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Proper timing for the evaluation of neonatal brain white matter development: a diffusion tensor imaging study.

Abstract：

OBJECTIVE:We aimed to determine the timing for assessing birth status of the developing brain (i.e. brain maturity at birth) by exploring the postnatal age-related changes in neonatal brain white matter (WM). METHODS:The institutional review board approved this study and all informed parental consents were obtained. 133 neonates (gestational age, 30-42 weeks) without abnormalities on MRI were studied with regard to WM development by diffusion tensor imaging-derived fractional anisotropy (FA). Tract-based spatial statistics (TBSS), locally-weighted scatterplot smoothing (LOESS) and piecewise linear-fitting were used to investigate the relationship between FA and postnatal age. FA along corticospinal tract (CST), optic radiation (OR), auditory radiation (AR) and thalamus-primary somatosensory cortex (thal-PSC) were extracted by automated fibre-tract quantification; their differences and associations with neonatal neurobehavioural scores at various postnatal age ranges were analysed by Wilcoxon's rank-sum test and Pearson's correlation. RESULTS:Using TBSS, postnatal age (days 1-28) positively correlated with FA in multiple WMs, including CST, OR, AR and thal-PSC (p<0.05). On the other hand, when narrowing the postnatal age window to days 1-14, no significant correlation was found, suggesting a biphasic WM development. LOESS and piecewise linear-fitting indicated that FA increased mildly before day 14 and its growth accelerated thereafter. Both FA and correlations with neurobehavioural scores in postnatal age range 2 (days 15-28) were significantly higher than in range 1 (days 1-14) (FA comparison: p<0.05; maximal correlation-coefficient: 0.693 vs. 0.169). CONCLUSION:Brain WM development during the neonatal stage includes two phases, i.e. a close-to-birth period within the first 14 days and a following accelerated maturation period. Therefore, evaluations of birth status should preferably be performed during the first period. KEY POINTS:• Brain white matter development within the first two postnatal weeks resembles a close-to-birth maturation. • Brain white matter development in the audio-visual, sensorimotor regions accelerates after two postnatal weeks. • Postnatal age-related effects should be considered in comparing preterm and term neonates.

journal_name

Eur Radiol

journal_title

European radiology

authors

Jin C,Li Y,Li X,Wang M,Liu C,Gao J,Sun Q,Qiu D,Zeng L,Zhou X,Li G,Zhang J,Zheng J,Yang J

doi

10.1007/s00330-018-5665-y

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

1527-1537

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-018-5665-y

journal_volume

pub_type

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Proper timing for the evaluation of neonatal brain white matter development: a diffusion tensor imaging study.