Microstructural Maturation of the Splenium of Corpus Callosum and Cognitive and Motor Outcome in Very Preterm Infants.

Neonatology Pub Date : 2025-02-03 DOI:10.1159/000543328
Ira Winkler, Anna Posod, Elke Ruth Gizewski, Stephanie Mangesius, Vera Neubauer, Ulrike Pupp Peglow, Ursula Kiechl-Kohlendorfer, Elke Griesmaier
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Abstract

Introduction: Common brain injuries of preterm infants do not entirely explain the incidence of neurodevelopmental impairment observed in this population. Evidence suggests an association with microstructural maturation of the splenium of corpus callosum. This study aimed to investigate a correlation between microstructural maturation of the splenium of corpus callosum and neurodevelopmental outcome in very preterm infants.

Method: In a cohort study of 373 very preterm infants, we used fractional anisotropy (FA) and apparent diffusion coefficient (ADC) derived from diffusion tensor imaging at term equivalent age (TEA) to quantitatively reflect microstructural maturation of the splenium of corpus callosum, and standardized follow-up assessments of cognitive and motor function at 24 months corrected age and 5 years chronological age. Correlation was tested by Spearman's rank correlation coefficients and multivariate regression analysis.

Results: At 24 months, we found significantly lower FA and higher ADC values in infants with abnormal mental indices, psychomotor developmental indices, and fine motor function. Scores of all three correlated positively with FA and negatively with ADC. Aged 5 years, lower FA values correlated significantly with abnormal overall motor function, and higher ADC values correlated significantly with abnormal full-scale intelligence quotient (FSIQ) and overall motor function. Scores of FSIQ, overall, and fine motor function correlated negatively with ADC.

Conclusion: The results emphasize an association between microstructural maturation of the splenium of corpus callosum at TEA and neurodevelopmental outcome, and suggest that ADC may be more strongly linked to these outcomes than FA, especially in the long-term.

极早产儿胼胝体脾的微观结构成熟与认知和运动结果。
前言:常见的早产儿脑损伤并不能完全解释在这一人群中观察到的神经发育障碍的发生率。证据表明与胼胝体脾的微观结构成熟有关。本研究旨在探讨极早产儿胼胝体脾微结构成熟与神经发育结局的关系。方法:在一项对373名极早产儿的队列研究中,我们使用足月等效年龄(TEA)弥散张量成像得出的分数各向异性(FA)和表观扩散系数(ADC)来定量反映胼胝体脾的微观结构成熟度,并在24个月矫正年龄和5岁实足年龄时对认知和运动功能进行标准化随访评估。采用Spearman秩相关系数和多元回归分析进行相关性检验。结果:在24个月时,我们发现心理指数、精神运动发育指数和精细运动功能异常的婴儿FA值明显降低,ADC值明显升高。三者的得分与FA呈正相关,与ADC呈负相关。5岁时,FA值较低与整体运动功能异常显著相关,ADC值较高与全量表智商(FSIQ)和整体运动功能异常显著相关。FSIQ评分、整体评分和精细运动功能评分与ADC呈负相关。结论:研究结果强调了TEA时胼胝体脾微结构成熟与神经发育结局之间的关联,并且表明ADC可能比FA与这些结局的关联更强,尤其是在长期内。
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