Article

The aim of this study was to determine whether tractography of white-matter
tracts can independently predict neurodevelopmental outcome in very preterm
infants. METHOD: Out of 84 very preterm infants admitted to a neonatal intensive
care unit, 64 (41 males, 23 females; median gestational age 29.1 weeks [range
25.6-31.9]; birthweight 1163 g [range 585-1960]) underwent follow-up at 2 years.
Diffusion tensor imaging (DTI) values obtained around term were associated with a
neurological examination and mental and psychomotor developmental index scores at
2 years based on the Bayley Scales of Infant Development (version 3). Univariate
and logistic regression analyses tested for associations between DTI values and
follow-up parameters. Cut-off values predicting motor delay and cerebral palsy
(CP) were determined for fractional anisotropy, apparent diffusion coefficient
(ADC), and fibre lengths. RESULTS: Infants with psychomotor delay and CP had
significantly lower fractional anisotropy values (p=0.002, p=0.04 respectively)
and shorter fibre lengths (p=0.02, p=0.02 respectively) of the posterior limb of
the internal capsule. Infants with psychomotor delay also had significantly
higher ADC values (p=0.03) and shorter fibre lengths (p=0.002) of the callosal
splenium. Fractional anisotropy values of the posterior limb of the internal
capsule independently predicted motor delay and CP, with sensitivity between 80
and 100% and specificity between 66 and 69%. ADC values of the splenium
independently predicted motor delay with sensitivity of 100% and specificity of 65%. INTERPRETATION: Diffusion tensor imaging tractography at term-equivalent age
independently predicts psychomotor delay at 2 years of age in preterm infants.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2013 Mac Keith
Press.

Langue : ANGLAIS