Weihong Yuan1,2, Leanne Tamm3,2, Karen Harpster4,2, Mekibib Altaye5,2, Venkata Sita Priyanka Illapani6, Nehal A Parikh7,8,9. 1. Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 2. University of Cincinnati College of Medicine, Cincinnati, OH, USA. 3. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 4. Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 5. Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 6. Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 7. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Nehal.Parikh@cchmc.org. 8. Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Nehal.Parikh@cchmc.org. 9. University of Cincinnati College of Medicine, Cincinnati, OH, USA. Nehal.Parikh@cchmc.org.
Abstract
PURPOSE: Very preterm (VPT) infants are at high risk for motor and behavioral deficits. We investigated microstructural differences using diffusion tensor imaging (DTI) among VPT infants with different grades of intraventricular hemorrhage (IVH), their association with early motor function and temperament ratings, and the potential moderating effect of IVH severity on the above structure-function relations. METHODS: Fifty-seven VPT (≤32 weeks gestational age) infants with IVH (Low Grade (Papile grading I/II): 42; High Grade (III/IV): 15) were studied. DTI was acquired between 39 and 44 weeks postmenstrual age and was analyzed using the tract-based spatial statistics approach. Early motor function and temperament were assessed at 3-month corrected age based on the Hammersmith Infant Neurological Examination (HINE) and Infant Behavioral Questionnaire - Revised, Short Version (IBQ-R-S), respectively. RESULTS: Significantly lower fractional anisotropy and higher mean, axial, and/or radial diffusivity were found in VPT infants with High Grade IVH compared to Low Grade IVH (p < 0.05). Significant associations were found between DTI metrics and motor function in both IVH groups and between DTI and Fear temperament ratings in the High Grade IVH Group (all p < 0.05). IVH severity had a significant moderating effect on the relation between DTI and motor and Fear ratings (p < 0.05). CONCLUSION: DTI is a sensitive neuroimaging biomarker providing a refined understanding of the impact and location of differing severities of IVH on the developing white matter of VPT infants. Early motor and behavioral outcomes are associated with microstructural changes that are influenced by severity of IVH.
PURPOSE: Very preterm (VPT) infants are at high risk for motor and behavioral deficits. We investigated microstructural differences using diffusion tensor imaging (DTI) among VPT infants with different grades of intraventricular hemorrhage (IVH), their association with early motor function and temperament ratings, and the potential moderating effect of IVH severity on the above structure-function relations. METHODS: Fifty-seven VPT (≤32 weeks gestational age) infants with IVH (Low Grade (Papile grading I/II): 42; High Grade (III/IV): 15) were studied. DTI was acquired between 39 and 44 weeks postmenstrual age and was analyzed using the tract-based spatial statistics approach. Early motor function and temperament were assessed at 3-month corrected age based on the Hammersmith Infant Neurological Examination (HINE) and Infant Behavioral Questionnaire - Revised, Short Version (IBQ-R-S), respectively. RESULTS: Significantly lower fractional anisotropy and higher mean, axial, and/or radial diffusivity were found in VPT infants with High Grade IVH compared to Low Grade IVH (p < 0.05). Significant associations were found between DTI metrics and motor function in both IVH groups and between DTI and Fear temperament ratings in the High Grade IVH Group (all p < 0.05). IVH severity had a significant moderating effect on the relation between DTI and motor and Fear ratings (p < 0.05). CONCLUSION: DTI is a sensitive neuroimaging biomarker providing a refined understanding of the impact and location of differing severities of IVH on the developing white matter of VPT infants. Early motor and behavioral outcomes are associated with microstructural changes that are influenced by severity of IVH.
Entities:
Keywords:
DTI; Intraventricular hemorrhage severity; Motor; Temperament; Very preterm
Authors: Julia M Young; Marlee M Vandewouw; Benjamin R Morgan; Mary Lou Smith; John G Sled; Margot J Taylor Journal: Brain Struct Funct Date: 2018-01-29 Impact factor: 3.270