Context Very preterm infants are prone to apnea and have an increased risk of death or disability... more Context Very preterm infants are prone to apnea and have an increased risk of death or disability. Caffeine therapy for apnea of prematurity reduces the rates of cerebral palsy and cognitive delay at 18 months of age. Objective To determine whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age.
To predict adverse neurodevelopmental outcome of very preterm neonates. A total of 166 preterm ne... more To predict adverse neurodevelopmental outcome of very preterm neonates. A total of 166 preterm neonates born between 24-32 weeks' gestation underwent brain MRI early in life. Radiomics features were extracted from T1-and T2-weighted images. Motor, cognitive, and language outcomes were assessed at a corrected age of 18 and 33 months and 4.5 years. Elastic Net was implemented to select the clinical and radiomic features that best predicted outcome. The area under the receiver operating characteristic (AUROC) curve was used to determine the predictive ability of each feature set. Clinical variables predicted cognitive outcome at 18 months with AUROC 0.76 and motor outcome at 4.5 years with AUROC 0.78. T1-radiomics features showed better prediction than T2-radiomics on the total motor outcome at 18 months and gross motor outcome at 33 months (AUROC: 0.81 vs 0.66 and 0.77 vs 0.7). T2-radiomics features were superior in two 4.5-year motor outcomes (AUROC: 0.78 vs 0.64 and 0.8 vs 0.57). Combining clinical parameters and radiomics features improved model performance in motor outcome at 4.5 years (AUROC: 0.84 vs 0.8). Radiomic features outperformed clinical variables for the prediction of adverse motor outcomes. Adding clinical variables to the radiomics model enhanced predictive performance. Despite advances in medical care and improved survival, infants born preterm are at risk for abnormal brain development and long-term neurodevelopmental impairments 1. These may arise in multiple functional domains including motor, cognitive, and language and continue beyond childhood and adolescence 1,2. White matter injury (WMI) is identified in up to 50% of very preterm neonates and constitutes a characteristic brain injury pattern 3. The severity of punctate WMI is best assessed on T1-weighted MRI acquired early in life before reaching term-equivalent age 4,5. Previously, we found that, in very preterm neonates, WMI location and volume on early MRI predict cognitive and motor outcomes at 18 months of age 6. However, manual volumetric segmentation of lesional burden relies on human experts and is cumbersome and time intensive. Radiomics uses a quantitative set of features calculated from radiologic images to detect distinct quantifiable phenotypic differences of tissues 7. Radiomic features quantify the intensity, texture and geometrical characteristics attributed to imaging data 8. They are increasingly used for computer-aided pattern recognition and classification, as well as image-based diagnosis and prognosis 9. Given the strong association between WMI and adverse outcomes, we hypothesized that radiomics predicts the neurodevelopmental outcome of preterm neonates at 18 months of age and beyond. We therefore aimed to (i) investigate the predictive value of radiomics to adverse neurodevelopmental outcome of preterm neonates with or without WMI, and (ii) evaluate whether integrating the clinical variables, previously established as predictors of adverse neurodevelopmental outcome 10 , can enhance the prediction accuracy of radiomics in this population.
Babies born very preterm (< 32 weeks postmenstral age), are at a high risk of having delayed or a... more Babies born very preterm (< 32 weeks postmenstral age), are at a high risk of having delayed or altered neurodevelopment. Diffusion MRI (dMRI) is a non-invasive neuroimaging modality that allows for early analysis of an infant's brain connectivity network (i.e., structural connectome) during the critical period of development shortly after birth. In this paper we present a method to accurately assess delayed brain maturation and then use our method to study how certain anatomical and diagnostic brain injury factors are related to this delay. We first train a model to predict the age of an infant from its structural brain network. We then define the relative brain network maturation index (RBNMI) as the predicted age minus the true age of that infant. To ensure the predicted age is as accurate as possible, we examine a variety of models to predict age and use one that performs best when trained on a normative subset (77 scans) of our preterm infant cohort dataset of 168 dMRI scans. We found that a random forest regressor could predict preterm infants' ages to within an average of ∼ 1.6 weeks. We validate our approach by analysing the correlation between RBNMI and a set of demographic, diagnostic and brain connectivity related variables.
Magnetoencephalography (MEG) is a brain imaging modality with considerable promise for understand... more Magnetoencephalography (MEG) is a brain imaging modality with considerable promise for understanding early neonatal brain development and its alteration in clinical populations, together with the long-term consequences of premature birth and adverse neonatal events. This article discusses present and potential contributions of MEG to neonatology and neonatal follow-up. We give a brief overview of MEG and discuss its advantages and capabilities. We review fetal MEG and neonatal MEG, including the recent introduction of dedicated neonatal MEG systems. The use of MEG for understanding long-term neurocognitive outcome in populations such as school-aged children born very preterm will be discussed, as well as recent advances in MEG that represent significant opportunities for understanding neonatal brain development. In summary, MEG provides a powerful method to create a noninvasive record of neuronal activity throughout fetal development, neonatal life, and childhood.
for neurocognitive function. However, the authors report in the abstract and results that the chi... more for neurocognitive function. However, the authors report in the abstract and results that the children exposed to morphine showed poorer performance on two of the NEPSY-II-NL subtests, but they fail to mention this finding in the discussion. The authors emphasized that the median group scores on neurocognitive function were within the average range. However, overall function can be within the normal range in a group, yet the variation among the individuals within the group may include many children with significant difficulties, as reflected in the significant correlations. Interpreting the associations in this study is difficult because the distribution of morphine exposure was not provided. Furthermore, only 11 of the 19 children had imaging completed, a 42% loss due to poor quality of data. The authors did not provide the dose range of morphine of the subsample of 11 children included in these analyses, and did not indicate what proportion of the 4 children without morphine exposure were scanned. In addition, correlations between brain volume and neuropsychological function were not reported. Dear Sir, van den Bosch et al. [1] studied the effects of morphine exposure on brain structure and neuropsychological function, among other outcomes, in 19 children born very preterm seen at 10 years of age. The original trial, which included 150 infants [2] , evaluated very-low-dose continuous infusion of morphine to manage stress and pain during mechanical ventilation. In this latest study, at age 10 years, these authors report moderate-to-large statistically significant negative correlations between gestational age, number of painful procedures, morphine exposure and brain volumes. Furthermore, greater morphine exposure was associated with poorer performance on two subtests of neuropsychological function, but not with other outcomes, such as pain threshold. Perhaps the most important sentences in a research publication are found in the conclusion of the abstract and the beginning and end of the discussion. Here, the authors state that their data suggest that while gestational age, neonatal pain and morphine were associated with reduced brain volumes, no such effect was shown Received: August 11, 2015 Accepted: November 2, 2015 Published online: December 16, 2015
Physical & Occupational Therapy in Pediatrics, Dec 12, 2018
Purpose: To determine concurrent validity of the Bayley Scales of Infant and Toddler Development,... more Purpose: To determine concurrent validity of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) and the Peabody Developmental Motor Scales, Second Edition (PDMS-2). Method: Tests were administered to 48 children with corrected age ranging from 29 days to 26 months. Concurrent validity between age-equivalent (AE) scores and standard scores was assessed for 4 age groups. Results: Moderate to very high correlation for all groups was found between the Bayley-III composite scores and the PDMS-2 Total Motor quotient scores. High correlations were found between the Bayley-III composite scores and the PDMS-2 Gross and Fine Motor quotients (12-26 months); high correlations were found between the Bayley-III and the PDMS-2 Gross Motor quotient (6-12 months) and moderate correlations were found for younger age groups. High concurrent validity for AE scores was found only above 18 months. Conclusions: The study supports the substitution of the Bayley-III for the PDMS-2 for standard scores or AE scores for children aged 19 to 26 months and for standard scores for children birth to 18 months.
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2021
ObjectiveTo examine whether the family integrated care (FICare) programme, a multifaceted approac... more ObjectiveTo examine whether the family integrated care (FICare) programme, a multifaceted approach which enables parents to be engaged as primary caregivers in the neonatal intensive care unit, impacts infant neurodevelopment and growth at 18 months’ corrected age.Design/MethodsProspective cohort study of infants born <29 weeks’ gestational age (GA) who participated in the FICare cluster randomised control trial (cRCT) and were assessed in the Canadian Neonatal Follow-Up Network (CNFUN). The primary outcome measure, Cognitive or Language composite score <85 on the Bayley-III, was compared between FICare exposed and routine care children using logistic regression, adjusted for potential confounders and employing generalised estimation equations to account for clustering of infants within sites.ResultsOf 756 infants <29 weeks’ GA in the FICare cRCT, 505 were enrolled in CNFUN and 455 were assessed (238 FICare, 217 control). Compared with controls, FICare infants had significa...
OBJECTIVE To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit (... more OBJECTIVE To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit (NICU) improves maternal chronic physiological stress and child behavior at 18-months of corrected age (CA) for infants born preterm. STUDY DESIGN Follow-up of a multicenter, prospective cluster-Randomized Controlled Trial comparing FICare and standard care of children born at <33 weeks of gestation and parents, stratified by tertiary NICUs, across Canada. Primary outcomes at 18-months CA were maternal stress hormones (cortisol [HCC], dehydroepiandrosterone [DHEA]) assayed from hair samples. Secondary outcomes included maternal reports of parenting stress, child behaviors (Internalizing, Externalizing, Dysregulation), and observer-rated caregiving behaviors. Outcomes were analyzed using multilevel modeling. RESULTS We included 126 mother-child dyads from 12 sites (6 FICare sites, n = 83; 6 standard care sites, n = 43). FICare intervention significantly lowered maternal physiological stress as indicated by HCC (B = -0.22 [-0.41, -0.04]) and Cortisol/DHEA ratio (B = -0.25 [-0.48, -0.02]), but not DHEA (B = 0.01, [-0.11, 0.14]. Enrollment in FICare led to lower child Internalizing (B = -0.93 [-2.33, 0.02]), and Externalizing behavior T-scores (B = -0.91 [-2.25, -0.01]), via improvements to maternal HCC (mediation). FICare buffered the negative effects of high maternal HCC on child Dysregulation T-scores (B = -11.40 [-23.01, 0.21]; moderation). For mothers reporting high parenting stress at 18-months, FICare was related to lower Dysregulation T-scores, via maternal HCC; moderated mediation = -0.17 [-0.41, -0.01]. CONCLUSION FICare has long-term beneficial effects for mother and child, attenuating maternal chronic physiological stress, and improving child behavior in toddlerhood.
Medical Image Computing and Computer-Assisted Intervention – MICCAI 2016, 2016
We present a new method to identify anatomical subnetworks of the human white matter connectome t... more We present a new method to identify anatomical subnetworks of the human white matter connectome that are predictive of neurodevelopmental outcomes. We employ our method on a dataset of 168 preterm infant connectomes, generated from diffusion tensor images (DTI) taken shortly after birth, to discover subnetworks that predict scores of cognitive and motor development at 18 months. Predictive subnetworks are extracted via sparse linear regression with weights on each connectome edge. By enforcing novel backbone network and connectivity based priors, along with a non-negativity constraint, the learned subnetworks are simultaneously anatomically plausible, well connected, positively weighted and reasonably sparse. Compared to other state-of-theart subnetwork extraction methods, we found that our approach extracts subnetworks that are more integrated, have fewer noisy edges and that are also better predictive of neurodevelopmental outcomes.
ObjectiveThe purpose of this study was to determine how preterm white matter injury (WMI) and lon... more ObjectiveThe purpose of this study was to determine how preterm white matter injury (WMI) and long‐term thalamic growth interact to predict 8‐year neurodevelopmental outcomes.MethodsA prospective cohort of 114 children born at 24 to 32 weeksʼ gestational age (GA) underwent structural and diffusion tensor magnetic resonance imaging early in life (median 32 weeks), at term‐equivalent age and at 8 years. Manual segmentation of neonatal WMI was performed on T1‐weighted images and thalamic volumes were obtained using the MAGeT brain segmentation pipeline. Cognitive, motor, and visual‐motor outcomes were evaluated at 8 years of age. Multivariable regression was used to examine the relationship among neonatal WMI volume, school‐age thalamic volume, and neurodevelopmental outcomes.ResultsSchool‐age thalamic volumes were predicted by neonatal thalamic growth rate, GA, sex, and neonatal WMI volume (p < 0.0001). After accounting for total cerebral volume, WMI volume remained associated with...
Context Very preterm infants are prone to apnea and have an increased risk of death or disability... more Context Very preterm infants are prone to apnea and have an increased risk of death or disability. Caffeine therapy for apnea of prematurity reduces the rates of cerebral palsy and cognitive delay at 18 months of age. Objective To determine whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age.
To predict adverse neurodevelopmental outcome of very preterm neonates. A total of 166 preterm ne... more To predict adverse neurodevelopmental outcome of very preterm neonates. A total of 166 preterm neonates born between 24-32 weeks' gestation underwent brain MRI early in life. Radiomics features were extracted from T1-and T2-weighted images. Motor, cognitive, and language outcomes were assessed at a corrected age of 18 and 33 months and 4.5 years. Elastic Net was implemented to select the clinical and radiomic features that best predicted outcome. The area under the receiver operating characteristic (AUROC) curve was used to determine the predictive ability of each feature set. Clinical variables predicted cognitive outcome at 18 months with AUROC 0.76 and motor outcome at 4.5 years with AUROC 0.78. T1-radiomics features showed better prediction than T2-radiomics on the total motor outcome at 18 months and gross motor outcome at 33 months (AUROC: 0.81 vs 0.66 and 0.77 vs 0.7). T2-radiomics features were superior in two 4.5-year motor outcomes (AUROC: 0.78 vs 0.64 and 0.8 vs 0.57). Combining clinical parameters and radiomics features improved model performance in motor outcome at 4.5 years (AUROC: 0.84 vs 0.8). Radiomic features outperformed clinical variables for the prediction of adverse motor outcomes. Adding clinical variables to the radiomics model enhanced predictive performance. Despite advances in medical care and improved survival, infants born preterm are at risk for abnormal brain development and long-term neurodevelopmental impairments 1. These may arise in multiple functional domains including motor, cognitive, and language and continue beyond childhood and adolescence 1,2. White matter injury (WMI) is identified in up to 50% of very preterm neonates and constitutes a characteristic brain injury pattern 3. The severity of punctate WMI is best assessed on T1-weighted MRI acquired early in life before reaching term-equivalent age 4,5. Previously, we found that, in very preterm neonates, WMI location and volume on early MRI predict cognitive and motor outcomes at 18 months of age 6. However, manual volumetric segmentation of lesional burden relies on human experts and is cumbersome and time intensive. Radiomics uses a quantitative set of features calculated from radiologic images to detect distinct quantifiable phenotypic differences of tissues 7. Radiomic features quantify the intensity, texture and geometrical characteristics attributed to imaging data 8. They are increasingly used for computer-aided pattern recognition and classification, as well as image-based diagnosis and prognosis 9. Given the strong association between WMI and adverse outcomes, we hypothesized that radiomics predicts the neurodevelopmental outcome of preterm neonates at 18 months of age and beyond. We therefore aimed to (i) investigate the predictive value of radiomics to adverse neurodevelopmental outcome of preterm neonates with or without WMI, and (ii) evaluate whether integrating the clinical variables, previously established as predictors of adverse neurodevelopmental outcome 10 , can enhance the prediction accuracy of radiomics in this population.
Babies born very preterm (< 32 weeks postmenstral age), are at a high risk of having delayed or a... more Babies born very preterm (< 32 weeks postmenstral age), are at a high risk of having delayed or altered neurodevelopment. Diffusion MRI (dMRI) is a non-invasive neuroimaging modality that allows for early analysis of an infant's brain connectivity network (i.e., structural connectome) during the critical period of development shortly after birth. In this paper we present a method to accurately assess delayed brain maturation and then use our method to study how certain anatomical and diagnostic brain injury factors are related to this delay. We first train a model to predict the age of an infant from its structural brain network. We then define the relative brain network maturation index (RBNMI) as the predicted age minus the true age of that infant. To ensure the predicted age is as accurate as possible, we examine a variety of models to predict age and use one that performs best when trained on a normative subset (77 scans) of our preterm infant cohort dataset of 168 dMRI scans. We found that a random forest regressor could predict preterm infants' ages to within an average of ∼ 1.6 weeks. We validate our approach by analysing the correlation between RBNMI and a set of demographic, diagnostic and brain connectivity related variables.
Magnetoencephalography (MEG) is a brain imaging modality with considerable promise for understand... more Magnetoencephalography (MEG) is a brain imaging modality with considerable promise for understanding early neonatal brain development and its alteration in clinical populations, together with the long-term consequences of premature birth and adverse neonatal events. This article discusses present and potential contributions of MEG to neonatology and neonatal follow-up. We give a brief overview of MEG and discuss its advantages and capabilities. We review fetal MEG and neonatal MEG, including the recent introduction of dedicated neonatal MEG systems. The use of MEG for understanding long-term neurocognitive outcome in populations such as school-aged children born very preterm will be discussed, as well as recent advances in MEG that represent significant opportunities for understanding neonatal brain development. In summary, MEG provides a powerful method to create a noninvasive record of neuronal activity throughout fetal development, neonatal life, and childhood.
for neurocognitive function. However, the authors report in the abstract and results that the chi... more for neurocognitive function. However, the authors report in the abstract and results that the children exposed to morphine showed poorer performance on two of the NEPSY-II-NL subtests, but they fail to mention this finding in the discussion. The authors emphasized that the median group scores on neurocognitive function were within the average range. However, overall function can be within the normal range in a group, yet the variation among the individuals within the group may include many children with significant difficulties, as reflected in the significant correlations. Interpreting the associations in this study is difficult because the distribution of morphine exposure was not provided. Furthermore, only 11 of the 19 children had imaging completed, a 42% loss due to poor quality of data. The authors did not provide the dose range of morphine of the subsample of 11 children included in these analyses, and did not indicate what proportion of the 4 children without morphine exposure were scanned. In addition, correlations between brain volume and neuropsychological function were not reported. Dear Sir, van den Bosch et al. [1] studied the effects of morphine exposure on brain structure and neuropsychological function, among other outcomes, in 19 children born very preterm seen at 10 years of age. The original trial, which included 150 infants [2] , evaluated very-low-dose continuous infusion of morphine to manage stress and pain during mechanical ventilation. In this latest study, at age 10 years, these authors report moderate-to-large statistically significant negative correlations between gestational age, number of painful procedures, morphine exposure and brain volumes. Furthermore, greater morphine exposure was associated with poorer performance on two subtests of neuropsychological function, but not with other outcomes, such as pain threshold. Perhaps the most important sentences in a research publication are found in the conclusion of the abstract and the beginning and end of the discussion. Here, the authors state that their data suggest that while gestational age, neonatal pain and morphine were associated with reduced brain volumes, no such effect was shown Received: August 11, 2015 Accepted: November 2, 2015 Published online: December 16, 2015
Physical & Occupational Therapy in Pediatrics, Dec 12, 2018
Purpose: To determine concurrent validity of the Bayley Scales of Infant and Toddler Development,... more Purpose: To determine concurrent validity of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) and the Peabody Developmental Motor Scales, Second Edition (PDMS-2). Method: Tests were administered to 48 children with corrected age ranging from 29 days to 26 months. Concurrent validity between age-equivalent (AE) scores and standard scores was assessed for 4 age groups. Results: Moderate to very high correlation for all groups was found between the Bayley-III composite scores and the PDMS-2 Total Motor quotient scores. High correlations were found between the Bayley-III composite scores and the PDMS-2 Gross and Fine Motor quotients (12-26 months); high correlations were found between the Bayley-III and the PDMS-2 Gross Motor quotient (6-12 months) and moderate correlations were found for younger age groups. High concurrent validity for AE scores was found only above 18 months. Conclusions: The study supports the substitution of the Bayley-III for the PDMS-2 for standard scores or AE scores for children aged 19 to 26 months and for standard scores for children birth to 18 months.
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2021
ObjectiveTo examine whether the family integrated care (FICare) programme, a multifaceted approac... more ObjectiveTo examine whether the family integrated care (FICare) programme, a multifaceted approach which enables parents to be engaged as primary caregivers in the neonatal intensive care unit, impacts infant neurodevelopment and growth at 18 months’ corrected age.Design/MethodsProspective cohort study of infants born <29 weeks’ gestational age (GA) who participated in the FICare cluster randomised control trial (cRCT) and were assessed in the Canadian Neonatal Follow-Up Network (CNFUN). The primary outcome measure, Cognitive or Language composite score <85 on the Bayley-III, was compared between FICare exposed and routine care children using logistic regression, adjusted for potential confounders and employing generalised estimation equations to account for clustering of infants within sites.ResultsOf 756 infants <29 weeks’ GA in the FICare cRCT, 505 were enrolled in CNFUN and 455 were assessed (238 FICare, 217 control). Compared with controls, FICare infants had significa...
OBJECTIVE To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit (... more OBJECTIVE To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit (NICU) improves maternal chronic physiological stress and child behavior at 18-months of corrected age (CA) for infants born preterm. STUDY DESIGN Follow-up of a multicenter, prospective cluster-Randomized Controlled Trial comparing FICare and standard care of children born at <33 weeks of gestation and parents, stratified by tertiary NICUs, across Canada. Primary outcomes at 18-months CA were maternal stress hormones (cortisol [HCC], dehydroepiandrosterone [DHEA]) assayed from hair samples. Secondary outcomes included maternal reports of parenting stress, child behaviors (Internalizing, Externalizing, Dysregulation), and observer-rated caregiving behaviors. Outcomes were analyzed using multilevel modeling. RESULTS We included 126 mother-child dyads from 12 sites (6 FICare sites, n = 83; 6 standard care sites, n = 43). FICare intervention significantly lowered maternal physiological stress as indicated by HCC (B = -0.22 [-0.41, -0.04]) and Cortisol/DHEA ratio (B = -0.25 [-0.48, -0.02]), but not DHEA (B = 0.01, [-0.11, 0.14]. Enrollment in FICare led to lower child Internalizing (B = -0.93 [-2.33, 0.02]), and Externalizing behavior T-scores (B = -0.91 [-2.25, -0.01]), via improvements to maternal HCC (mediation). FICare buffered the negative effects of high maternal HCC on child Dysregulation T-scores (B = -11.40 [-23.01, 0.21]; moderation). For mothers reporting high parenting stress at 18-months, FICare was related to lower Dysregulation T-scores, via maternal HCC; moderated mediation = -0.17 [-0.41, -0.01]. CONCLUSION FICare has long-term beneficial effects for mother and child, attenuating maternal chronic physiological stress, and improving child behavior in toddlerhood.
Medical Image Computing and Computer-Assisted Intervention – MICCAI 2016, 2016
We present a new method to identify anatomical subnetworks of the human white matter connectome t... more We present a new method to identify anatomical subnetworks of the human white matter connectome that are predictive of neurodevelopmental outcomes. We employ our method on a dataset of 168 preterm infant connectomes, generated from diffusion tensor images (DTI) taken shortly after birth, to discover subnetworks that predict scores of cognitive and motor development at 18 months. Predictive subnetworks are extracted via sparse linear regression with weights on each connectome edge. By enforcing novel backbone network and connectivity based priors, along with a non-negativity constraint, the learned subnetworks are simultaneously anatomically plausible, well connected, positively weighted and reasonably sparse. Compared to other state-of-theart subnetwork extraction methods, we found that our approach extracts subnetworks that are more integrated, have fewer noisy edges and that are also better predictive of neurodevelopmental outcomes.
ObjectiveThe purpose of this study was to determine how preterm white matter injury (WMI) and lon... more ObjectiveThe purpose of this study was to determine how preterm white matter injury (WMI) and long‐term thalamic growth interact to predict 8‐year neurodevelopmental outcomes.MethodsA prospective cohort of 114 children born at 24 to 32 weeksʼ gestational age (GA) underwent structural and diffusion tensor magnetic resonance imaging early in life (median 32 weeks), at term‐equivalent age and at 8 years. Manual segmentation of neonatal WMI was performed on T1‐weighted images and thalamic volumes were obtained using the MAGeT brain segmentation pipeline. Cognitive, motor, and visual‐motor outcomes were evaluated at 8 years of age. Multivariable regression was used to examine the relationship among neonatal WMI volume, school‐age thalamic volume, and neurodevelopmental outcomes.ResultsSchool‐age thalamic volumes were predicted by neonatal thalamic growth rate, GA, sex, and neonatal WMI volume (p < 0.0001). After accounting for total cerebral volume, WMI volume remained associated with...
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Papers by Ruth E Grunau