-skeleton were associated with language and reading. In the preterm group, regions of the FA-skeleton were significantly associated with verbal IQ, linguistic processing speed, syntactic comprehension, and decoding. Combined, the regions formed a composite map of 22 clusters on 15 tracts in both hemispheres and in the ventral and dorsal streams. ROI analyses in the preterm group found that several of these regions also showed positive associations with receptive vocabulary, verbal memory, and reading comprehension. Some of the same regions showed weak negative correlations within the full-term group. Exploratory multiple regression in the preterm group found that specific white matter pathways were related to different aspects of language processing and reading, accounting for 27-44% of the variance. The findings suggest that higher performance in language and reading in a group of preterm but not full-term children is associated with higher fractional anisotropy of a bilateral and distributed white matter network.
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Affiliation(s)
- Heidi M Feldman
- Department of Pediatrics, Stanford University School of Medicine, CA 94304, USA.
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