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Early brain morphometrics from neonatal MRI predict motor and cognitive outcomes at 2-years corrected age in very preterm infants

贝利婴儿发育量表 蹒跚学步的孩子 神经影像学 认知 医学 磁共振成像 运动评估 队列 心理学 儿科 运动技能 听力学 物理医学与康复 精神运动学习 发展心理学 精神科 病理 放射科
作者
Alex M. Pagnozzi,Liza van Eijk,Kerstin Pannek,Roslyn N. Boyd,Susmita Saha,Joanne M. George,Samudragupta Bora,DanaKai Bradford,Michael Fahey,Michael Ditchfield,Anil K. Malhotra,Helen G. Liley,Paul B. Colditz,Stephen Rose,Jürgen Fripp
出处
期刊:NeuroImage [Elsevier BV]
卷期号:267: 119815-119815 被引量:9
标识
DOI:10.1016/j.neuroimage.2022.119815
摘要

Infants born very preterm face a range of neurodevelopmental challenges in cognitive, language, behavioural and/or motor domains. Early accurate identification of those at risk of adverse neurodevelopmental outcomes, through clinical assessment and Magnetic Resonance Imaging (MRI), enables prognostication of outcomes and the initiation of targeted early interventions. This study utilises a prospective cohort of 181 infants born <31 weeks gestation, who had 3T MRIs acquired at 29-35 weeks postmenstrual age and a comprehensive neurodevelopmental evaluation at 2 years corrected age (CA). Cognitive, language and motor outcomes were assessed using the Bayley Scales of Infant and Toddler Development – Third Edition and functional motor outcomes using the Neuro-sensory Motor Developmental Assessment. By leveraging advanced structural MRI pre-processing steps to standardise the data, and the state-of-the-art developing Human Connectome Pipeline, early MRI biomarkers of neurodevelopmental outcomes were identified. Using Least Absolute Shrinkage and Selection Operator (LASSO) regression, significant associations between brain structure on early MRIs with 2-year outcomes were obtained (r = 0.51 and 0.48 for motor and cognitive outcomes respectively) on an independent 25% of the data. Additionally, important brain biomarkers from early MRIs were identified, including cortical grey matter volumes, as well as cortical thickness and sulcal depth across the entire cortex. Adverse outcome on the Bayley-III motor and cognitive composite scores were accurately predicted, with an Area Under the Curve of 0.86 for both scores. These associations between 2-year outcomes and patient prognosis and early neonatal MRI measures demonstrate the utility of imaging prior to term equivalent age for providing earlier commencement of targeted interventions for infants born preterm.
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