Journal Article

Preterm birth affects the developmental synergy between cortical folding and cortical connectivity observed on multimodal MRI

Melbourne, Andrew, Gunny, Roxanna, Kendall, Giles S., Cardoso, M. Jorge, Marlow, Neil, Robertson, Nicola J., Ourselin, Sebastien

2014

Overview

The survival rates of infants born prematurely have improved as a result of advances in neonatal care, although there remains an increased risk of subsequent disability. Accurate measurement of the shape and appearance of the very preterm brain at term-equivalent age may guide the development of predictive biomarkers of neurological outcome. We demonstrate in 92 preterm infants (born at an average gestational age of 27.0±2.7weeks) scanned at term equivalent age (scanned at 40.4±1.74weeks) that the cortical sulcation ratio varies spatially over the cortical surface at term equivalent age and correlates significantly with gestational age at birth (r=0.49,p<0.0001). In the underlying white matter, fractional anisotropy of local white matter regions correlated significantly with gestational age at birth at term equivalent age (for the genu of the corpus callosum r=0.26,p=0.02 and for the splenium r=0.52,p<0.001) and in addition the fractional anisotropy in these local regions varies according to location. Finally, we demonstrate that connectivity measurements from tractography correlate significantly and specifically with the sulcation ratio of the overlying cortical surface at term equivalent age in a subgroup of 20 infants (r={0.67,0.61,0.86}, p={0.004,0.01,0.00002}) for tract systems emanating from the left and right corticospinal tracts and the corpus callosum respectively). Combined, these results suggest a close relationship between the cortical surface phenotype and underlying white matter structure assessed by diffusion weighted MRI. The spatial surface pattern may allow inference on the connectivity and developmental trajectory of the underlying white matter complementary to diffusion imaging and this result may guide the development of biomarkers of functional outcome. •Survival rates of infants born prematurely have improved recently.•Accurate measurement of the shape of the brain may guide the development of predictive biomarkers.•We show in 92 infants that the cortical folding pattern varies with gestational age at birth.•In preterm WM, connectivity measurements correlate with the overlying cortical surface pattern.•Cortical folding may allow inference on the connectivity and developmental trajectory of WM

• Publisher: Elsevier Inc,Elsevier,Elsevier Limited
• Subject: Age / Biological and medical sciences / Biomedical research / Brain research / Cerebral Cortex - abnormalities / Connectivity / Diffusion Magnetic Resonance Imaging / Female / Fundamental and applied biological sciences. Psychology / Histology / Humans / Infant / Intensive care / Magnetic Resonance Imaging / Male / Medical research / Multimodal Imaging / Neonate / Nerve Fibers, Myelinated - pathology / Nerve Net - abnormalities / NMR / Nuclear magnetic resonance / Pregnancy / Premature Birth - pathology / Surface shape / Tractography / University colleges / Vertebrates: nervous system and sense organs / White matter