Early growth in brain volume is preserved in the majority of preterm infants
Corresponding Author
James P. Boardman MRCPCH, PhD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London W12 0NN, United KingdomSearch for more papers by this authorSerena J. Counsell PhD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorDaniel Rueckert PhD
Department of Computing, Imperial College London, London, United Kingdom
Search for more papers by this authorJo V. Hajnal PhD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorKanwal K. Bhatia MSc
Department of Computing, Imperial College London, London, United Kingdom
Search for more papers by this authorLatha Srinivasan MRCPCH, MSc
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorOlga Kapellou MRCPCH
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorPaul Aljabar MSc
Department of Computing, Imperial College London, London, United Kingdom
Search for more papers by this authorLeigh E. Dyet MRCPCH
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorMary A. Rutherford FRCR, MD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorJoanna M. Allsop DCR
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorA. David Edwards FMedSci
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorCorresponding Author
James P. Boardman MRCPCH, PhD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London W12 0NN, United KingdomSearch for more papers by this authorSerena J. Counsell PhD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorDaniel Rueckert PhD
Department of Computing, Imperial College London, London, United Kingdom
Search for more papers by this authorJo V. Hajnal PhD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorKanwal K. Bhatia MSc
Department of Computing, Imperial College London, London, United Kingdom
Search for more papers by this authorLatha Srinivasan MRCPCH, MSc
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorOlga Kapellou MRCPCH
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorPaul Aljabar MSc
Department of Computing, Imperial College London, London, United Kingdom
Search for more papers by this authorLeigh E. Dyet MRCPCH
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorMary A. Rutherford FRCR, MD
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorJoanna M. Allsop DCR
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorA. David Edwards FMedSci
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom
Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, United Kingdom
Search for more papers by this authorAbstract
Objective
Preterm infants have reduced cerebral tissue volumes in adolescence. This study addresses the question: Is reduced global brain growth in the neonatal period inevitable after premature birth, or is it associated with specific medical risk factors?
Methods
Eighty-nine preterm infants at term equivalent age without focal parenchymal brain lesions were studied with 20 full-term control infants. Using a deformation-based morphometric approach, we transformed images to a reference anatomic space, and we used the transformations to calculate whole-brain volume and ventricular volume for each subject. Patterns of volume difference were correlated with clinical data.
Results
Cerebral volume is not reduced compared with term born control infants (p = 0.765). Supplemental oxygen requirement at 28 postnatal days is associated with lower cerebral tissue volume at term (p < 0.001), but there were no significant differences in cerebral volumes attributable to perinatal sepsis (p = 0.515) and quantitatively defined diffuse white matter injury (p = 0.183). As expected, the ventricular system is significantly larger in preterm infants at term equivalent age compared with term control infants (p < 0.001).
Interpretation
Cerebral volume is not reduced during intensive care for the majority of preterm infants, but prolonged supplemental oxygen dependence is a risk factor for early attenuation of global brain growth. The reduced cerebral tissue volume seen in adolescents born preterm does not appear to be an inevitable association of prematurity, but rather caused by either specific disease during intensive care or factors operating beyond the neonatal period. Ann Neurol 2007
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