The effects of mild germinal matrix-intraventricular haemorrhage on the developmental white matter microstructure of preterm neonates

a DTI study

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: To evaluate white matter (WM) microstructural changes in preterm neonates (PN) with mild germinal matrix-intraventricular haemorrhage (mGMH-IVH) (grades I and II) and no other associated MRI abnormalities, and correlate them with gestational age (GA) and neurodevelopmental outcome. Methods: Tract-based spatial-statistics (TBSS) was performed on DTI of 103 patients studied at term-equivalent age, to compare diffusional parameters (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)) between mGMH-IVH neonates (24/103) and controls matched by GA at birth and sex. The relationship between DTI abnormalities, GA and neurodevelopmental outcome assessed with Griffiths’ Developmental Scale-Revised:0-2 was explored using TBSS and Spearman-correlation analysis (p <.05). Results: Affected neonates had lower FA, higher RD and MD of the corpus callosum, limbic pathways and cerebellar tracts. Extremely preterm neonates (GA < 29 weeks) presented more severe microstructural impairment (higher RD and MD) in periventricular regions. Neonates of GA ≥ 29 weeks had milder WM alterations (lower FA), also in subcortical WM. DTI abnormalities were associated with poorer locomotor, eye-hand coordination and performance outcomes at 24 months. Conclusions: WM microstructural changes occur in PN with mGMH-IVH with a GA-dependent selective vulnerability of WM regions, and correlate with adverse neurodevelopmental outcome at 24 months. Key Points: • DTI-TBSS analysis identifies WM microstructural changes in preterm neonates with mGMH-IVH. • Extremely preterm neonates with mGMH-IVH presented more severe impairment of WM microstructure. • Extremely preterm neonates with mGMH-IVH presented microstructural impairment of periventricular WM. • mGMH-IVH affects subcortical WM in preterm neonates with gestational age ≥ 29 weeks. • WM microstructural alterations are related to neurodevelopmental impairments at 24 months.

Original languageEnglish
Pages (from-to)1157-1166
Number of pages10
JournalEuropean Radiology
Volume28
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

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Newborn Infant
Hemorrhage
Gestational Age
Anisotropy
White Matter
Spatial Analysis
Corpus Callosum
Hand
Parturition

Keywords

  • Diffusion tensor imaging
  • Haemorrhage
  • Newborn
  • Premature
  • White matter

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{157120f5bf6f46f59a377a56d0bfa16e,
title = "The effects of mild germinal matrix-intraventricular haemorrhage on the developmental white matter microstructure of preterm neonates: a DTI study",
abstract = "Objectives: To evaluate white matter (WM) microstructural changes in preterm neonates (PN) with mild germinal matrix-intraventricular haemorrhage (mGMH-IVH) (grades I and II) and no other associated MRI abnormalities, and correlate them with gestational age (GA) and neurodevelopmental outcome. Methods: Tract-based spatial-statistics (TBSS) was performed on DTI of 103 patients studied at term-equivalent age, to compare diffusional parameters (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)) between mGMH-IVH neonates (24/103) and controls matched by GA at birth and sex. The relationship between DTI abnormalities, GA and neurodevelopmental outcome assessed with Griffiths’ Developmental Scale-Revised:0-2 was explored using TBSS and Spearman-correlation analysis (p <.05). Results: Affected neonates had lower FA, higher RD and MD of the corpus callosum, limbic pathways and cerebellar tracts. Extremely preterm neonates (GA < 29 weeks) presented more severe microstructural impairment (higher RD and MD) in periventricular regions. Neonates of GA ≥ 29 weeks had milder WM alterations (lower FA), also in subcortical WM. DTI abnormalities were associated with poorer locomotor, eye-hand coordination and performance outcomes at 24 months. Conclusions: WM microstructural changes occur in PN with mGMH-IVH with a GA-dependent selective vulnerability of WM regions, and correlate with adverse neurodevelopmental outcome at 24 months. Key Points: • DTI-TBSS analysis identifies WM microstructural changes in preterm neonates with mGMH-IVH. • Extremely preterm neonates with mGMH-IVH presented more severe impairment of WM microstructure. • Extremely preterm neonates with mGMH-IVH presented microstructural impairment of periventricular WM. • mGMH-IVH affects subcortical WM in preterm neonates with gestational age ≥ 29 weeks. • WM microstructural alterations are related to neurodevelopmental impairments at 24 months.",
keywords = "Diffusion tensor imaging, Haemorrhage, Newborn, Premature, White matter",
author = "Domenico Tortora and Carola Martinetti and Mariasavina Severino and Sara Uccella and Mariya Malova and Alessandro Parodi and Fabia Brera and Giovanni Morana and Ramenghi, {Luca Antonio} and Andrea Rossi",
year = "2018",
month = "3",
day = "1",
doi = "10.1007/s00330-017-5060-0",
language = "English",
volume = "28",
pages = "1157--1166",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",
number = "3",

}

TY - JOUR

T1 - The effects of mild germinal matrix-intraventricular haemorrhage on the developmental white matter microstructure of preterm neonates

T2 - a DTI study

AU - Tortora, Domenico

AU - Martinetti, Carola

AU - Severino, Mariasavina

AU - Uccella, Sara

AU - Malova, Mariya

AU - Parodi, Alessandro

AU - Brera, Fabia

AU - Morana, Giovanni

AU - Ramenghi, Luca Antonio

AU - Rossi, Andrea

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objectives: To evaluate white matter (WM) microstructural changes in preterm neonates (PN) with mild germinal matrix-intraventricular haemorrhage (mGMH-IVH) (grades I and II) and no other associated MRI abnormalities, and correlate them with gestational age (GA) and neurodevelopmental outcome. Methods: Tract-based spatial-statistics (TBSS) was performed on DTI of 103 patients studied at term-equivalent age, to compare diffusional parameters (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)) between mGMH-IVH neonates (24/103) and controls matched by GA at birth and sex. The relationship between DTI abnormalities, GA and neurodevelopmental outcome assessed with Griffiths’ Developmental Scale-Revised:0-2 was explored using TBSS and Spearman-correlation analysis (p <.05). Results: Affected neonates had lower FA, higher RD and MD of the corpus callosum, limbic pathways and cerebellar tracts. Extremely preterm neonates (GA < 29 weeks) presented more severe microstructural impairment (higher RD and MD) in periventricular regions. Neonates of GA ≥ 29 weeks had milder WM alterations (lower FA), also in subcortical WM. DTI abnormalities were associated with poorer locomotor, eye-hand coordination and performance outcomes at 24 months. Conclusions: WM microstructural changes occur in PN with mGMH-IVH with a GA-dependent selective vulnerability of WM regions, and correlate with adverse neurodevelopmental outcome at 24 months. Key Points: • DTI-TBSS analysis identifies WM microstructural changes in preterm neonates with mGMH-IVH. • Extremely preterm neonates with mGMH-IVH presented more severe impairment of WM microstructure. • Extremely preterm neonates with mGMH-IVH presented microstructural impairment of periventricular WM. • mGMH-IVH affects subcortical WM in preterm neonates with gestational age ≥ 29 weeks. • WM microstructural alterations are related to neurodevelopmental impairments at 24 months.

AB - Objectives: To evaluate white matter (WM) microstructural changes in preterm neonates (PN) with mild germinal matrix-intraventricular haemorrhage (mGMH-IVH) (grades I and II) and no other associated MRI abnormalities, and correlate them with gestational age (GA) and neurodevelopmental outcome. Methods: Tract-based spatial-statistics (TBSS) was performed on DTI of 103 patients studied at term-equivalent age, to compare diffusional parameters (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)) between mGMH-IVH neonates (24/103) and controls matched by GA at birth and sex. The relationship between DTI abnormalities, GA and neurodevelopmental outcome assessed with Griffiths’ Developmental Scale-Revised:0-2 was explored using TBSS and Spearman-correlation analysis (p <.05). Results: Affected neonates had lower FA, higher RD and MD of the corpus callosum, limbic pathways and cerebellar tracts. Extremely preterm neonates (GA < 29 weeks) presented more severe microstructural impairment (higher RD and MD) in periventricular regions. Neonates of GA ≥ 29 weeks had milder WM alterations (lower FA), also in subcortical WM. DTI abnormalities were associated with poorer locomotor, eye-hand coordination and performance outcomes at 24 months. Conclusions: WM microstructural changes occur in PN with mGMH-IVH with a GA-dependent selective vulnerability of WM regions, and correlate with adverse neurodevelopmental outcome at 24 months. Key Points: • DTI-TBSS analysis identifies WM microstructural changes in preterm neonates with mGMH-IVH. • Extremely preterm neonates with mGMH-IVH presented more severe impairment of WM microstructure. • Extremely preterm neonates with mGMH-IVH presented microstructural impairment of periventricular WM. • mGMH-IVH affects subcortical WM in preterm neonates with gestational age ≥ 29 weeks. • WM microstructural alterations are related to neurodevelopmental impairments at 24 months.

KW - Diffusion tensor imaging

KW - Haemorrhage

KW - Newborn

KW - Premature

KW - White matter

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U2 - 10.1007/s00330-017-5060-0

DO - 10.1007/s00330-017-5060-0

M3 - Article

VL - 28

SP - 1157

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JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 3

ER -