Abnormalities In Preterm Infants Research Articles

Biventricular function in preterm infants with patent ductus arteriosus ligation: A three-dimensional echocardiographic study

BackgroundThe detailed hemodynamics after patent ductus arteriosus (PDA) ligation in preterm infants remain unknown. We aimed to clarify the effect of surgical ligation on left ventricular (LV) and right ventricular (RV) volume and function.MethodsEchocardiography was performed in 41 preterm infants (median gestational age: 25 weeks) before and after PDA ligation. Global longitudinal strain was determined using three-dimensional speckle-tracking echocardiography. These values were compared with those in 36 preterm infants without PDA (non-PDA).ResultsPreoperatively, the PDA group had greater end-diastolic volume (EDV) and cardiac output (CO) in both ventricles, a higher LV ejection fraction (LVEF) (53% vs 44%) and LV global longitudinal strain, and a lower RVEF (47% vs 52%) than the non-PDA group. At 4–8 h postoperatively, the two groups had a similar LVEDV and RVEDV. However, the PDA group had a lower EF and CO in both ventricles than the non-PDA group. At 24–48 h postoperatively, the RVEF was increased, but the LVEF remained decreased, and LVCO was increased.ConclusionsPDA induces biventricular loading and functional abnormalities in preterm infants, and they dramatically change after surgery. Three-dimensional echocardiography may be beneficial to understand the status of both ventricles.ImpactPreterm infants are at high risk of hemodynamic compromise following a sudden change in loading conditions after PDA ligation.Three-dimensional echocardiography enables quantitative and serial evaluation of ventricular function and volume in preterm infants with PDA.PDA induces biventricular loading and functional abnormalities in preterm infants, and they dramatically change after surgery.

Assessment of brain structure and volume reveals neurodevelopmental abnormalities in preterm infants with low-grade intraventricular hemorrhage

There is increasing evidence of abnormal neurodevelopmental outcomes in preterm infants with low-grade intraventricular hemorrhage (IVH). The purpose of the study was to explore whether brain microstructure and volume are associated with neuro-behavioral outcomes at 40 weeks corrected gestational age in preterm infants with low-grade IVH. MR imaging at term-equivalent age (TEA) was performed in 25 preterm infants with mild IVH (Papile grading I/II) and 40 control subjects without IVH. These subjects all had neonatal behavioral neurological assessment (NBNA) at 40 weeks’ corrected age. Microstructure and volume evaluation of the brain were performed by using diffusion kurtosis imaging (DKI) and Synthetic MRI. Correlations among microstructure parameters, volume, and developmental outcomes were explored by using Spearman's correlation. In preterm infants with low-grade IVH, the volume of brain parenchymal fraction (BPF) was reduced. In addition, mean kurtosis (MK), fractional anisotropy (FA), radial kurtosis (RK), axial kurtosis (AK) in several major brain regions were reduced, while mean diffusivity (MD) was increased (P < 0.05). BPF, RK in the cerebellum, MK in the genu of the corpus callosum, and MK in the thalamus of preterm infants with low-grade IVH were associated with lower NBNA scores (r = 0.831, 0.836, 0.728, 0.772, P < 0.05). DKI and Synthetic MRI can quantitatively evaluate the microstructure alterations and brain volumes in preterm infants with low-grade IVH, which provides clinicians with a more comprehensive and accurate neurobehavioral assessment of preterm infants with low-grade IVH.

The Spectrum of clinical manifestations in newborns with the COQ4 mutation: case series and literature review.

Coenzyme Q10 (CoQ10) plays an important role in the electron transport chain within the human mitochondrial respiratory chain. The manifestations of this deficiency exhibit a diverse range. This study investigates the clinical manifestations of primary coenzyme Q10 deficiency in neonates with the COQ4 mutation to improve the diagnosis of the disease and the prognosis through targeted treatment. We report 4 patients with primary coenzyme Q10 deficiency by COQ4 variants in neonates. A comprehensive literature search and review for original articles and case reports with COQ4 mutation published from January 1989 to November 2023 was performed through Pubmed. We review clinical manifestations, diagnostic approaches, and treatment monitoring in these and 20 previously reported patients. Within the cohort of four cases examined, three females and one male were identified from two distinct families. Specifically, case 1 and 2 consisted of monoamniotic twins. Cases 3 and 4 were siblings. A comprehensive review of 20 cases involving neonatal-onset COQ4 mutation was conducted. Half of the cases are Chinese. There was no statistically significant difference in the mortality between Chinese (9/12, 75%) and other regions (11/12, 91.7%) (P = 0.27). The survival time for the 24 cases was 60.0 ± 98.0 days (95% confidence interval CI: 0-252.0 days). The incidence of prenatal abnormalities in preterm infants was significantly higher than that in full-term infants (66.7% vs. 16.7%, P = 0.02). Hyperlactatemia was one of the most common manifestations, accounting for 75% of cases (18/24). Twenty of the 24 cases were diagnosed by whole exome sequencing. Only 9 patients received exogenous coenzyme Q10 treatment, and all the 4 surviving patients received coenzyme Q10 supplementation. The prognosis of COQ4 mutation in the neonatal period indicates a low survival rate and an poor prognosis. This may be due to the incomplete understanding of the mechanism of how COQ4 gene defects lead to coenzyme Q10 deficiency and why CoQ10 supplementation does not respond well to treatment. To improve the diagnostic rate, in addition to genetic testing, mitochondrial functional verification should be prioritized in southern China, where the incidence is relatively high. It will facilitate more in-depth mechanistic studies.

Enriched environment rescues neonatal pain induced cognitive deficits and the impaired hippocampal synaptic plasticity later in life.

Although extensive and untreated pain that occurs during a critical developmental window may impair cognition later in life, environmental interventions early in life might promote cognition. However, the underlying mechanism is poorly understood. Our current study utilized a rat model of "repetitive needle pricks" from the day of birth (P0) to postnatal day 7 (P7) to mimic the painful experience of preterm neonates in the neonatal intensive care unit. Enriched environment (EE) during development period (from P15 to P70) was implemented as a nonpharmacological intervention approach. Electrophysiological recording, behavioral tests, and biochemical analysis were performed after the end of EE (between P71 and P80). The results showed neonatal repetitive pain resulted in a reduction in mechanical withdrawal thresholds by the von Frey test in P70 (p&lt;.001). Furthermore, neonatal repetitive pain impaired spatial learning and memory (p&lt;.05) and even led to dysfunction in fear memory (p&lt;.01). In contrast, EE rescued neonatal pain-induced cognitive deficits and normalized hippocampal long-term potentiation in rats exposed to neonatal pain (p &lt;&lt;.05). The beneficial effect of EE might be the improvements in hippocampal synaptic plasticity via upregulating neurotrophic factors and N-methyl-d-aspartate (NMDA) receptors in the hippocampus. Our findings provide evidence that early environmental intervention might be a safe strategy to overcome neurodevelopmental abnormalities in preterm infants who experienced multiple procedural painful events during the early critical period.

Anomalies oculaires des enfants nés prématurément à l’Hôpital gynéco-obstétrique et pédiatrique de Yaoundé

To identify ocular abnormalities in premature children in order to treat reversible visual disorders and help prevent low vision and blindness in this population at risk. This was a cross-sectional, analytical study carried out from November 1, 2018 to July 31, 2019 at the Yaoundé Gyneco-Obstetric And Pediatric Hospital, including premature children, aged 3 to 15 years. The variables studied were age, sex, prenatal, birth and past ophthalmological history, visual acuity, oculomotor examination and fundus examination. For statistical analysis, we used the epi-info software 3.5.4, the Chi2 test, odds ratio and a 95% confidence interval with a significance P<0.05. Of the 50 patients examined, the mean age was 6.02 years±2.58. Of the 22 optically corrected patients, hyperopia and hyperopic astigmatism were predominant (70.5%) (n=31). Distance visual acuity, measured in 31 cooperative patients (62 eyes), was between 3/10 and 8/10 in 14 eyes (22.6%), and<3/10 in two eyes (3.2%). Strabismus was present in 21 patients (42%), of which 13 cases were esotropia (61.9%). Tropical endemic limbo-conjunctivitis was found in eight eyes (8%). There were no cases of retinopathy of prematurity. Very low birth weight (<1500g) and neonatal resuscitation were associated with strabismus. Ocular abnormalities in preterm infants are dominated by strabismus, which is associated with very low birth weight and neonatal resuscitation.

Assessment of Thoracic Abnormalities in Premature Infants

Background: There is a large incidence of congenital thoracic abnormalities that manifest as deformities and or defects of anterior chest walls. Thoracic abnormalities in preterm infants may also be associated with malpositioning in the incubator in the presence of respiratory disease and prolonged mechanical ventilation. Immaturity of respiratory and musculoskeletal system need to compromise biomechanical function of thorax. Thus, the purpose of the study is to access the thoracic alteration and the factors associated with its abnormalities in the infants born prematurely.&#x0D; Objective: Assess thoracic alteration in premature infants. &#x0D; Methods: This was an observational study with infants in first year of age, born prematurely with birth weight &lt; 2000g. Exclusion criteria were: major congenital malformations as defined by the centers for disease contol and prevention, grade III/IV intraventricular hemorrhage or preventricular leucomalacia. Physical examinations were performed independently to assess shoulder elevation and thoracic alterations.&#x0D; Results: 34 infants born prematurely were included for the study according to the inclusion criteria from which 20 infants (58.8%) showed thoracic abnormalities and remaining 14 infants (41.1%) were without abnormalities.&#x0D; Conclusion: The prevalence of thoracic abnormalities was high in infants born prematurely, and was associated with pulmonary disease, and may also have compromised the growth rate of these infants during the first year of life.

Magnetic Resonance Imaging Findings in Preterm Infants With Bilirubin Encephalopathy Beyond Three Years Corrected Age

BackgroundMagnetic resonance imaging (MRI) abnormalities in preterm infants with bilirubin encephalopathy (BE) become less clear as the infants age. We assessed MRI findings in children with preterm BE older than 36 months corrected age (CA). MethodsIn a previous questionnaire survey, hospitals were asked to provide head MRI data of patients older than 36 months CA. MRI findings were reviewed by three pediatric neurology specialists and classified as no abnormalities, partial globus pallidus (GP) lesions, or diffuse GP lesions. ResultsIn total, 33 MRI scans were available from 28 patients. The median gestational age and birth weight were 26 weeks and 824 g, respectively. The prevalence of MRI abnormalities was 100% in patients at 37 to 48 months CA, 71% in those at 49 to 60 months CA, 50% in those at 61 to 72 months CA, 67% in those at 73 to 84 months CA, and 38% in those at 85 months CA or older. Partial GP lesions were more common than diffuse GP lesions at all ages. No significant differences in sex, gestational age, birth weight, or gross motor function impairment were observed among lesion groups. ConclusionsGP lesions were detected on MRI in most children with preterm BE when studied after 36 months CA, although MRI abnormalities became less apparent along with age. Partial GP lesions may be a characteristic of older children with preterm BE.

Auditory brainstem response in preterm infants with bilirubin encephalopathy

AimTo clarify auditory brainstem response (ABR) in preterm infants with bilirubin encephalopathy and the relationships between ABR and clinical variables. MethodWe retrospectively reviewed the ABR waveforms of 56 preterm infants with BE and graded them as “no response”, “abnormal interwave separation”, or “normal”. Patient backgrounds, the peak total bilirubin level, the bilirubin/albumin ratio, verbal communication ability, and newborn hearing screening test results from an automated ABR evaluation had been collected during an earlier nationwide survey. ResultsThe frequency of abnormal ABR findings decreased with age. Verbal communication tended to be poorer in patients with more severe ABR abnormalities. ABR findings improved in 7 of 29 infants with available serial ABR data. Both gestational age and the peak total bilirubin level were relatively lower in patients with than in those without improved ABR findings. Newborn hearing screening using automated ABR evaluation yielded data consistent with manual ABR findings in 16 of 20 patients who underwent both examinations. ConclusionsABR abnormalities in preterm infants with bilirubin encephalopathy may improve over time, especially in those with a lower gestational age and peak total bilirubin level. Newborn hearing screening using automated ABR may fail to detect abnormalities in some infants.

Perinatal factors associated with amplitude‐integrated electroencephalography abnormalities in preterm infants on the first day of life

ObjectiveEvaluate the association between perinatal factors and amplitude‐integrated electroencephalogram abnormalities in preterm infants on the first day of life. MethodsThis was a cross‐sectional study of 60 infants with gestational age between 23 and 32 weeks, without malformations. Infants were continuously monitored by amplitude‐integrated electroencephalogram on the first day of life, for at least 3h. The tracings were recorded and analyzed in each column for the following: burst‐suppression pattern, sleep‐wake cycle, and amplitude of the lower margin (<3μV or <5μV). The association of maternal complications, mode of delivery, birth weight, gestational age, neonatal sex, resuscitation procedures, hypothermia on admission, and the Score for Neonatal Acute Physiology, Perinatal Extension, Version II [SNAPPE‐II]) with amplitude‐integrated electroencephalogram alterations was assessed by multiple logistic regression. ResultsA discontinuous pattern occurred in 65% of infants, and a continuous pattern occurred in 23%. The burst‐suppression pattern was associated with vaginal delivery (OR: 7.6; 95% CI: 1.1–53.1) and SNAPPE‐II≥40 (OR: 13.1; 95% CI: 1.8–95.1). A lower margin of the amplitude‐integrated electroencephalogram of <3μV was also associated with SNAPPE‐II≥40 (OR: 10.6, 95% CI: 2.3–49.2), while a value <5μV was associated with lower GA (OR: 0.51, 95% CI: 0.34–0.76). There were no associations between the perinatal variables and the absence of a sleep‐wake cycle in amplitude‐integrated electroencephalogram recordings on the first day of life. ConclusionBiological variables and clinical severity are associated with electroencephalographic characteristics of preterm infants on the first day of life and should be considered in clinical practice when amplitude‐integrated electroencephalogram is performed.

High Dose Indomethacin for Patent Ductus Arteriosus Closure Increases Neonatal Morbidity.

Symptomatic patent ductus arteriosus (sPDA) is the most common heart abnormality in preterm infants. Optimal duration and dose of medical treatment is still unclear. We assessed undesired effects and closure rate of high-dose indomethacin (HDI) for pharmacological closure of sPDA. Retrospective single center analysis of 248 preterm infants born between January 2006 and December 2015 with a birth weight <2,000 g and sPDA which was treated with indomethacin. Patients were treated with either standard dose indomethacin (SDI; n = 196) or HDI (n = 52). Undesired effects and PDA closure were compared between patients treated with SDI and HDI. In univariate analysis, patients receiving HDI had a significant increase in gastrointestinal hemorrhage (32.7 vs.11.7%, p = 0.001), bronchopulmonary dysplasia (BPD) (77.8 vs. 55.1%, p = 0.003), and retinopathy of prematurity (13.5 vs. 2.6%, p = 0.004). Moreover, HDI patients needed longer mechanical ventilation (2.5 vs. 1.0 days, p = 0.01). Multivariate analyses indicated that necrotizing enterocolitis (17 vs. 7%, p = 0.01) and BPD (79 vs. 55%, p = 0.02) were more frequent in HDI patients. PDA closure rate was 79.0% with HDI versus 65.3% with SDI. HDI used for PDA closure is associated with an increase in necrotizing enterocolitis and BPD. Risks of HDI should be balanced against other treatment options.

Perinatal factors associated with amplitude-integrated electroencephalography abnormalities in preterm infants on the first day of life

ObjectiveEvaluate the association between perinatal factors and amplitude-integrated electroencephalogram abnormalities in preterm infants on the first day of life. MethodsThis was a cross-sectional study of 60 infants with gestational age between 23 and 32 weeks, without malformations. Infants were continuously monitored by amplitude-integrated electroencephalogram on the first day of life, for at least 3h. The tracings were recorded and analyzed in each column for the following: burst-suppression pattern, sleep-wake cycle, and amplitude of the lower margin (<3μV or <5μV). The association of maternal complications, mode of delivery, birth weight, gestational age, neonatal sex, resuscitation procedures, hypothermia on admission, and the Score for Neonatal Acute Physiology, Perinatal Extension, Version II [SNAPPE-II]) with amplitude-integrated electroencephalogram alterations was assessed by multiple logistic regression. ResultsA discontinuous pattern occurred in 65% of infants, and a continuous pattern occurred in 23%. The burst-suppression pattern was associated with vaginal delivery (OR: 7.6; 95% CI: 1.1–53.1) and SNAPPE-II≥40 (OR: 13.1; 95% CI: 1.8–95.1). A lower margin of the amplitude-integrated electroencephalogram of <3μV was also associated with SNAPPE-II≥40 (OR: 10.6, 95% CI: 2.3–49.2), while a value <5μV was associated with lower GA (OR: 0.51, 95% CI: 0.34–0.76). There were no associations between the perinatal variables and the absence of a sleep-wake cycle in amplitude-integrated electroencephalogram recordings on the first day of life. ConclusionBiological variables and clinical severity are associated with electroencephalographic characteristics of preterm infants on the first day of life and should be considered in clinical practice when amplitude-integrated electroencephalogram is performed.

Objective and Automated Detection of Diffuse White Matter Abnormality in Preterm Infants Using Deep Convolutional Neural Networks.

Diffuse white matter abnormality (DWMA), or diffuse excessive high signal intensity is observed in 50–80% of very preterm infants at term-equivalent age. It is subjectively defined as higher than normal signal intensity in periventricular and subcortical white matter in comparison to normal unmyelinated white matter on T2-weighted MRI images. Despite the well-documented presence of DWMA, it remains debatable whether DWMA represents pathological tissue injury or a transient developmental phenomenon. Manual tracing of DWMA exhibits poor reliability and reproducibility and unduly increases image processing time. Thus, objective and ideally automatic assessment is critical to accurately elucidate the biologic nature of DWMA. We propose a deep learning approach to automatically identify DWMA regions on T2-weighted MRI images. Specifically, we formulated DWMA detection as an image voxel classification task; that is, the voxels on T2-weighted images are treated as samples and exclusively assigned as DWMA or normal white matter voxel classes. To utilize the spatial information of individual voxels, small image patches centered on the given voxels are retrieved. A deep convolutional neural networks (CNN) model was developed to differentiate DWMA and normal voxels. We tested our deep CNN in multiple validation experiments. First, we examined DWMA detection accuracy of our CNN model using computer simulations. This was followed by in vivo assessments in a cohort of very preterm infants (N = 95) using cross-validation and holdout validation. Finally, we tested our approach on an independent preterm cohort (N = 28) to externally validate our model. Our deep CNN model achieved Dice similarity index values ranging from 0.85 to 0.99 for DWMA detection in the aforementioned validation experiments. Our proposed deep CNN model exhibited significantly better performance than other popular machine learning models. We present an objective and automated approach for accurately identifying DWMA that may facilitate the clinical diagnosis of DWMA in very preterm infants.

Preterm birth disrupts cerebellar development by affecting granule cell proliferation program and Bergmann glia

Preterm birth is a leading cause of long-term motor and cognitive deficits. Clinical studies suggest that some of these deficits result from disruption of cerebellar development, but the mechanisms that mediate cerebellar abnormalities in preterm infants are largely unknown. Furthermore, it remains unclear whether preterm birth and precocious exposure to the ex-utero environment directly disrupt cerebellar development or indirectly by increasing the probability of cerebellar injury, including that resulting from clinical interventions and protocols associated with the care of preterm infants. In this study, we analyzed the cerebellum of preterm pigs delivered via c-section at 91% term and raised for 10 days, until term-equivalent age. The pigs did not receive any treatments known or suspected to affect cerebellar development and had no evidence of brain damage. Term pigs sacrificed at birth were used as controls. Immunohistochemical analysis revealed that preterm birth did not affect either size or numbers of Purkinje cells or molecular layer interneurons at term-equivalent age. The number of granule cell precursors and Bergmann glial fibers, however, were reduced in preterm pigs. Preterm pigs had reduced proliferation but not differentiation of granule cells. qRT-PCR analysis of laser capture microdissected external granule cell layer showed that preterm pigs had a reduced expression of Ccnd1 (Cyclin D1), Ccnb1 (Cyclin B1), granule cell master regulatory transcription factor Atoh1, and signaling molecule Jag1. In vitro rescue experiments identified Jag1 as a central granule cell gene affected by preterm birth. Thus, preterm birth and precocious exposure to the ex-utero environment disrupt cerebellum by modulating expression of key cerebellar developmental genes, predominantly affecting development of granule precursors and Bergmann glia.

Cranial Sonography in Preterm Infants with Short Review of Literature.

Background:Premature newborn infants are exposed to a wide spectrum of brain lesions which are clinically silent supporting a possible role of cerebral ultrasound screening. Aim of the study is to describe the pattern of cranial ultrasound abnormalities in preterm infants defining the short term and long term neurologic outcomes.Material and Methods:A hospital-based bedside cranial ultrasound was carried out at day 1, 3, 7 and follow-up scan at 3-6 months in the Department of Radio-diagnosis.Results:One hundred infants were included. The different abnormalities detected in cranial ultrasound of premature newborn infants include hydrocephalus in 12%, intracranial hemorrhage in 6%, brain edema in 6%, periventricular leukomalacia in 2%, choroid plexus cyst in 1%, intraventricular septa in 1% and colocephaly in 1%.Conclusion:Gestational age, newborn birth weight and neurologic symptoms were the most important risk factors for detecting brain lesions. The main purpose of cranial ultrasound was the demonstration or exclusion of an intracranial hemorrhage in a preterm neonate.

Cranial ultrasound in detection of neurological lesions in preterm neonates in a tertiary center in North Kerala, India

Background: Incomplete formation and maturation of the central nervous system makes it extremely vulnerable to injury, in the case of premature neonates. This can result in a broad range of neurodevelopmental abnormalities. Cranial ultrasound is a sensitive tool for the early detection of these. Hence the present study was undertaken to assess the prevalence of neurosonological abnormality in preterm infants. The aims of the study were to identify and enumerate the neurosonographic features, to assess the severity of brain injuries by grading the neurosonographic findings and to correlate the clinical presentations with the neurosonographic findings.Methods: The present study was conducted in Department of Radiodiagnosis, Pariyaram Medical College. It consisted of all preterm neonates (less than 37 weeks of gestational age) referred to the Radiology department. The initial scan will be done as soon as possible (within 2 weeks of birth) followed by a repeat scan of the same infants at 36 weeks of corrected age, and at 8weeks post-partum.Results: A total of 100 neonates with gestational age varying from 29 to 37 weeks were studied, with the birth weight varying from 1.5 to 1.9 kg. The most common abnormality found on neurosonogram was germinal-matrix haemorrhage, followed by periventricular leukomalacia.Conclusions: Real time sonography is a sensitive non-invasive initial investigation for the detection of various brain lesions in the preterm neonates.

Cerebral ultrasound abnormalities in preterm infants caused by late-onset sepsis.

IntroductionThis study describes cerebral ultrasound abnormalities caused by late-onset sepsis (LOS) in very preterm infants with a gestational age of < 32 weeks and/or birthweight < 1500 grams.MethodsThe prospective study (“INFANT study”) included 117 preterm infants with suspected LOS. Proven LOS was defined as a positive blood culture after 72 hours of life. In case of coagulase-negative staphylococci an elevated C-reactive protein was additionally required to establish proven LOS. Patients were identified as proven LOS and patients with only clinical symptoms of LOS. Cerebral ultrasound images were obtained in the first week after birth, during/after LOS and before discharge. Cerebral findings were divided in no/minor and major abnormalities.ResultsEighty-six preterm infants had proven LOS and 31 preterm infants had only clinical signs of LOS. Four infants were excluded because pre-existing major brain abnormalities. No significant differences (p = 0.624) for incidence of major brain abnormalities on cerebral ultrasound were found.ConclusionNo differences were revealed in prevalence of major brain abnormalities between the groups with proven LOS and with clinical signs of LOS. Both infants with a gram negative sepsis developed major brain abnormalities, whereas only two of 66 preterm infants coagulase-negative staphylococci sepsis developed major brain abnormalities.

Correlating early motor skills to white matter abnormalities in preterm infants using diffusion tensor imaging.

Diffusion tensor imaging (DTI) can detect injury to specific white matter (WM) tracts involved with sensorimotor processing and may provide sensitive measures for latent or nascent motor skills. We hypothesized that DTI measures of WM fractional anisotropy (FA) could predict early motor scores on a standardized assessment in a cohort of preterm infants at risk for WM injury. In this prospective study, preterm infants (n= 26, 11 female, 15 male, mean gestational age 29.1 ± 2.5) underwent the Test of Infant Motor Performance (TIMP) at term and at 12 weeks corrected age (CA) and underwent an non-sedated magnetic resonance imaging (MRI) with DTI at a mean of 42 ± 1.5 weeks CA. Fractional anisotropy (FA) was measured by Voxelwise statistical analysis using Tract-Based Spatial Statistics (TBSS) in the specific regions of interest. Significant differences were found between infants with poor versus average performance on motor assessments at 12-weeks and FA values in several left hemispheric WM tracts (p< 0.05). High FA of the left anterior limb of the internal capsule (ALIC) predicted mean increase in TIMP scores on specific items for head lift in prone and head lift turn to sound (p= 0.045 and p= 0.002). Subtle WM injury, as indicated by low FA in left WM tracts, can predict outcomes of early motor skills performance testing at 3 months. Early DTI may identify infants with silent WM injury who need early intervention. Further studies may establish if individual tract FA improve after targeted treatment.

Correlating Early Motor Skills to White Matter Abnormalities in Preterm Infants

Abstract Date Presented 4/8/2016 Neuroimaging of specific white matter (WM) tracts can predict early motor skills in a cohort of preterm infants. Several WM tracts indicate that connectivity of the frontal cortex, the occipital visual cortex, the temporal lobe, and thalamus are important to early motor skill development. Primary Author and Speaker: Patty Coker-Bolt Additional Authors and Speaker: Emma Humphries, Andrew Barbour, Dorothea Jenkins, Jordan Tillman, Emily Ward

OP74 – 2880: Biometry of the corpus callosum assessed by 3D ultrasound in very low birth weight infants and its correlation to neurodevelopmental outcome

Objective One of the most common brain abnormalities in preterm infants is thinning of the corpus calloisum (CC). Such injury may be partly explained by the vulnerability of the developing CC to hypoxic-ischemic damage and hemorrhage due to intrinsic vulnerability of immature oligodendrocytes. The CC is among the last structures to be completed during postnatal maturation. Several studies have shown a relation between the size of CC and motor outcome in preterm infants. Three-dimensional ultrasound (3D-US) offers new perspectives in cerebral imaging. Methods 43 preterm infants with a gestational age Results By 3D US reference values for size, length, circumference and surface area of the CC at all different timepoints could be established. The data examined at corrected term age showed a significant correlation of corpus size of CC and visual motor integration (p=0.04) and of circumference and surface area of CC and simultanous processing scale (p=0.01) and mental processing composite (p=0.04) of K-ABC. A trend was seen for the correlation of surface area oft the CC and achievement scale of the K-ABC (p=0.08) and visual perception assessed by VMI (p=0.08). Conclusion Biometry of the CC in preterm infants can sufficiently be done by 3D US. Especially surface area of the CC at corrected term age correlates with later neurodevelopmental outcome.

Diffusion tensor imaging for understanding brain development in early life.

The human brain rapidly develops during the final weeks of gestation and in the first two years following birth. Diffusion tensor imaging (DTI) is a unique in vivo imaging technique that allows three-dimensional visualization of the white matter anatomy in the brain. It has been considered to be a valuable tool for studying brain development in early life. In this review, we first introduce the DTI technique. We then review DTI findings on white matter development at the fetal stage and in infancy as well as DTI applications for understanding neurocognitive development and brain abnormalities in preterm infants. Finally, we discuss limitations of DTI and potential valuable imaging techniques for studying white matter myelination.