335 - Brain Growth in Nutritionally-Sensitive Regions Associated with Neurobehavioral Outcomes in Very Low Birth Weight Infants

Poster Number: 335
Publication Number: 335.442

Katherine Ottolini, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, FPO, Armed Forces - AP, United States; Nickie Andescavage, Children's National Health System, Washington, DC, United States; Sudeepta Basu, George Washington University School of Medicine and Health Sciences, Washington, DC, United States; Yushuf Sharker, Nationwide Children's Hospital, Washington, DC, United States; Kushal Kapse, Developing Brain Institute, Washington, DC, United States; Nicole Andersen, Children's National Health System, Washington, DC, United States; Jonathan Murnick, Children's National Health System, Washington, DC, United States; Catherine Limperopoulos, Children's National Health System, Washington, DC, United States

Background: We have previously reported positive associations between early lipid and breast milk intake and total and regional (cerebellar and amygdala-hippocampal) brain volumes in a cohort of very low birth weight (VLBW, < 1500g) preterm infants. However, the functional implications of these findings remain largely unknown.

Objective:
The objective of this study was to examine the relationship between brain volumes using 3-D MRI and neonatal neurobehavioral outcomes in VLBW infants.

Design/Methods: We prospectively enrolled infants born at less than or equal to 32 weeks gestational age and VLBW admitted to our level IV NICU within the first week of life. Infants with parenchymal brain injury were excluded. NNNS and brain MRI were performed at term-equivalent age (TEA). 3-D volumetric MRI data were acquired on a 3T scanner, from which regional (cortical gray matter, cortical white matter, deep gray matter, brainstem, amygdala-hippocampus, cerebellum) and total brain volumes were calculated. We also administered the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS). We investigated the correlation between brain volumes and NNNS summary scores using bivariate linear regression analysis with Pearson's correlation coefficient (r).

Results: Forty-four VLBW infants underwent NNNS assessment and brain MRI at TEA (40+1.4 weeks) (Table 1). Cerebellar volume was positively associated with higher quality of movement scores (r= 0.35, p < 0.01). Increased cerebellar (r= -0.46, p < 0.01), amygdala-hippocampal (r= -0.40, p < 0.01), and total brain (r= -0.44, p < 0.01) volumes were also significantly associated with lower stress/abstinence scores on the NNNS (Figure 1).Conclusion(s): In VLBW neonates, total brain and regional cerebellar and amygdala-hippocampal volumetric growth at TEA, previously associated with nutritional interventions, are also associated with improved neurobehavioral regulation at term. The benefits of early nutritional optimization on long-term structural and function neurodevelopment warrants further study.
Table 1Table 1.jpegClinical characteristics of the preterm cohort.
Figure 1Figure 1.jpegCorrelation between brain volumes in cm^3 (x-axis) and NNNS summary score (y-axis).