Punctate White Matter Abnormality in Moderate-to-Late Preterm Infants.

IF 8.1 1区医学 Q1 CLINICAL NEUROLOGY

Annals of Neurology Pub Date : 2025-06-09 DOI:10.1002/ana.27261

Eleanor Kennedy, Ting Guo, Sian Williams, Thiviya Selvanathan, Jane M Alsweiler, Frank H Bloomfield, Malcolm Battin, David Dubowitz, Steven P Miller, Catherine Morgan, David Perry, Ngaire Susan Stott, Jane E Harding

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引用次数: 0

Abstract

Objective: Moderate-to-late preterm (MLP) infants contribute to the greatest proportion of preterm children with neurodevelopmental impairments. White matter injury (WMI) is common and predicts adverse outcomes in very preterm (VP) infants. However, little is known about white matter abnormality (WMA) in MLP infants. We investigated the burden and distribution of WMA in MLP infants.

Methods: MLP infants were recruited from a randomized trial on neonatal nutrition and a prospective observational cohort in New Zealand, and underwent brain magnetic resonance imaging (MRI) soon after birth and at term-equivalent age (TEA). WMA was manually segmented using an established method. Total and regional WMA volumes and percentage of WMA to total cerebral volume were calculated. Probabilistic WMA maps were generated and compared with WMI in VP infants and term infants with congenital heart disease.

Results: Of 101 infants (32 females), 40 (39.6%) had WMA on at least 1 scan. In 37 infants with WMA who had both scans, WMA was less visible in 22 (59.5%) or undetectable in 7 (18.9%) infants with a mean reduction of 72.7 ± 207.5 mm³ in WMA volume from early-life to term. Infants with and without WMA had mostly comparable pregnancy and neonatal characteristics. Probabilistic maps demonstrated a characteristic WMA topology, with most lesions in posterior followed by central and anterior regions. Trigonal areas were vulnerable across neonatal populations.

Interpretation: WMA is much more common in MLP infants than previously reported and occurs in a characteristic topology. WMA may be missed on TEA MRI, and its relationship with outcomes in MLP infants warrants attention. ANN NEUROL 2025.

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中晚期早产儿点状白质异常。

目的：中度至晚期早产儿（MLP）在早产儿神经发育障碍中所占比例最大。白质损伤（WMI）是非常早产（VP）婴儿常见的和预测不良后果。然而，对MLP婴儿的白质异常（WMA）知之甚少。我们调查了MLP婴儿WMA的负担和分布。方法：从新西兰的新生儿营养随机试验和前瞻性观察队列中招募MLP婴儿，并在出生后不久和足月等效年龄（TEA）接受脑磁共振成像（MRI）检查。采用既定方法对WMA进行手工分割。计算WMA总体积和局部体积以及WMA占总脑体积的百分比。生成WMA概率图，并与VP婴儿和先天性心脏病足月婴儿的WMI进行比较。结果：101例婴儿（32例女性）中，40例（39.6%）在至少一次扫描中出现WMA。在37名同时进行两次扫描的WMA婴儿中，22名（59.5%）婴儿的WMA不明显，7名（18.9%）婴儿的WMA体积从生命早期到足月平均减少72.7±207.5 mm3。有WMA和没有WMA的婴儿大多具有相似的妊娠和新生儿特征。概率图显示了典型的WMA拓扑结构，大多数病变位于后部，其次是中央和前部区域。在新生儿群体中，三角区域是脆弱的。解释：WMA在MLP婴儿中比以前报道的更常见，并且发生在一个特征拓扑结构中。TEA MRI可能会遗漏WMA，其与MLP婴儿预后的关系值得关注。Ann neurol 2025。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Neurology 医学-临床神经学

CiteScore

18.00

自引率

1.80%

发文量

270

审稿时长

3-8 weeks

期刊介绍： Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.