Background: Very-low-birth-weight preterm infants have a higher rate of language impairments
compared with children born full term. Early identification of preterm infants at
risk for language delay is essential to guide early intervention at the time of optimal
neuroplasticity. This study examined near-term structural brain magnetic resonance
imaging (MRI) and white matter microstructure assessed on diffusion tensor imaging
(DTI) in relation to early language development in children born very preterm. Methods:
A total of 102 very-low-birth-weight neonates (birthweight <= 1500g, gestational age
<= 32-weeks) were recruited to participate from 2010 to 2011. Near-term structural
MRI was evaluated for white matter and cerebellar abnormalities. DTI fractional anisotropy,
mean diffusivity, axial diffusivity, and radial diffusivity were assessed. Language
development was assessed with Bayley Scales of Infant-Toddler Development-III at 18
to 22 months adjusted age. Multivariate models with leave-one-out cross-validation
and exhaustive feature selection identified three brain regions most predictive of
language function. Distinct logistic regression models predicted high-risk infants,
defined by language scores >1 S.D. below average. Results: Of 102 children, 92 returned
for neurodevelopmental testing. Composite language score mean +/- S.D. was 89.0 +/-
16.0; 31 of 92 children scored <85, including 15 of 92 scoring <70, suggesting moderate-to-severe
delay. Children with cerebellar asymmetry had lower receptive language subscores (P
= 0.016). Infants at high risk for language impairments were predicted based on regional
white matter microstructure on DTI with high accuracy (sensitivity, specificity) for
composite (89%, 86%), expressive (100%, 90%), and receptive language (100%, 90%).
Conclusions: Multivariate models of near-term structural MRI and white matter microstructure
on DTI may assist in identification of preterm infants at risk for language impairment,
guiding early intervention. (C) 2020 Elsevier Inc. All rights reserved.
