Diffuse white matter abnormalities predict cognitive, language weaknesses in preemies
03 May 2020
MRI contrasts agents are crucial for clearer imaging – but are now under scrutiny in view of the recent issues pertaining its safety and efficacy.Objectively diagnosed diffuse white matter abnormalities (DWMAs) are correlated with poorer cognitive and language outcomes in very preterm infants, a recent study has shown.
Researchers conducted a prospective, multicentre, population-based cohort study on 74 very preterm infants who were free of severe brain injury. Structural magnetic resonance imaging (MRI) was used to objectively measure DWMA volume. Cognition and language skills at 2 years of age was evaluated using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).
Upon structural MRI, ten (13.5 percent) had grade 3 DWMA and 21 (28.4 percent) had grade 2 lesions. Majority (71.6 percent) had no signs of brain injury, while 21.6 percent and 6.8 percent had mild and moderate injuries, respectively. At an average of 24.2±1.5 months of corrected age, the mean Bayley-III cognitive and language scores were 99.1±13.8 and 96.4±15.4, respectively.
In multivariable analysis controlled for other known predictors of Bayley-III scores, the normalized volume of DWMA emerged as a significant predictor of cognitive (coefficient, –15.21, 95 percent confidence interval [CI], –22.16 to –8.26; p<0.001) and language (coefficient, –8.04, 95 percent CI, –15.88 to –0.21; p=0.044) scores.
In absolute terms, a 10-percent jump in DWMA volume correlated with significant 15-point and 8-point drops in cognitive and language scores, respectively.
Notably, visual and qualitative diagnoses of DWMA showed no significant interaction with Bayley-III cognitive (p=0.73) and language (p=0.79) scores.