Regional Brain Biometrics at Term-Equivalent Age and Developmental Outcome in Extremely Low-Birth-Weight Infants

Melbourne, Launice; Murnick, Jonathan; Chang, Taeun; Glass, Penny; Massaro, An N.

doi:10.1055/s-0035-1552936

Cited by 10 publications

(4 citation statements)

References 24 publications

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“…The large proportion of the population exceeding this cut-off value limits the utility BPW as a predictor for adverse outcome. Additionally, results for BPW are inconsistent [5,7,19]. Contrary to the aforementioned study, Melbourne et al [19] did not observe any association between BPW and developmental outcome in a small cohort of very preterm infants, including also those with brain injury.…”

Section: Discussionmentioning

confidence: 85%

“…Additionally, results for BPW are inconsistent [5,7,19]. Contrary to the aforementioned study, Melbourne et al [19] did not observe any association between BPW and developmental outcome in a small cohort of very preterm infants, including also those with brain injury. Dewan et al [7] recently stated that a small BPW is not a risk factor for neurodevelopmental impairment in a cohort of very preterm infants without high-grade injury.…”

Section: Discussionmentioning

confidence: 85%

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Supratentorial Brain Metrics Predict Neurodevelopmental Outcome in Very Preterm Infants without Brain Injury at Age 2 Years

et al. 2020

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Introduction: Very preterm infants are at risk for adverse neurodevelopmental outcome. To better identify children without brain injury at risk for developmental sequelae, we assessed predictive values of supratentorial brain metrics in relation to outcome. Methods: Very preterm infants underwent magnetic resonance imaging (MRI) at term-equivalent age. Infants with any grade of supra-or infratentorial brain injury according to Kidokoro et al. [Pediatrics 2014; 134:e444-53] were excluded. Supratentorial brain metrics (biparietal width, extracerebral space, interhemispheric distance) were measured and categorised using existing cutoff values. The Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) were assessed using the Bayley Scales of Infant Development, second and third edition, at 2 years of age. Developmental delay was defined as a score < 85. Positive and negative predictive values for developmental delay were calculated. Results: A total of 237 very preterm infants were enrolled. Of all infants, 59 (21.2%) showed developmental delay. Infants with z-scores less than-0.5 for biparietal width had significantly lower PDI (p = 0.039) and MDI (p = 0.042) than infants with normal z-scores. Enlargement of extracerebral spaces was also related to lower PDI (p = 0.047) and MDI (p = 0.036). Negative predictive value was highest when all brain metrics were within the normal range (PDI < 85: 96.6%, MDI < 85: 90.0%). Combining the biparietal width and the interhemispheric distance showed highest positive predictive values for developmental delay (MDI or PDI < 85: 58.3%). Discussion: Supratentorial brain metrics are predictive for neurodevelopmental outcome in infants with ostensibly normal MRI. A combination of supratentorial brain metrics is most meaningful for identifying infants at risk for long-term sequelae.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 85%

Supratentorial Brain Metrics Predict Neurodevelopmental Outcome in Very Preterm Infants without Brain Injury at Age 2 Years

et al. 2020

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“…17 At TEA, transcerebellar diameter was associated with fidgety general movements at 3-month corrected age (CA), 18 poorer cognitive outcomes at 12-month CA, 19 and poorer motor and cognitive outcomes at 2-year CA. 20 Reduced deep gray matter area at TEA was associated with poorer motor and cognitive outcomes, 19 and an increased interhemispheric distance independently predicted poorer cognitive development at 2-year CA. 3 Reduced biparietal width at TEA predicted both motor and cognitive outcomes at 2-year CA in infants born very preterm.…”

mentioning

confidence: 99%

Validation of an MRI Brain Injury and Growth Scoring System in Very Preterm Infants Scanned at 29- to 35-Week Postmenstrual Age

George¹,

Fiori

Fripp

et al. 2017

AJNR Am J Neuroradiol

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“…Some authors found that preterm born infants have a higher prevalence of head shape abnormalities such as elongated head shape (dolichocephaly) [48]. Additionally, regional biometric differences reflecting impaired cerebellar size or deviating head diameters were reported in children [49] and adults [28] born preterm and may be associated with cognitive and motor outcomes [49].…”

Section: Discussionmentioning

confidence: 99%

Automated quantitative evaluation of brain MRI may be more accurate for discriminating preterm born adults

et al. 2019

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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 birthweight (VP/VLBW) adults. Methods: We analyzed 3T MRIs acquired 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 white matter, deep grey matter and cortical grey 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 grey 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), 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 grey 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.

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Regional Brain Biometrics at Term-Equivalent Age and Developmental Outcome in Extremely Low-Birth-Weight Infants

Abstract: TE-MRI biometrics reflecting impaired deep gray matter, callosal, and cerebellar size is associated with worse early childhood cognitive and motor outcomes. DGMA may be the most robust single biometric measure to predict adverse developmental outcome in preterm survivors.

Cited by 10 publications

References 24 publications

Supratentorial Brain Metrics Predict Neurodevelopmental Outcome in Very Preterm Infants without Brain Injury at Age 2 Years

Supratentorial Brain Metrics Predict Neurodevelopmental Outcome in Very Preterm Infants without Brain Injury at Age 2 Years

Validation of an MRI Brain Injury and Growth Scoring System in Very Preterm Infants Scanned at 29- to 35-Week Postmenstrual Age

Automated quantitative evaluation of brain MRI may be more accurate for discriminating preterm born adults

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