Study Says Quantitative MRI Can Detect Biomarkers of Neurological Conditions in Adolescents with Extremely Preterm Birth

New research suggests the use of quantitative magnetic resonance imaging (MRI) may be beneficial in differentiating atypical brain development in adolescents with extremely preterm births who develop neurological conditions such as cerebral palsy and autism.

In the multicenter study of 368 adolescents between the ages of 14 to 16 who were born extremely preterm (less than 28 weeks in gestational age), researchers utilized multiparametric quantitative magnetic resonance imaging (qMRI) to assess 116 adolescents with atypical neurological development and 252 adolescents with normal neurological development. Girls with atypical neurological development had lower cerebrospinal fluid (CSF)-normalized proton density (nPD) in white matter (WM) compared to girls with normal neurological development (557 10 x pu vs. 573 10 x pu), according to the study. The study authors found that boys with atypical neurological development had a longer T1 in WM (814 msec) in comparison to boys with normal neurological development (789 msec).

“Quantitative MRI in a large dataset allows you to identify small differences between populations that may reflect microstructural tissue abnormalities not visually observable from imaging,” said study co-author Hernan Jara, M.D., professor of radiology at the Boston University School of Medicine.

In comparing girls and boys with atypical neurological development, researchers noted that girls had lower nPD in WM and gray matter (GM) as well as shorter T2 in WM and GM. The study authors also noted subtle differences in WM related to proton density.

“This might be the tip of the iceberg since the amount of free water is highly regulated in the brain,” suggested Dr. Jara. “The fact that this difference was observed more in females than males may also be related to the known comparative resilience of females as demonstrated in findings from earlier (studies).”

Dr. Jara and colleagues also found that girls with atypical neurological development had smaller WM volume (399 cm³) and GM volume (611 cm³) in comparison to girls with typical neurological development (433 cm³ for WM volume, 666 cm³ for GM volume). In contrast to boys with normal neurological development, the study authors found that boys with atypical neurological development also had lower WM volume (446 cm³ compared to 473 cm³) and lower GM volume (690 cm³ compared to 726 cm³).

“Our results complement the existing body of evidence that abnormal developmental pathways can be potentially understood with use of multiparametric qMRI, with potential implications for improving diagnosis and therapeutic intervention … ,” wrote Dr. Jara and colleagues.

While previous studies have documented enlarged ventricular spaces as common complications of extremely preterm birth, the researchers noted no differences in ventricular CSF volume between those with atypical neurological development and those with normal neurological development in this study.

In regard to study limitations, the authors noted the use of triple turbo spin echo (TSE) imaging in this study can be subject to variations with different device manufacturers as well as scanner models and software. They also noted a restriction of data sets due to the use of metallic braces and dental implants by adolescents.