Diffusion tensor imaging and behavior in premature infants at 8 years of age, a randomized controlled trial with long-chain polyunsaturated fatty acids. (April 2016)

• Record Type: Journal Article
• Authors: Almaas, Astrid Nylander; Tamnes, Christian K.; Nakstad, Britt; Henriksen, Christine; Grydeland, Håkon; Walhovd, Kristine B.; Fjell, Anders M.; Iversen, Per Ole; Drevon, Christian A.
• Is Part Of: Early human development. Volume 95(2016)
• Page Start: 41
• Page End: 46
• Publication Date: 2016-04
• Subjects: AA arachidonic acid -- AD axial diffusivity -- BW birth weight -- CBCL Child Behavior Checklist -- CC corpus callosum -- DHA docosahexaenoic acid -- DTI diffusion tensor imaging -- FA fractional anisotropy -- GA gestational age -- LCPUFA long-chain polyunsaturated fatty acid -- MD mean diffusivity -- MRI magnetic resonance imaging -- RCT randomized controlled trial -- RD radial diffusivity -- SDQ Strengths and Difficulties Questionnaire -- TBSS Tract-Based Spatial Statistics -- TFCE Threshold-free cluster enhancement -- VLBW very low birth weight (< 1500 g); Premature children -- Long-chain polyunsaturated fatty acids -- Brain development -- Behavioral outcome -- Diffusion tensor imaging -- White matter maturation; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2016.01.021
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: Very low birth weight (VLBW, birth weight &lt; 1500 g) children have increased risk of behavioral problems. Diffusion tensor imaging (DTI) of the brain shows reduced white matter maturation. Long-chain polyunsaturated fatty acids are hypothesized to improve both myelination and behavioral outcome. Aims: To test the hypothesis that postnatal supplementation with docosahexaenoic acid (DHA) and arachidonic acid (AA) to very low birth weight infants would influence cerebral white matter measured by DTI and improve behavioral outcome at 8 years of age. Study design: Eight-year follow-up of a randomized, double-blinded, placebo-controlled study of postnatal supplementation with DHA and AA to 129 VLBW infants fed human milk. Subjects: Ninety-eight children (76%) met for follow-up at 8 years. Outcome measures: Cerebral white matter measured by DTI. Behavioral outcome measured by Strengths and Difficulties questionnaire and selected scales from the Child Behavior Checklist. Results: No significant differences between the intervention group and the control group were found on white matter microstructure or behavioral data. A non-significant finding of higher fractional anisotropy (FA) in a cluster in the corpus callosum of the intervention group is discussed. Conclusions: The present study is the first long-term follow-up of a randomized controlled trial with DHA and AA to human milk fed VLBW infants exploring cerebral white matter microstructure measured by DTI and parent-reported behavioral problems. No effects on white matter microstructure or behavioral outcome were observed at 8 years of age. Highlights: Very low birth weight (VLBW) children have increased risk of behavioral problems. Diffusion tensor imaging (DTI) of the premature brain shows reduced white matter maturation. The long-chain polyunsaturated fatty acids docosahexaenoic acid (DHA) and arachidonic acid (AA) are hypothesized to improve both myelination and behavioral outcome. This 8 year follow-up study of an RCT with postnatal DHA/AA-supplementation to VLBW infants is the first report on both brain microstructure measured by DTI and behavioral outcomes. No significant effects of the supplementation were detected at 8 years of age.