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White matter tract integrity and developmental outcome in newborn infants with hypoxic‐ischemic encephalopathy treated with hypothermia
Author(s) -
Massaro An N,
Evangelou Iordanis,
Fatemi Ali,
Vezina Gilbert,
Mccarter Robert,
Glass Penny,
Limperopoulos Catherine
Publication year - 2015
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12646
Subject(s) - fractional anisotropy , corticospinal tract , diffusion mri , white matter , medicine , encephalopathy , corpus callosum , bayley scales of infant development , gestational age , pediatrics , hypoxic ischemic encephalopathy , psychomotor learning , magnetic resonance imaging , radiology , pathology , pregnancy , cognition , psychiatry , genetics , biology
Aim To determine whether corpus callosum (CC) and corticospinal tract ( CST ) diffusion tensor imaging ( DTI ) measures relate to developmental outcome in encephalopathic newborn infants after therapeutic hypothermia. Method Encephalopathic newborn infants enrolled in a longitudinal study underwent DTI after hypothermia. Parametric maps were generated for fractional anisotropy, mean, radial, and axial diffusivity. CC and CST were segmented by DTI ‐based tractography. Multiple regression models were used to examine the association of DTI measures with Bayley‐ II Mental ( MDI ) and Psychomotor Developmental Index ( PDI ) at 15 months and 21 months of age. Results Fifty‐two infants (males n =32, females n =20) underwent DTI at median age of 8 days. Two were excluded because of poor magnetic resonance imaging quality. Outcomes were assessed in 42/50 (84%) children at 15 months and 35/50 (70%) at 21 months. Lower CC and CST fractional anisotropy were associated with lower MDI and PDI respectively, even after controlling for gestational age, birth weight, sex, and socio‐economic status. There was also a direct relationship between CC axial diffusivity and MDI , while CST radial diffusivity was inversely related to PDI . Interpretation In encephalopathic newborn infants, impaired microstructural organization of the CC and CST predicts poorer cognitive and motor performance respectively. Tractography provides a reliable method for early assessment of perinatal brain injury.