Scanning a premature baby’s brain shortly after delivery to map the location and volume of lesions — areas of injury in the brain’s white matter — may help doctors better predict whether the baby will develop specific types of disabilities, according to a new study published in the journal Neurology.
Lack of oxygen to the brain — which damages the brain’s white matter — is the most common form of brain injury in premature babies. White matter contains nerve fibers that regulate communication between various parts of the brain and body. Damage to this area can interfere with the signals the nerve fibers send out to other areas.
The findings show that preemies with greater frontal lobe injuries have a 79-fold greater chance of developing thinking problems than infants without such injuries, as well as a 64-fold greater chance of problems with movement development.
“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,” said study author Steven P. Miller, MDCM, of The Hospital for Sick Children (SickKids) in Toronto, Canada. “Just as important is to be able to reassure parents of infants who may not be at risk,”
The study tracked a group of premature infants who had been admitted to the neonatal intensive care unit (NICU) at British Columbia’s Women’s Hospital during a seven-year period. They found 58 babies with white matter injury who had an MRI brain scan at an average of what would have been 32 weeks of gestation. At 18 months of age, these babies were then evaluated for motor, thinking and language skills.
The findings show 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. In addition, 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 study emphasizes the importance of injury location when considering developmental outcomes. For example, preemies with larger frontal lobe injuries had a 79-fold greater chance of developing thinking problems than infants without such injuries, as well as a 64-fold greater chance of problems with movement development.
According to the researchers, 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.
Source: American Academy of Neurology