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Published in: European Radiology 3/2019

01-03-2019 | Paediatric

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

Authors: Chao Jin, Yanyan Li, Xianjun Li, Miaomiao Wang, Congcong Liu, Jie Gao, Qinli Sun, Deqiang Qiu, Lingxia Zeng, Xihui Zhou, Gailian Li, Jinni Zhang, Jie Zheng, Jian Yang

Published in: European Radiology | Issue 3/2019

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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.
Appendix
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Metadata
Title
Proper timing for the evaluation of neonatal brain white matter development: a diffusion tensor imaging study
Authors
Chao Jin
Yanyan Li
Xianjun Li
Miaomiao Wang
Congcong Liu
Jie Gao
Qinli Sun
Deqiang Qiu
Lingxia Zeng
Xihui Zhou
Gailian Li
Jinni Zhang
Jie Zheng
Jian Yang
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5665-y

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