Objective:

Extremely preterm children are at high risk for adverse neurodevelopmental outcomes. Identifying predictors of discrete developmental outcomes early in life would allow for targeted neuroprotective therapies when neuroplasticity is at its peak. Our goal was to examine whether diffusion magnetic resonance imaging (MRI) metrics of the inferior longitudinal and uncinate fasciculi early in life could predict later cognitive and language outcomes.

Study Design:

In this pilot study, 43 extremely low-birth-weight preterm infants were scanned using diffusion MRI at term-equivalent age. White matter tracts were assessed via diffusion tensor imaging metrics of fractional anisotropy and mean diffusivity. The Language and Cognitive subscale scores of the Bayley Scales of Infant & Toddler Development-III at 18-22 months corrected age were our outcomes of interest. Multiple linear regression models were created to assess diffusion metrics of the inferior longitudinal and uncinate fasciculi as predictors of Bayley scores. We controlled for brain injury score on structural MRI, maternal education, birth weight, and age at MRI scan.

Results:

Of the 43 infants, 36 infants had high-quality diffusion tensor imaging and returned for developmental testing. The fractional anisotropy of the inferior longitudinal fasciculus was associated with Bayley-III scores in univariate analyses and was an independent predictor of Bayley-III cognitive and language development over and above known predictors in multivariable analyses.

Conclusions:

Incorporating new biomarkers such as the fractional anisotropy of the inferior longitudinal fasciculus with structural MRI findings could enhance accuracy of neurodevelopment predictive models. Additional research is needed to validate our findings in a larger cohort.

中文翻译：

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下纵束的微观结构测量可预测出生体重极低的婴儿后期的认知和语言发展

客观的：

极早产儿出现不良神经发育结果的风险很高。在生命早期确定离散发育结果的预测因子将有助于在神经可塑性达到顶峰时进行有针对性的神经保护治疗。我们的目标是检查生命早期下纵束和钩束的扩散磁共振成像（MRI）指标是否可以预测以后的认知和语言结果。

学习规划：

在这项试点研究中，43 名出生体重极低的早产儿在足月当量年龄使用扩散 MRI 进行了扫描。通过分数各向异性和平均扩散率的扩散张量成像指标来评估白质束。我们感兴趣的结果是 18-22 个月校正年龄时贝利婴幼儿发展量表 III 的语言和认知分量表分数。创建多元线性回归模型来评估下纵束和钩束的扩散指标作为贝利评分的预测因子。我们控制了结构 MRI 的脑损伤评分、母亲教育程度、出生体重和 MRI 扫描年龄。

结果：

在 43 名婴儿中，有 36 名婴儿进行了高质量弥散张量成像并返回进行发育测试。在单变量分析中，下纵束的分数各向异性与 Bayley-III 评分相关，并且是多变量分析中超过已知预测因素的 Bayley-III 认知和语言发展的独立预测因素。

结论：

将下纵束分数各向异性等新生物标志物与结构 MRI 结果相结合，可以提高神经发育预测模型的准确性。需要进行更多研究来在更大的队列中验证我们的发现。