Diagnostic accuracy of neonatal structural MRI scores to predict 6-year motor outcomes of children born very preterm
Year: 2024
Type: article
Study design: Observational Study
Abstract: • Early and Term MRI brain abnormality scores had similar associations and predictive accuracy for 6-years motor outcomes. • Structural MRI had stronger accuracy to predict cerebral palsy (CP) vs mild/moderate motor outcomes. • Early and Term MRI showed high specificity, but low sensitivity for predicting MABC-2 outcome. • Cerebellum scores on Early and Term MRI showed strongest associations to 6-year motor outcome. • Early MRI deep grey matter score had strongest predictive accuracy for an outcome of CP. This study aimed to (1) evaluate associations between Early and Term structural MRI (sMRI) brain abnormality scores and adverse motor outcomes at 6-years corrected age (CA), (2) determine their diagnostic accuracy in predicting adverse motor outcomes and cerebral palsy (CP) at 6-years CA. Infants born < 31-weeks gestational age (GA) returning for 6-year follow-up were included. Early and Term sMRI were scored using a validated method, deriving white matter, cortical grey matter, deep grey matter, cerebellar and global brain abnormality scores (GBAS). At 6-years CA, Movement Assessment Battery for Children-2nd Edition (MABC-2) was administered. Linear regression assessed associations between Early and Term GBAS/subscale scores and 6-year MABC-2 total score. For diagnostic accuracy, sMRI scores were categorised as none/mild vs moderate/severe, MABC-2 cut-off ≤ 5th percentile, and CP as present/absent. Infants had Early MRI (n = 123) at mean PMA 32.5-weeks (median GA 28.4-weeks; mean birthweight 1101 g) and n = 114 had Term MRI (Mean PMA 40.8-weeks). Nine had CP and n = 116 had MABC-2 scores. Early (B: −1.92; p ≤ 0.001) and Term (B: −1.67; p ≤ 0.01) GBAS were negatively associated with MABC-2 scores. Both Early and Term GBAS had high specificity (Sp) and low sensitivity (Se) in predicting MABC-2 ≤ 5th percentile (Early: Se 36 %, Sp 82 %; Term: Se 28 %, Sp 93 %) and predicted CP with high Se and Sp (Early: Se 78 %, Sp 78 %; Term: Se 75 %, Sp 89 %). High Sp of Early and Term MRI predicting an outcome on MABC-2 may help accurately identify infants unlikely to develop motor impairments at 6-years CA.
Source: NeuroImage Clinical
Institutions: The University of Queensland, Mater Research, Rainbow Babies & Children's Hospital, Case Western Reserve University, Commonwealth Scientific and Industrial Research Organisation, Australian e-Health Research Centre, CSIRO Health and Biosecurity, Meyer Children's Hospital, University of Pisa, Griffith University, Royal Brisbane and Women's Hospital, Children's Health Queensland Hospital and Health Service
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,400
Funders: Financial Markets Foundation for Children, Case Western Reserve University, School of Medicine, Case Western Reserve University, Cerebral Palsy Alliance Research Foundation, University Hospitals, Mater Foundation, University of Queensland, Ministero della Salute, Queensland Government, Cerebral Palsy Alliance, National Health and Medical Research Council, Australasian Cerebral Palsy Clinical Trials Network, University of Queensland
OpenAlex ID: W4405356221