Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Division of Pediatric Orthopaedics, Stanford University School of Medicine, Stanford, CA, USA.
Neuroimage Clin. 2020;28:102446. doi: 10.1016/j.nicl.2020.102446. Epub 2020 Sep 29.
To determine whether variability in diffusion MRI (dMRI) white matter tract metrics, obtained in a cohort of preterm infants prior to neonatal hospital discharge, would be associated with language outcomes at age 2 years, after consideration of age at scan and number of major neonatal complications.
30 children, gestational age 28.9 (2.4) weeks, underwent dMRI at mean post menstrual age 36.4 (1.4) weeks and language assessment with the Bayley Scales of Infant Development-III at mean age 22.2 (1.7) months chronological age. Mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated for 5 white matter tracts. Hierarchical linear regression assessed associations between tract FA, moderating variables, and language outcomes.
FA of the left inferior longitudinal fasciculus accounted for 17% (p = 0.03) of the variance in composite language and FA of the posterior corpus callosum accounted for 19% (p = 0.02) of the variance in composite language, beyond that accounted for by post-menstrual age at scan and neonatal medical complications. The number of neonatal medical complications moderated the relationship between language and posterior corpus callosum FA but did not moderate the association in the other tract.
Language at age 2 is associated with white matter metrics in early infancy in preterm children. The different pattern of associations by fiber group may relate to the stage of brain maturation and/or the nature and timing of medical complications related to preterm birth. Future studies should replicate these findings with a larger sample size to assure reliability of the findings.
在考虑扫描时的年龄和主要新生儿并发症的数量后，确定早产儿队列在新生儿出院前获得的弥散磁共振成像（dMRI）白质束指标的变异性是否与 2 岁时的语言结果相关。
30 名胎龄为 28.9（2.4）周的婴儿，在平均孕龄 36.4（1.4）周时进行 dMRI 检查，并在平均年龄 22.2（1.7）个月时进行贝利婴幼儿发展量表-III 语言评估。计算了 5 条白质束的平均各向异性分数（FA）和平均弥散度（MD）。分层线性回归评估了束 FA、调节变量和语言结果之间的关联。
左侧下纵束的 FA 占复合语言方差的 17%（p=0.03），后胼胝体的 FA 占复合语言方差的 19%（p=0.02），超出了扫描时的孕龄和新生儿医疗并发症所解释的范围。新生儿医疗并发症的数量调节了语言和后胼胝体 FA 之间的关系，但没有调节其他束的关联。
2 岁时的语言与早产儿早期的白质指标有关。纤维束之间的关联模式不同可能与大脑成熟的阶段和/或与早产相关的医学并发症的性质和时间有关。未来的研究应该用更大的样本量复制这些发现，以确保结果的可靠性。
