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Proper timing for the evaluation of neonatal brain white matter development: a diffusion tensor imaging study

  • Paediatric
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Abstract

Objective

We aimed to determine the timing for assessing birth status of the developing brain (i.e. brain maturity at birth) by exploring the postnatal age-related changes in neonatal brain white matter (WM).

Methods

The institutional review board approved this study and all informed parental consents were obtained. 133 neonates (gestational age, 30–42 weeks) without abnormalities on MRI were studied with regard to WM development by diffusion tensor imaging-derived fractional anisotropy (FA). Tract-based spatial statistics (TBSS), locally-weighted scatterplot smoothing (LOESS) and piecewise linear-fitting were used to investigate the relationship between FA and postnatal age. FA along corticospinal tract (CST), optic radiation (OR), auditory radiation (AR) and thalamus-primary somatosensory cortex (thal-PSC) were extracted by automated fibre-tract quantification; their differences and associations with neonatal neurobehavioural scores at various postnatal age ranges were analysed by Wilcoxon’s rank-sum test and Pearson’s correlation.

Results

Using TBSS, postnatal age (days 1–28) positively correlated with FA in multiple WMs, including CST, OR, AR and thal-PSC (p<0.05). On the other hand, when narrowing the postnatal age window to days 1–14, no significant correlation was found, suggesting a biphasic WM development. LOESS and piecewise linear-fitting indicated that FA increased mildly before day 14 and its growth accelerated thereafter. Both FA and correlations with neurobehavioural scores in postnatal age range 2 (days 15–28) were significantly higher than in range 1 (days 1–14) (FA comparison: p<0.05; maximal correlation-coefficient: 0.693 vs. 0.169).

Conclusion

Brain WM development during the neonatal stage includes two phases, i.e. a close-to-birth period within the first 14 days and a following accelerated maturation period. Therefore, evaluations of birth status should preferably be performed during the first period.

Key Points

• Brain white matter development within the first two postnatal weeks resembles a close-to-birth maturation.

• Brain white matter development in the audio-visual, sensorimotor regions accelerates after two postnatal weeks.

• Postnatal age-related effects should be considered in comparing preterm and term neonates.

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Abbreviations

AR:

Auditory radiation

CST:

Corticospinal tract

DTI:

Diffusion tensor imaging

FA:

Fractional anisotropy

GA:

Gestational age

LOESS:

Locally-weighted scatterplot smoothing

MR imaging:

Magnetic resonance imaging

OR:

Optic radiation

TBSS:

Tract-based spatial statistics

thal-PSC:

Thalamus-primary somatosensory cortex

WM:

White matter

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Funding

This study has received funding by the National Key Research and Development Program of China (2016YFC0100300), National Natural Science Foundation of China (No. 81171317, 81471631, 81771810 and 51706178), the 2011 New Century Excellent Talent Support Plan of the Ministry of Education, China (NCET-11-0438), China Postdoctoral Science Foundation (No. 2017M613145), Shaanxi Provincial Natural Science Foundation for Youths of China (No. 2017JQ8005), the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University (No. XJTU1AF-CRF-2015-004) and the Hospital Fund of the First Affiliated Hospital of Xi’an Jiaotong University, China (No. 2016QN-08).

Author information

Author notes

  1. Chao Jin and Yanyan Li contributed equally to this study.

Authors and Affiliations

  1. Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China

    Chao Jin, Yanyan Li, Xianjun Li, Miaomiao Wang, Congcong Liu, Jie Gao, Qinli Sun & Jian Yang

  2. Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, 30322, USA

    Deqiang Qiu

  3. Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, 710054, People’s Republic of China

    Lingxia Zeng

  4. Department of Neonatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China

    Xihui Zhou & Gailian Li

  5. Department of Pediatric, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China

    Jinni Zhang

  6. Clinical Research Center, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China

    Jie Zheng

Authors
  1. Chao Jin
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  2. Yanyan Li
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  14. Jian Yang
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Corresponding author

Correspondence to Jian Yang.

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Guarantor

The scientific guarantor of this publication is Jian Yang, the First Affiliated Hospital of Xi'an Jiaotong University

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Observational

• Performed at one institution

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Jin, C., Li, Y., Li, X. et al. Proper timing for the evaluation of neonatal brain white matter development: a diffusion tensor imaging study. Eur Radiol 29, 1527–1537 (2019). https://doi.org/10.1007/s00330-018-5665-y

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  • DOI: https://doi.org/10.1007/s00330-018-5665-y

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