Corpus callosum long-term biometry in very preterm children related to cognitive and motor outcomes

Abstract

Background: The corpus callosum (CC) is suggested as an indirect biomarker of white matter volume, which is often affected in preterm birth. However, diagnosing mild white matter injury is challenging.

Methods: We studied 124 children born preterm (mean age: 8.4 ± 1.1 years), using MRI to assess CC measurements and cognitive/motor outcomes based on the Wechsler Intelligence Scale for Children-V (WPPSI-V) and Movement Assessment Battery for Children-2 (MABC-2).

Results: Children with normal outcomes exhibited greater height (10.2 ± 2.1 mm vs. 9.4 ± 2.3 mm; p = 0.01) and fractional anisotropy at splenium (895[680-1000] vs 860.5[342-1000]) and total CC length (69.1 ± 4.8 mm vs. 67.3 ± 5.1 mm; p = 0.02) compared to those with adverse outcomes. All measured CC areas were smaller in the adverse outcome group. Models incorporating posterior CC measurements demonstrated the highest specificity (83.3% Sp, AUC: 0.65) for predicting neurological outcomes. CC length and splenium height were the only linear measurements associated with manual dexterity and total MABC-2 score while both the latter and genu were related with Full-Scale Intelligence Quotient.

Conclusions: CC biometry in children born very preterm at school-age is associated with outcomes and exhibits a specific subregion alteration pattern. The posterior CC may serve as an important neurodevelopmental biomarker in very preterm infants.

Impact: The corpus callosum has the potential to serve as a reliable and easily measurable biomarker of white matter integrity in very preterm children. Estimating diffuse white matter injury in preterm infants using conventional MRI sequences is not always conclusive. The biometry of the posterior part of the corpus callosum is associated with cognitive and certain motor outcomes at school age in children born very preterm. Length and splenium measurements seem to serve as reliable biomarkers for assessing neurological outcomes in this population.

Fig. 1. Flowchart of prospective inclusion and final sample size of the study.

IQ intelligence quotient, MABC-2 Movement Assessment Battery for Children-2, MRI cerebral magnetic resonance imaging, VLBWI very low birth weight infant, GA weeks of gestational age, WISC-V Wechsler Intelligence Scale for Children-V.

Fig. 2. Linear measurements, areas and fractional anisotropy (FA) of corpus callosum.

a length; b total area; c linear measurements of genu (purple), body (green), isthmus (light blue) and splenium (red) (performed according to ref. . d anterior and posterior subdivision areas. e Region of interest FA measurement at the genu (blue dot) and splenium (white dot).

Fig. 3. Linear CC measurements related with motor and cognitive subscales.

All models were adjusted by GA at birth, sex and age at MRI. Only statistically significant results were expressed in the tables. CC corpus callosum, GA gestational age, MRI magnetic resonance imaging.

Fig. 4. CC areas related with motor and cognitive subscales.

All models were adjusted by GA at birth, sex and age at MRI. Only statistically significant results were expressed in the tables. CC corpus callosum, GA gestational age, MRI magnetic resonance imaging.