Published online February 1, 2008
PEDIATRICS Vol. 121 No. 2 February 2008, pp. 306-316 (doi:10.1542/peds.2007-0414)

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Constable, R. T. Articles by Reiss, A. R. Search for Related Content PubMed PubMed Citation Articles by Constable, R. T. Articles by Reiss, A. R. Related Collections Premature & Newborn Social Bookmarking                         What's this?

ARTICLE

Prematurely Born Children Demonstrate White Matter Microstructural Differences at 12 Years of Age, Relative to Term Control Subjects: An Investigation of Group and Gender Effects

R. Todd Constable, PhD^a, Laura R. Ment, MD^b,c, Betty R. Vohr, MD^d, Shelli R. Kesler, MD^e, Robert K. Fulbright, MD^a, Cheryl Lacadie, MD^a, Susan Delancy, MD^b, Karol H. Katz, MD^b,f, Karen C. Schneider, MD^b, Robin J. Schafer, MD^a, Robert W. Makuch, MD^f and Allan R. Reiss, MD^e

^a Departments of Diagnostic Imaging
^b Pediatrics
^c Neurology
^f Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
^d Department of Pediatrics, Brown Medical School, Providence, Rhode Island
^e Department of Psychiatry, Stanford University School of Medicine, Palo Alto, California

OBJECTIVE. The goal was to use diffusion tensor imaging to test the hypothesis that prematurely born children demonstrate long-term, white matter, microstructural differences, relative to term control subjects.

METHODS. Twenty-nine preterm subjects (birth weight: 600–1250 g) without neonatal brain injury and 22 matched, term, control subjects were evaluated at 12 years of age with MRI studies, including diffusion tensor imaging and volumetric imaging; voxel-based morphometric strategies were used to corroborate regional diffusion tensor imaging results. Subjects also underwent neurodevelopmental assessments.

RESULTS. Neurodevelopmental assessments showed significant differences in full-scale, verbal, and performance IQ and Developmental Test of Visual Motor Integration scores between the preterm and term control subjects. Diffusion tensor imaging studies demonstrated widespread decreases in fractional anisotropy (a measure of fiber tract organization) in the preterm children, compared with the control subjects. Regions included both intrahemispheric association fibers subserving language skills, namely, the right inferior frontooccipital fasciculus and anterior portions of the uncinate fasciculi bilaterally, and the deep white matter regions to which they project, as well as the splenium of the corpus callosum. These changes in fractional anisotropy occurred in subjects with significant differences in frontal, temporal, parietal, and deep white matter volumes. Fractional anisotropy values in the left anterior uncinate correlated with verbal IQ, full-scale IQ, and Peabody Picture Vocabulary Test-Revised scores for preterm male subjects. In addition, preterm male subjects were found to have the lowest values for fractional anisotropy in the right anterior uncinate fasciculus, and fractional anisotropy values in that region correlated with both verbal IQ and Peabody Picture Vocabulary Test-Revised scores for the preterm groups; these findings were supported by changes identified with voxel-based morphometric analyses.

CONCLUSIONS. Compared with term control subjects, prematurely born children with no neonatal ultrasound evidence of white matter injury manifest changes in neural connectivity at 12 years of age.

---

Key Words: diffusion tensor imaging • premature • language

Abbreviations: DTI—diffusion tensor imaging • FA—fractional anisotropy • ROI—region of interest • VBM—voxel-based morphometry • PPVT-R—Peabody Picture Vocabulary Test-Revised • VMI—Developmental Test of Visual Motor Integration • FSIQ—full-scale IQ • VIQ—verbal IQ

---

Accepted Jul 20, 2007.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				Z. Nagy, J. Ashburner, J. Andersson, S. Jbabdi, B. Draganski, S. Skare, B. Bohm, A.-C. Smedler, H. Forssberg, and H. Lagercrantz Structural Correlates of Preterm Birth in the Adolescent Brain Pediatrics, November 1, 2009; 124(5): e964 - e972. [Abstract] [Full Text] [PDF]

				J. D. Yeatman, M. Ben-Shachar, R. Bammer, and H. M. Feldman Using Diffusion Tensor Imaging and Fiber Tracking to Characterize Diffuse Perinatal White Matter Injury: A Case Report J Child Neurol, July 1, 2009; 24(7): 795 - 800. [Abstract] [PDF]

				C. C. Cloak, T. Ernst, L. Fujii, B. Hedemark, and L. Chang Lower diffusion in white matter of children with prenatal methamphetamine exposure Neurology, June 16, 2009; 72(24): 2068 - 2075. [Abstract] [Full Text] [PDF]

				L. R. Ment, S. Kesler, B. Vohr, K. H. Katz, H. Baumgartner, K. C. Schneider, S. Delancy, J. Silbereis, C. C. Duncan, R. T. Constable, et al. Longitudinal Brain Volume Changes in Preterm and Term Control Subjects During Late Childhood and Adolescence Pediatrics, February 1, 2009; 123(2): 503 - 511. [Abstract] [Full Text] [PDF]