Relationship between very early brain structure and neuromotor, neurological and neurobehavioral function in infants born <31&#8239;weeks gestational age

Abstract

Aim: This study aimed to examine associations between structural MRI and concurrent motor, neurological andneurobehavioral measures at 30–32 weeks postmenstrual age (PMA; ‘Early’), and at term equivalent age(‘Term’).Method: In this prospective cohort study, infants underwent Early MRI (n = 119; 73 male; median 32 weeks1 day PMA) and Term MRI (n = 102; 61 male; median 40 weeks 4 days PMA) at 3 T. Structural images werescored generating white matter (WM), cortical gray matter, deep gray matter, cerebellar and global brain ab-normality scores. Clinical measures were General Movements Assessment (GMs), Hammersmith NeonatalNeurological Examination (HNNE) and NICU Neonatal Neurobehavioral Scale (NNNS). The Premie-Neuro wasadministered Early and the Test of Infant Motor Performance (TIMP) and a visual assessment at Term.Results: Early MRI cerebellar scores were strongly associated with neurological components of HNNE (reflexes),NNNS (Hypertonicity), the Premie-Neuro neurological subscale (regression coefficient β = −0.06; 95% con-fidence interval CI = −0.09, −0.04; p < .001) and cramped-synchronized GMs (β = 1.10; 95%CI = 0.57,1.63; p < .001). Term MRI WM and global scores were strongly associated with the TIMP (WM β = −1.02;95%CI = −1.67, −0.36; p = .002; global β = −1.59; 95%CI = −2.62, −0.56; p = .001).Interpretation: Brain structure on Early and Term MRI was associated with concurrent motor, neurological andneurobehavioral function in very preterm infants.