by
Christina Hwang, Contributing Reporter | April 12, 2016
Scoring MRs to predict neurodevelopmental outcomes in premature infants has been made more objective in a new study, and in the process, researchers found that an often unreported abnormality of the brain’s gray matter can indicate future impairment of the infant.
Clinician-researchers at Nationwide Children’s Hospital based their study on 122 infants born premature with a weight equal to or less than 2.2 pounds, and discovered moderate-to-severe gyral maturational delay, the ridge or fold between two clefts on the cerebral surface in the brain, was the only significant predictor of overall neurodevelopmental impairment.
Brain MRs were performed at term-equivalent age at Memorial Hermann Children’s Hospital under the supervision of Dr. Nehal Parikh, the study’s senior author, and principal investigator in the Center for Perinatal Research in The Research Institute at Nationwide Children’s.
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At 18 to 24 months of age, the infants were tested using the Bayley Scales of Infant and Toddler Development III, a test that assesses developmental functioning of infants and toddlers in five fields: cognitive, language, motor, social-emotional and adaptive behavior. Additionally, all had a standard neurological examination for the presence of cerebral palsy.
By using the data-driven scoring system rather than the more opinion-based system, the researchers also found that diffuse cystic abnormality was a significant predictor of cerebral palsy.
The predictors had a high specificity of 95 to 99 percent, so when gyral maturational delay and diffuse cystic abnormality were found, other impairments were as well. However, the study also illustrates that the absence of these two factors does not always mean impairments will also be absent.
According to Dr. Laurel Slaughter, assistant professor of clinical pediatrics at Ohio State University College of Medicine, neurologist at Nationwide Children’s and lead author of the study, the study may suggest to physicians that if these predictors were found, therapies should begin the moment impairments become obvious.
“We can’t predict with certainty that these babies are going to do well just because the MRs looked good,” added Dr. Slaughter. “These are still significantly premature babies that we need to monitor.”
