Diffusion Tensor MRI of White Matter of Healthy Full-term Newborns: Relationship to Neurodevelopmental Outcomes
Kaiyang Feng, Amy C. Rowell, Aline Andres, Betty Jayne Bellando, Xiangyang Lou, Charles M. Glasier, Raghu H. Ramakrishnaiah, Thomas M. Badger, Xiawei Ou
Author Affiliations
From the Departments of Radiology (K.F., A.C.R., C.M.G., R.H.R., X.O.) and Pediatrics (A.A., B.J.B., X.L., C.M.G., T.M.B., X.O.), University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Nutrition Center, 15 Children's Way, Little Rock, AR 72202 (A.A., X.L., T.M.B., X.O.); and Arkansas Children’s Research Institute, 1 Children’s Way, Slot 105, Little Rock, AR 72202 (X.O.).
Address correspondence to X.O. (e-mail: ouxiawei@uams.edu).
Published Online:Jun 4 2019https://doi.org/10.1148/radiol.2019182564
See editorial byHouchun H. Hu
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Abstract
Measurement of fractional anisotropy using diffusion tensor MRI in multiple white matter regions of healthy full-term newborns correlated with neurodevelopmental outcomes of these infants at age 2 years in our study, independent of potential prenatal and postnatal confounders.

Background
It is well known that white matter injuries observed at birth are associated with adverse neurodevelopmental outcomes later in life. Whether white matter developmental variations in healthy newborns are also associated with changes in later neurodevelopment remains to be established.

Purpose
To evaluate whether developmental variations of white matter microstructures identified by MRI correlate with neurodevelopmental outcomes in healthy full-term infants.

Materials and Methods
In this prospective study, pregnant women were recruited and their healthy full-term newborns underwent a brain MRI including diffusion tensor imaging at approximately 2 weeks of age. These infants were tested at approximately 2 years of age with the Bayley Scales of Infant Development (BSID). Voxel-wise correlation analyses of fractional anisotropy (FA), measured with diffusion tensor MRI, and neurodevelopmental test scores, measured by using BSID, were performed by using tract-based spatial statistics (TBSS), followed by region-of-interest (ROI) analyses of correlations between mean FA in selected white matter ROIs and each BSID subscale score.

Results
Thirty-eight full-term infants (20 boys, 18 girls) underwent MRI examination at 2 weeks of age (14.3 days ± 1.6) and BSID measurement at 2 years of age (732 days ± 6). TBSS analyses showed widespread clusters in major white matter tracts, with positive correlations (P ≤ .05, corrected for the voxel-wise multiple comparisons) between FA values and multiple BSID subscale scores. These correlations were largely independent of several demographic parameters as well as family environment. Gestational age at birth appeared to be a confounding factor as TBSS-observed correlations weakened when it was included as a covariate; however, after controlling for gestational age at birth, ROI analyses still showed positive correlations (P ≤ .05, R = 0.35 to 0.48) between mean FA in many white matter ROIs and BSID cognitive, language, and motor scores.

Conclusion
There were significant associations between white matter microstructure developmental variations in healthy full-term newborns and their neurodevelopmental outcomes.

© RSNA, 2019