Affiliations: [a] Division of Occupational Therapy, College of Health Professions, Charleston, SC, USA | [b] Department of Pediatrics, MUSC, Charleston, SC, USA | [c] Department of Radiology and Radiological Sciences, the Center for Advanced Imaging Research, MUSC, Charleston, SC, USA
Correspondence:
[*]
Corresponding author: Patty Coker-Bolt, Division of Occupational Therapy, Medical University of South Carolina, 151 Rutledge Ave. Charleston, SC 29403, USA. Tel.: +1 843 792 7491; E-mail:[email protected]
Abstract: PURPOSE: Diffusion tensor imaging (DTI) can detect injury to
specific white matter (WM) tracts involved with sensorimotor processing and
may provide sensitive measures for latent or nascent motor skills. We
hypothesized that DTI measures of WM fractional anisotropy (FA) could
predict early motor scores on a standardized assessment in a cohort of
preterm infants at risk for WM injury. METHODS: In this prospective study, preterm infants
(n= 26, 11 female, 15 male, mean gestational age 29.1 ± 2.5) underwent
the Test of Infant Motor Performance (TIMP) at term and at 12 weeks
corrected age (CA) and underwent an non-sedated magnetic resonance imaging
(MRI) with DTI at a mean of 42 ± 1.5 weeks CA. Fractional anisotropy (FA)
was measured by Voxelwise statistical analysis using Tract-Based Spatial
Statistics (TBSS) in the specific regions of interest. RESULTS: Significant differences were found between infants with
poor versus average performance on motor assessments at 12-weeks and FA
values in several left hemispheric WM tracts (p< 0.05). High FA of the left
anterior limb of the internal capsule (ALIC) predicted mean increase in TIMP
scores on specific items for head lift in prone and head lift turn to sound
(p= 0.045 and p= 0.002). CONCLUSION: Subtle WM injury, as indicated by low FA in left WM
tracts, can predict outcomes of early motor skills performance testing at 3 months. Early DTI may identify infants with silent WM injury who need early
intervention. Further studies may establish if individual tract FA improve
after targeted treatment.
Keywords: Premature infant, motor development, diffusion tensor imaging, neuroimaging
