Diffusion tensor imaging analysis of white matter microstructural integrity in infants with retinopathy of prematurity

Abstract

PURPOSE. To investigate white matter maturation in preterm infants with and without retinopathy of prematurity (ROP) and to determine whether ROP is associated with white matter microstructural integrity at term-equivalent ages. METHODS. In 82 preterm and 34 full-term infants who had undergone brain magnetic resonance imaging diffusion tensor imaging at term-equivalent ages, white matter microstructural integrity was assessed based on mean fractional anisotropy (FA) and mean diffusivity (MD) values in 23 predefined regions of interest by using atlas-based analyses. The values were compared among preterm and full-term infants, and a general linear model was used to evaluate the association of the values with ROP or severe (i.e., stage ˃ 3) ROP. RESULTS. Significant differences in FA and MD values were observed among preterm and fullterm infants in 17 (73.9%) and 15 (65.2%) of the 23 white matter areas evaluated, respectively. However, ROP was significantly associated with MD values in only two areas (superior longitudinal fasciculus [P = 0.030] and cerebral peduncle [P = 0.005]). Severe ROP was significantly associated with FA values within the anterior limb of the internal capsule (P = 0.049) and MD values within the stria terminalis (P = 0.035). A network analysis showed that preterm infants with severe ROP had lower small-world index values than those without. CONCLUSIONS. Preterm birth may be more strongly associated with white matter maturation at term-equivalent ages than ROP, but severe ROP may be associated with decreased structural connectivity.