Abstract
Background and PurposeIndividuals born very preterm (before 33 weeks of gestation, VPT) are at risk of damage to developing white matter, which may affect later cognition and behaviour.MethodsWe used diffusion tensor MRI (DT-MRI) to assess white matter microstructure (fractional anisotropy; FA) in 80 VPT and 41 term-born individuals (mean age 19.1 years, range 17–22, and 18.5 years, range17–22 years, respectively). VPT individuals were part of a 1982–1984 birth cohort which had been followed up since birth; term individuals were recruited by local press advertisement. General intellectual function, executive function and memory were assessed.ResultsThe VPT group had reduced FA in four clusters, and increased FA in four clusters relative to the Term group, involving several association tracts of both hemispheres. Clusters of increased FA were associated with more severe neonatal brain injury in the VPT group. Clusters of reduced FA were associated with lower birth weight and perinatal hypoxia, and with reduced adult cognitive performance in the VPT group only.ConclusionsAlterations of white matter microstructure persist into adulthood in VPT individuals and are associated with cognitive function.
Highlights
Preterm birth is associated with a range of adverse outcomes, including impaired cognitive function and academic underperformance [1,2,3]
The principle Diffusion tensor magnetic resonance imaging (DT-MRI) measure is fractional anisotropy (FA), which describes the degree to which water diffusion is constrained in a certain direction [15], and is likely to be sensitive to both the alignment of white matter fibres and their structural integrity, including the degree of myelination [16,17,18]
Characteristics of the Study Groups DT-MRI data were successfully acquired on 87 VPT and 49
Summary
Preterm birth is associated with a range of adverse outcomes, including impaired cognitive function and academic underperformance [1,2,3] These sequelae have been attributed to perinatal brain injury [4], when this involves white matter [5,6,7,8,9,10,11]. DT-MRI studies indicate that white matter microstructure is altered in preterm neonates [24,25,26] and children [21] and in very-low-birth-weight adolescents [29,30] and is associated with neurocognitive outcome [27,28,29,30]. Individuals born very preterm (before 33 weeks of gestation, VPT) are at risk of damage to developing white matter, which may affect later cognition and behaviour
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