H G Moss1,2, L G Wolf3, P Coker-Bolt4, V Ramakrishnan5, T Aljuhani4,5, M Yazdani6, T R Brown2,6, J H Jensen7,2,6, D D Jenkins2,3. 1. From the Department of Neuroscience (H.G.M., J.H.J.) mossh@musc.edu. 2. Center for Biomedical Imaging (H.G.M., T.R.B., J.H.J., D.D.J.). 3. Department of Pediatrics (L.G.W., D.D.J.). 4. Division of Occupational Therapy (P.C.-B., T.A.), College of Health Sciences. 5. Division of Public Health Sciences (V.R., T.A.). 6. Department of Radiology and Radiological Science (M.Y., T.R.B., J.H.J.), Medical University of South Carolina, Charleston, South Carolina. 7. From the Department of Neuroscience (H.G.M., J.H.J.).
Abstract
BACKGROUND AND PURPOSE: Preterm infants are at risk for overt and silent CNS injury, with developmental consequences that are difficult to predict. The novel Specific Test of Early Infant Motor Performance, administered in preterm infants at term age, is indicative of later developmental gross motor and cognitive scores at 12 months. Here, we assessed whether functional performance on this early assessment correlates with CNS integrity via MR spectroscopy or diffusional kurtosis imaging and whether these quantitative neuroimaging methods improve predictions for future 12-month developmental scores. MATERIALS AND METHODS: MR spectroscopy and quantitative diffusion MR imaging data were acquired in preterm infants (n = 16) at term. Testing was performed at term and 3 months using the Specific Test of Early Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, Third Edition, at 12 months. We modeled the relationship of MR spectroscopy and diffusion MR imaging data with both test scores via multiple linear regression. RESULTS: MR spectroscopy NAA ratios at a TE of 270 ms in the frontal WM and basal ganglia and kurtosis metrics in major WM tracts correlated strongly with total Specific Test of Early Infant Motor Performance scores. The addition of MR spectroscopy and diffusion separately improved the functional predictions of 12-month outcomes. CONCLUSIONS: Microstructural integrity of the major WM tracts and metabolism in the basal ganglia and frontal WM strongly correlate with early developmental performance, suggesting that the Specific Test of Early Infant Motor Performance reflects CNS integrity after preterm birth. This study demonstrates that combining quantitative neuroimaging and early functional movement improves the prediction of 12-month outcomes in premature infants.
BACKGROUND AND PURPOSE: Preterm infants are at risk for overt and silent CNS injury, with developmental consequences that are difficult to predict. The novel Specific Test of Early Infant Motor Performance, administered in preterm infants at term age, is indicative of later developmental gross motor and cognitive scores at 12 months. Here, we assessed whether functional performance on this early assessment correlates with CNS integrity via MR spectroscopy or diffusional kurtosis imaging and whether these quantitative neuroimaging methods improve predictions for future 12-month developmental scores. MATERIALS AND METHODS: MR spectroscopy and quantitative diffusion MR imaging data were acquired in preterm infants (n = 16) at term. Testing was performed at term and 3 months using the Specific Test of Early Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, Third Edition, at 12 months. We modeled the relationship of MR spectroscopy and diffusion MR imaging data with both test scores via multiple linear regression. RESULTS: MR spectroscopy NAA ratios at a TE of 270 ms in the frontal WM and basal ganglia and kurtosis metrics in major WM tracts correlated strongly with total Specific Test of Early Infant Motor Performance scores. The addition of MR spectroscopy and diffusion separately improved the functional predictions of 12-month outcomes. CONCLUSIONS: Microstructural integrity of the major WM tracts and metabolism in the basal ganglia and frontal WM strongly correlate with early developmental performance, suggesting that the Specific Test of Early Infant Motor Performance reflects CNS integrity after preterm birth. This study demonstrates that combining quantitative neuroimaging and early functional movement improves the prediction of 12-month outcomes in premature infants.
Authors: Iona Novak; Cathy Morgan; Lars Adde; James Blackman; Roslyn N Boyd; Janice Brunstrom-Hernandez; Giovanni Cioni; Diane Damiano; Johanna Darrah; Ann-Christin Eliasson; Linda S de Vries; Christa Einspieler; Michael Fahey; Darcy Fehlings; Donna M Ferriero; Linda Fetters; Simona Fiori; Hans Forssberg; Andrew M Gordon; Susan Greaves; Andrea Guzzetta; Mijna Hadders-Algra; Regina Harbourne; Angelina Kakooza-Mwesige; Petra Karlsson; Lena Krumlinde-Sundholm; Beatrice Latal; Alison Loughran-Fowlds; Nathalie Maitre; Sarah McIntyre; Garey Noritz; Lindsay Pennington; Domenico M Romeo; Roberta Shepherd; Alicia J Spittle; Marelle Thornton; Jane Valentine; Karen Walker; Robert White; Nadia Badawi Journal: JAMA Pediatr Date: 2017-09-01 Impact factor: 16.193
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