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דף הבית >> ארכיון כנסים >> כנס העמותה להתפתחות הילד2012 >> פוסטרים מכנס העמותה >> שלמות החומר הלבן במסלולים עצביים כמנבא של התפתחות נוירולוגית מוקדמת בפגים

WHITE MATTER INTEGRITY AS PREDICTOR OF NEONATAL BEHAVIORAL PERFORMANCE IN PRETERMS  

שלמות החומר הלבן במסלולים עצביים כמנבא של התפתחות נוירולוגית מוקדמת בפגים 
 
Maya Weinstein1,2, Ronella Marom3, Irit Berger3, Dafna Ben-Bashat1, Varda Gross-Tsur4, Liat Ben Sira1, Vicki Myers1, Moran Artzi1,5, Shimrit Uliel6, Yael Leitner6, Ronny Geva2
 
מאיה וינשטיין1,2, רונלה מרום3, עירית ברגר3, דפנה בן בעש"ט1, ורדה גרוס- צור4, ליאת בן- סירה1, ויקי מאיירס1, מורן ארצי1,5, שמרית אוליאל6, יעל לייטנר6, רוני גבע2
1The Functional  Brain Center, The Wohl Institute for Advanced Imaging, TASMC, Israel , 2Department of Psychology, Gonda  Multidisciplinary Brain Research Center, Bar Ilan University, Israel, 3Department of Neonatology, Lis  Maternity Hospital,TASMC, Israel, 4Neuropediatric Unit,  Shaare-Zedek Medical Center, Israel, 5Sackler Faculty  of Medicine, Tel Aviv University, Israel, 6Pediatric Neurology and  Child Development Unit, TASMC, Israel

Preference: poster
 
Introduction: Abnormal diffusion values detected at term equivalent age have been associated with poor neuro-developmental outcome at 2 years corrected age1,3. The aim of this study was to evaluate neurodevelopmental outcome at a much earlier stage of development, and to investigate the association between white matter (WM) integrity in major fibre tracts and neurodevelopment in preterms.

Materials & Methods: 39 premature infants (gestational age- GA <34 weeks, with mild echogenicity on ultrasound underwent magnetic resonance imaging (MRI) at term. Diffusion tensor imaging (DTI) analysis was performed in major WM tracts, using the neonate DTI atlas2 . Neurodevelopmental outcome was assessed at term and at 44 weeks, using the Rapid Neonatal Neurobehavioral Assessment Procedure (NB). 

Results: Preterm babies demonstrated abnormal neuro-behavioral scores, both at term and at 44 weeks (mean score 20.2± 2.4). Higher mean diffusion (MD) in the corpus callosum (CC), superior cerebellar peduncle (SCP) and cerebral peduncle were associated with poorer NB outcomes at 44 weeks (rs range 3.1-4.3, ps<0.05).Hierarchical regression analysis indicated that MD of these major tracts, and maturation factors (GA and age of NB assessment), explained 31.7% of the variance, mostly accredited to the CC and SCP (F(1,38)=6.01; F(1,37)=5.36, p<0.005, respectively).

Conclusion: Poorer neurodevelopmental outcome related to higher diffusion values can be detected already in the neonatal period. WM integrity of major fiber tracts in preterms with mild WM abnormalities correlate with abnormal neurodevelopmental performance at infancy. DTI is a sensitive method for evaluation of WM integrity and may serve as a useful tool for outcome prediction. 
1 Krishnan, M. L. et al.(2007). 
2 Oishi, K. et al.(2011). 
3 van Kooij, B. J. M. et al.(2011).
 
 
 
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