Network researchers find mapping brain injury location in preemies may predict later disability

January 20, 2017

Scanning a premature infant’s brain shortly after birth to map the location and volume of small areas of injury to white matter may help doctors better predict whether the baby will have disabilities later, according to a new study co-funded by Kids Brain Health.

Drawing from research conducted at the Neonatal ICU at British Columbia’s Women’s Hospital by Network Investigators Steven P. Miller, Ruth Grunau, Anne Synnes and colleagues, "Quantitative assessment of white matter injury in preterm neonates: association with outcomes" was published in the January 18, 2017, online issue of Neurology, the medical journal of the American Academy of Neurology.

In Canada, 2.4 out of 1,000 live births involves an infant with a brain injury caused by lack of oxygen before or during delivery. The most common form of brain injury in premature infants, oxygen deprivation results in damage to the white matter in the brain. White matter contains nerve fibers that maintain contact between various parts of the brain. Damage to these structures can interfere with communication in the brain and the signals it sends to other parts of the body.

“In general, babies who are born before 31 weeks gestation have a higher risk of thinking, language and movement problems throughout their lives, so being able to better predict which infants will face certain developmental problems is important so they get the best early interventions possible. Just as important is to be able to reassure parents of infants who may not be at risk,” said study author Steven P. Miller, MDCM, of The Hospital for Sick Children (SickKids).

For the study, researchers looked at a group of premature infants who were admitted to the Neonatal ICU at British Columbia’s Women’s Hospital over a seven year period. They found 58 babies with white matter injury who had an MRI brain scan at an average of 32 weeks after gestation. These babies were then evaluated for motor, thinking and language skills when they were 18 months old.

Researchers found that a greater volume of small areas of injury, no matter where they were located in the brain, could predict movement problems at 18 months. They also found that a greater volume of these small areas of injury in the frontal lobe could predict thinking problems. The frontal lobe is the area of the brain that regulates problem solving, memory, language skills and voluntary movement skills.

The findings from this study highlight the importance of injury location when considering developmental outcomes. For example, premature infants with larger frontal lobe injuries had a 79-fold greater odds of developing cognitive deficits than infants without such injuries, as well as a 64-fold greater odds of problems with movement development.

Miller said that future studies should evaluate premature infants not just at 18 months, but at various points throughout childhood to determine the long-term consequences of early injuries in the brain. In addition to support from Kids Brain Health Network (formerly NeuroDevNet), the study was supported by the Canadian Institutes of Health Research, The Research Training Centre at The Hospital for Sick Children and SickKids Foundation, and the Ontario Brain Institute.

Based on Neurology  press release, "Mapping Brain in Preemies May Predict Later Disability"