White Matter Abnormalities Are Related to Microstructural Changes in Preterm Neonates at Term-Equivalent Age: A Diffusion Tensor Imaging and Probabilistic Tractography Study

Liu, Y.; Aeby, Alec; Balériaux, Danielle; David, Philippe; Absil, Julie; Maertelaer, Viviane De; Bogaert, Patrick Van; Avni, Freddy; Metens, Thierry

doi:10.3174/ajnr.a2872

Cited by 25 publications

(45 citation statements)

References 44 publications

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“…The decrease in AD indicates a decrease in water diffusion parallel to white matter fibre tracts, suggesting that there is a breakdown of axon integrity within these ROIs (38). The reduction in RD, reflecting the degree of water diffusion perpendicular to white matter fibre tracts in anatomical brain structures, also suggests that myelin might be affected (38). This observation is consistent with a previous observation that LPS exposure decreased myelination in fetal sheep (39).…”

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging Colour Mapping Threshold for Identification of Ventilation-Induced Brain Injury after Intrauterine Inflammation in Preterm Lambs

et al. 2017

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PurposeThe aim of this study is to examine whether advanced magnetic resonance imaging (MRI) techniques can detect early brain injury caused by intrauterine inflammation and inappropriate initial respiratory support in preterm lambs.HypothesisNeuropathology caused by intrauterine inflammation is exacerbated by mechanical ventilation at birth and is detectable with advanced MRI techniques.MethodsPregnant ewes received intra-amniotic lipopolysaccharide (LPS) 7 days prior to delivery at ~125 days of gestation (85% of gestation), whereupon lambs were delivered and randomised to receive an injurious (LPS + INJ, n = 6) or protective (LPS + PROT, n = 6) ventilation strategy. MRI of the brain was conducted 90 min after preterm delivery, using structural, diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (MRS) techniques. A colour map threshold technique was utilised to compare distributions of low diffusivity voxels in the brains of LPS-exposed lambs with those not exposed to LPS (PROT, n = 7 PROT and INJ, n = 10).ResultsNo overt cerebral injury was identified on structural MRI images of any lamb. However, on DTI, axial diffusivity, radial diffusivity, and mean diffusivity values were lower and significantly more heterogeneous in specific brain regions of lambs in the LPS + INJ group compared to the LPS + PROT group. Colour mapping revealed lower diffusivity in the thalamus, periventricular white matter, internal capsule, and frontal white matter in the LPS + INJ group compared to LPS + PROT group. The MRS peak area ratios of lactate, relative to those for the metabolites creatine, choline, and N-acetylaspartate, were not different between LPS-exposed groups. Lambs exposed to LPS had lower diffusivity within the white matter regions assessed than non-LPS-treated control lambs.ConclusionDTI colour map threshold techniques detected early brain injury in preterm lambs exposed to intrauterine inflammation and detected differences between injurious and protective ventilation strategies. DTI mapping approaches are potentially useful for early detection of subtle brain injury in premature infants.

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Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging Colour Mapping Threshold for Identification of Ventilation-Induced Brain Injury after Intrauterine Inflammation in Preterm Lambs

et al. 2017

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“…Previous studies of preterm infants using diffusion tractography have investigated only a small number of tracts, namely the corticospinal tract [8]–[17], [49], the corpus callosum [13], [15]–[20], [50], thalamic radiations [11]–[13], [15], [21]–[25], and the superior longitudinal fasciculus [11]–[13], [15]. Studies of individual tracts, similar to traditional region of interest (ROI) analysis, require strong a priori hypotheses regarding affected tracts.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to providing metrics that may reflect ongoing brain maturation, diffusion MRI also offers a method for the delineation of white matter pathways in vivo with tractography. Diffusion tractography studies of the preterm infant brain have predominantly assessed the corticospinal tract [8]–[17], the corpus callosum [13]–[20], and the optic radiations [11]–[13], [15], [21]–[25]. Tractography can, however, also be used to study networks of connections (i.e.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Structural Connectivity in the Preterm Brain at Term Equivalent Age Using Diffusion MRI and T2 Relaxometry: A Network-Based Analysis

et al. 2013

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Preterm birth is associated with a high prevalence of adverse neurodevelopmental outcome. Non-invasive techniques which can probe the neural correlates underpinning these deficits are required. This can be achieved by measuring the structural network of connections within the preterm infant's brain using diffusion MRI and tractography. We used diffusion MRI and T2 relaxometry to identify connections with altered white matter properties in preterm infants compared to term infants. Diffusion and T2 data were obtained from 9 term neonates and 18 preterm-born infants (born <32 weeks gestational age) at term equivalent age. Probabilistic tractography incorporating multiple fibre orientations was used in combination with the Johns Hopkins neonatal brain atlas to calculate the structural network of connections. Connections of altered diffusivity or T2, as well as their relationship with gestational age at birth and postmenstrual age at the time of MRI, were identified using the network based statistic framework. A total of 433 connections were assessed. FA was significantly reduced in 17, and T2 significantly increased in 18 connections in preterm infants, following correction for multiple comparisons. Cortical networks associated with affected connections mainly involved left frontal and temporal cortical areas: regions which are associated with working memory, verbal comprehension and higher cognitive function – deficits which are often observed later in children and adults born preterm. Gestational age at birth correlated with T2, but not diffusion in several connections. We found no association between diffusion or T2 and postmenstrual age at the time of MRI in preterm infants. This study demonstrates that alterations in the structural network of connections can be identified in preterm infants at term equivalent age, and that incorporation of non-diffusion measures such as T2 in the connectome framework provides complementary information for the assessment of brain development.

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“…This has facilitated sensitive detection of microstructural white matter injury and aberrant brain development in extremely preterm infants, making DTI a powerful diagnostic tool and potential early imaging biomarker for cognitive and other neurodevelopmental impairments. 8–10, 11 There is emerging evidence that DTI can predict neurodevelopmental impairments in very low birth weight (≤ 1500 grams) infants. 12–15 However, studies in more immature extremely low birth weight (ELBW) (≤ 1000 grams) populations are lacking, and the incremental benefits of DTI over conventional MRI remain poorly defined.…”

Section: Introductionmentioning

confidence: 99%

Role of Diffusion Tensor Imaging as an Independent Predictor of Cognitive and Language Development in Extremely Low-Birth-Weight Infants

Pogribna¹,

Burson²,

Lasky³

et al. 2013

American Journal of Neuroradiology

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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 R2 = 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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White Matter Abnormalities Are Related to Microstructural Changes in Preterm Neonates at Term-Equivalent Age: A Diffusion Tensor Imaging and Probabilistic Tractography Study

Cited by 25 publications

References 44 publications

Diffusion Tensor Imaging Colour Mapping Threshold for Identification of Ventilation-Induced Brain Injury after Intrauterine Inflammation in Preterm Lambs

Diffusion Tensor Imaging Colour Mapping Threshold for Identification of Ventilation-Induced Brain Injury after Intrauterine Inflammation in Preterm Lambs

Assessment of Structural Connectivity in the Preterm Brain at Term Equivalent Age Using Diffusion MRI and T2 Relaxometry: A Network-Based Analysis

Role of Diffusion Tensor Imaging as an Independent Predictor of Cognitive and Language Development in Extremely Low-Birth-Weight Infants

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