Elda Fischi-Gomez^1,2, Alessandra Griffa¹, Alessandro Daducci¹, François Lazeyras^3,4, Jean-Philippe Thiran^1,5, and Petra S. Hüppi^2
1Ecole Polytechnique Federale de Lausanne (EPFL). Signal Processing Laboratory (LTS5), Lausanne, Switzerland, ²Division of Development and Growth. Department of Pediatrics. University of Geneva, Geneva, Switzerland, ³Center for Biomedical Imaging (CIBM),Lausanne and Geneva, Switzerland,⁴Department of Radiology, University of Geneva and University Hospital of Geneva, Geneva, Switzerland, ⁵Department of Radiology of the University Hospital Center (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland

We used DTI and network analysis to determine the impact of prematurity and prenatal growth restriction in neurostructural outcome of preterm born children at age 6 years-old. We construct individual brain network graphs derived from structural connectivity matrices, composed by an efficacy component (weighted by the mean FA value of the bundle connecting two cortical regions) and the density component (assumed to be constant within a group). Both groups, when compared to controls, show smaller efficiency (with an average path length's increase) and transitivity that may contribute to learning disabilities and behavior disorders linked to preterm infants at school age.

Gareth Ball¹, Serena J Counsell¹, Tomoki Arichi^1,2, Nazakat Merchant^1,2, Daniel Rueckert³, A David Edwards^1,2, and James P Boardman^1,4
1Centre for the Developing Brain, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, United Kingdom, ²Division of Neonatology, Imperial College London Healthcare NHS Trust, London, United Kingdom, ³Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, United Kingdom, ⁴Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom

Preterm birth is associated with poor neurodevelopmental outcome. Microstructural alterations in the developing white matter are thought to represent key components of preterm brain injury. Developing early imaging biomarkers that are sensitive to these alterations, such as TBSS, would be beneficial to the evaluation of early neuroprotective strategies in preterm infants. Here, the sensitivity of TBSS to detect changes in white matter microstructure in neonates is tested by simulating global treatment ‘effects’, represented by increased fractional anisotropy, in groups of different sizes. Simulations were found to predict well a real biological effect, represented by increasing age at scan.

Linda Chang¹, Kenichi Oishi², Jon Skranes³, Steve Buchthal¹, Caroline Jiang¹, Dan Alicata⁴, Antonette Hernandez¹, Heather Johansen¹, Christine Cloak¹, Tricia Wright⁵, Lillian Fujimoto⁶, Susumu Mori², and Thomas Ernst^1
1Dept of Medicine, University of Hawaii, Honolulu, Hawaii, United States, ²Dept of Radiology, Johns Hopkins University, Baltimore, Maryland, United States, ³Dept of Laboratory Medicine, Children’s & Women’s Health, Norwegian University of Science and Technology, Tronheim, Oslo, Norway, ⁴Dept of Psychiatry, University of Hawaii, Honolulu, Hawaii, United States, ⁵Dept of Obstetric & Gynecology, University of Hawaii, Honolulu, Hawaii, United States,⁶Straub Mililani Clinic, Mililani, Hawaii, United States

Prenatal stimulant-exposure, with nicotine and/or methamphetamine may be associated with abnormal brain development, although data in humans are limited. This study aims to evaluate whether the major white matter tracts and deep gray matter are abnormal in neonates with stimulant exposure (n=18) compared to unexposed healthy neonates (n=45). An automated atlas with LDDMM was used to assess diffusion tensor imaging (DTI) measures. Stimulant-exposed neonates showed lower FA in fornix and slower age-related decline in diffusion (axonal and radial) in the superior longitudinal fasciculus than unexposed infants. These findings suggest delayed brain myelination despite similar subject characteristics at time of scans.

Catherine Lebel¹, Eric Kan², Sarah Mattson³, Edward Riley³, Kenneth Jones⁴, Colleen Adnams⁵, Philip May⁶, Mary O'Connor⁷, Katherine Narr¹, and Elizabeth Sowell^1,2
1Neurology, University of California, Los Angeles, CA, United States, ²Children's Hospital Los Angeles, CA, United States, ³Psychology, San Diego State University, CA, United States, ⁴Pediatrics, University of California, San Diego, CA, United States, ⁵Psychiatry and Mental Health, University of Cape Town, South Africa, ⁶Nutrition, University of North Carolina, Chapel Hill, NC, United States, ⁷Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States

Children and youth prenatally exposed to alcohol demonstrate structural brain abnormalities compared to controls, but it is not clear whether these abnormalities change over time. In the first longitudinal study of cortical development, we demonstrate several brain regions with different developmental trajectories between alcohol-exposed subjects and controls, mainly in the parietal lobe. In general, subjects with prenatal alcohol exposure demonstrated less overall volume change, suggesting decreased cortical plasticity compared to controls. These results are important to consider in studies of group differences, which may change over time, and also are relevant for treatment and interventions in this population.

Etay Ziv¹, Olga Tymofiyeva¹, Sonia L Bonifacio², Patrick S McQuillen², Donna M Ferriero², A James Barkovich¹, Duan Xu¹, and Christopher P Hess^1
1Department of Radiology & Biomedical Imaging, UCSF, San Francisco, CA, United States, ²Department of Pediatrics, UCSF, San Francisco, CA, United States

Neonatal encephalopathy represents a heterogeneous group of conditions associated with life-long developmental disabilities. The ability to predict outcome early on in the perinatal period could potentially have a significant impact on subsequent treatment. Structural connectivity networks of the brain can be constructed using diffusion MRI. We hypothesize that networks derived from patients who have poor outcome may have different structure than those who have good outcome. Here we present an unbiased approach to enumerate a large set of network properties and using a combination of unsupervised and supervised learning, we demonstrate surprisingly good discrimination between good and poor neurological outcome.

Malek I Makki¹, Rabia Liamlahi², Hitendu Dave³, Bea Latal⁴, Vera Bernet⁵, Ianina Scheer⁶, Klaudija Batinic², Cornelia Hagmann⁷, and Walter Knirsch^2
1MRI Research, University Children Hospital Zurich, Zurich, Switzerland, ²Cardiology, University Children Hospital Zurich, ³Congenital Cardiovascular Surgery, University Children Hospital Zurich, ⁴Child Development, University Children Hospital Zurich, ⁵Pediatrics Intensive Care, University Children Hospital Zurich, ⁶Diagnostic Imaging, University Children Hospital Zurich, ⁷University Hospital Zurich

Fifteen neonates with d-transposition of the great artery underwent DTI before and after cardiopulmonary bypas surgery. The genu and splenium od the corpus callosum were investigated with DTI and compared to ten age amtched healthy neonates. Abnormal white matter growth was reported in the genu but not in the splenium.

Gao Jie¹, Li Xianjun², Hou Xin¹, Sun Qinli¹, Yu Bolang¹, Ed X Wu³, Wan Mingxi², and Yang Jian^1
1Department of radiology, the first affiliated hospital of medical college, Xi’an Jiaotong University, Xi'an, Shannxi, China,²Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an, Shannxi, China,³Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, China

TThe aim of this study is to use tract-based spatial statistics (TBSS) to test the voxel-wise differences in fractional anisotropy (FA),1,2,3 between normal and mild hypoxic-ischemic (HI) neonatal brains. 41 full term neonates (17 neonates with mild HI injury, 24 neonates as normal control,) and 31 preterm neonates (11 neonates with mild HI injury, 20 neonates as normal control) underwent T1 weighted images (T1WIs), T2 weighted images (T2WIs) and diffusion tensor image (DTI) within 28 days after birth. The results of TBSS mainly showed significantly decreased FA and increased 2, 3 in multiple white matter tracts (p<0.05). These differences of DTI indexes between the mild HI and normal neonates were mainly located in cerebral peduncle (CP), posterior limb of internal capsule (PLIC) and corona radiata (CR) both in full term and preterm groups. Moreover, the additional regions with above changes of DTI indexes in full term neonates were exhibited in external capsule (EC) and splenium of the corpus callosum (SCC) mainly. This is the first study to explore white matter injury in both preterm and term neonatal brains with mild HI injury by using TBSS for DTI data analyzing. TBSS, as an objective and sensitive method, can reveal multiple white matter microstructural abnormalities in mild HI neonatal brains.

Katyucia de Macedo Rodrigues¹, Maria de Carmen Fons Stupina^2,3, Ainsley MacLean⁴, Janet Soul², Rudolph Pienaar⁵, Omar Khwaja², and P. Ellen Grant^5
1Radiology, Children's Hospital Boston, Boston, Massachusettes, United States, ²Neurology, Children's Hospital Boston, Boston, Massachusettes, United States, ³Pediatric Neurology, Sant Joan de Seu Hospital for Children, Barcelona, Spain, ⁴Neuroradiology, Brigham and Women's Hospital, Boston, Massachusettes, United States, ⁵Center for Fetal-Neonatal Neuroimaging & Developmental Science, Children's Hospital Boston, Boston, Massachusettes, United States

We performed a tractography-based DTI analysis of projection and comissural tracts in term/near term neonates who presented perinatal HIE and had a brain MRI performed within 7 postnatal days and neonates with normal MRI without HIE and studied its correlation with early motor outcome. Tractography-based analysis demonstrated selective vulnerability of corticospinal tract in HIE, with low mean tract ADC and FA correlating significantly with early neurological outcome. Treatment with hypothermia was associated with increase in mean ADC in the splenium of the corpus callosum and significantly higher mean tract FA suggesting less metabolic compromise and preservation of white matter microstructure.

Saurabh Chaturvedi¹, Puneet Goyal², Vimal K Paliwal³, Ankita Chourasia¹, Yogita Rai¹, Ravindra Kumar Garg⁴, Ram Kishore Singh Rathore⁵, and Rakesh Kumar Gupta^1
1Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar pradesh, India, ²Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, ³Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India, ⁴Neurology, Chhatrapati Sahu ji Maharaj Medical University, Lucknow, Uttar Pradesh, India, ⁵Indian Institute of Technology, Kanpur

We examined 10 CP children twice (10 base line&10 follow up at 6month; 8 boys&2 girls) (mean age=6 years) who had spastic diplegia, GMFM score ranging from 50-60 and with grade II spasticity. There was a significant difference between FA values of baseline and follow-up in left motor, left sensory, CG, ATR, PTR bundles. A significant positive correlation was found between GMFM scores and FA values of left motor (r=0.723, p<0.001), left sensory (r=0.609, p=0.004), CG (r=0.787, p<0.001) and ATR (r=0.420, p=0.065).We conclude that improvement in white matter fibers is associated with physical improvement in these children.

Eva-Maria Ratai¹, Jason M Johnson², Bindu Setty², Joseph Chou³, Kalpathy Krishnamoorthy⁴, Paul Caruso², and P Ellen Grant^5
1Radiology, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States, ²Radiology, Massachusetts General Hospital, United States, ³Pediatric Medical Services / Neonatal ICU, Massachusetts General Hospital, United States, ⁴Pediatric Neurology, Massachusetts General Hospital, United States, ⁵Radiology, Children’s Hospital Boston, United States

The goal of this study was to investigate the prognostic values of ADC and MRS in neonatal hypoxic ischemic injury within 5 days of life. Eight of 17 patients died before discharge from the hospital and nine had unfavorable outcome including severe developmental delay. Low concentrations of N-acetylaspartate, choline, creatine and low ADC values in the basal ganglia were predictive of poor outcome. High glutamate/glutamine levels were also associated with poor outcome. Spearman Rank analysis between ADC and spectroscopic markers revealed significant correlations between ADC and choline as well as ADC and N-Acetylaspartate. No correlation with lactate was found.