Post-hemorrhagic ventricular dilatation affects white matter maturation in extremely preterm infants,Pediatric Research

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Post-hemorrhagic ventricular dilatation affects white matter maturation in extremely preterm infants
Pediatric Research ( IF 3.1 ) Pub Date : 2021-08-26 , DOI: 10.1038/s41390-021-01704-2
Astrid Nieuwets _{1,

2} , Mehmet N Cizmeci _{1,

2,

3} , Floris Groenendaal _{1,

2} , Lara M Leijser _{1,

2,

4} , Corine Koopman _{1,

2} , Manon J N L Benders _{1,

2} , Jeroen Dudink _{1,

2} , Linda S de Vries _{1,

2} , Niek E van der Aa _{1,

2}

Affiliation

Background

Data on microstructural white matter integrity in preterm infants with post-hemorrhagic ventricular dilatation (PHVD) using diffusion tensor imaging (DTI) are limited. Also, to date, no study has focused on the DTI changes in extremely preterm (EP) infants with PHVD.

Methods

A case–control study of EP infants <28 weeks’ gestation with PHVD was conducted. Diffusivity and fractional anisotropy (FA) values of corticospinal tracts (CST) and corpus callosum (CC) were measured using DTI at term-equivalent age. Outcomes were assessed at 2-years-corrected age.

Results

Twenty-one infants with PHVD and 21 matched-controls were assessed. FA values in the CC were lower in infants with PHVD compared with controls (mean difference, 0.05 [95% confidence interval (CI), 0.02–0.08], p < 0.001). In infants with periventricular hemorrhagic infarction, FA values in the CC were lower than in controls (mean difference, 0.05 [95% CI, 0.02–0.09], p = 0.005). The composite cognitive and motor scores were associated with the FA value of the CC (coefficient 114, p = 0.01 and coefficient 147, p = 0.004; respectively).

Conclusions

Extremely preterm infants with PHVD showed lower FA values in CC. A positive correlation was also shown between the composite cognitive and motor scores and FA value of the CC at 2-years-corrected age.

Impact

Extremely preterm infants with post-hemorrhagic ventricular dilatation showed lower fractional anisotropy values in their corpus callosum compared with controls reflecting the impaired microstructure of these commissural nerve fibers that are adjacent to the dilated ventricles.
Impaired microstructure of the corpus callosum was shown to be associated with cognitive and motor scores at 2-years-corrected age.

中文翻译：

极早产儿出血后脑室扩张影响白质成熟

背景

使用弥散张量成像 (DTI) 的出血后脑室扩张 (PHVD) 早产儿的显微结构白质完整性数据有限。此外，迄今为止，还没有研究关注患有 PHVD 的极早产 (EP) 婴儿的 DTI 变化。

方法

对小于 28 周妊娠的 EP 婴儿与 PHVD 进行了病例对照研究。使用 DTI 在足月等效年龄测量皮质脊髓束 (CST) 和胼胝体 (CC) 的扩散率和分数各向异性 (FA) 值。结果在 2 岁矫正年龄时进行评估。

结果

评估了 21 名患有 PHVD 的婴儿和 21 名匹配的对照。与对照组相比，PHVD 婴儿 CC 中的 FA 值较低（平均差，0.05 [95% 置信区间 (CI)，0.02-0.08]，p < 0.001）。在患有脑室周围出血性梗死的婴儿中，CC 的 FA 值低于对照组（平均差，0.05 [95% CI，0.02-0.09]，p = 0.005）。综合认知和运动评分与 CC 的 FA 值相关（系数 114，p = 0.01 和系数 147，p = 0.004；分别）。