Changes in brain morphology and microstructure in relation to early brain activity in extremely preterm infants

Tataranno, Maria Luisa, Claessens, Nathalie H P, Moeskops, Pim, Toet, Mona C, Kersbergen, Karina J, Buonocore, Giuseppe, Išgum, Ivana, Leemans, Alexander, Counsell, Serena J., Groenendaal, Floris, de Vries, Linda S, Benders, Manon J N L


Pediatric Research


OBJECTIVE: To investigate the relation of early brain activity with structural (growth of the cortex and cerebellum) and white matter microstructural brain development.

METHODS: 33 preterm neonates (gestational age 26±1 weeks) without major brain abnormalities were continuously monitored with electroencephalography (EEG) during the first 48 h of life. Rate of spontaneous activity transients per minute (SAT rate) and interSAT interval (ISI) in seconds per minute were calculated. Infants underwent brain MRI around 30 (mean 30.5, min:29.3-max:32.0) and 40 (41.1; 40.0-41.8) weeks postmenstrual age. Increase in cerebellar volume, cortical gray matter volume, gyrification index, fractional anisotropy (FA) of posterior limb of the internal capsule (PLIC) and corpus callosum (CC) were measured.

RESULTS: SAT rate was positively associated with cerebellar growth (P=0.01), with volumetric growth of the cortex (P=0.027), increase in gyrification (P=0.043) and increase in FA of the CC (P=0.037). ISI was negatively associated with cerebellar growth (P=0.002).

CONCLUSIONS: Increased early brain activity is associated with cerebellar and cortical growth, structures with rapid development during preterm life. Higher brain activity is related to FA microstructural changes in the CC, a region responsible for inter-hemispheric connections. This study underlines the importance of brain activity for (micro)structural brain development.Pediatric Research accepted article preview online, 15 December 2017. doi:10.1038/pr.2017.314.