Multimodal image analysis of clinical influences on preterm brain development

Gareth Ball, Paul Aljabar, Phumza Nongena, Nigel Kennea, Nuria Gonzalez-Cinca, Shona Falconer, Andrew T M Chew, Nicholas Harper, Julia Wurie, Mary A Rutherford, Serena J Counsell, A David Edwards

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Premature birth is associated with numerous complex abnormalities of white and grey matter and a high incidence of long-term neurocognitive impairment. An integrated understanding of these abnormalities and their association with clinical events is lacking. The aim of this study was to identify specific patterns of abnormal cerebral development and their antenatal and postnatal antecedents. 


In a prospective cohort of 449 infants (226 male), we performed a multi-variate and data-driven analysis combining multiple imaging modalities. Using canonical correlation analysis, we sought separable multimodal imaging markers associated with specific clinical and environmental factors and correlated to neurodevelopmental outcome at 2 years. 


We found five independent patterns of neuroanatomical variation that related to clinical factors including age, prematurity, sex, intrauterine complications, and postnatal adversity. We also confirmed the association between imaging markers of neuroanatomical abnormality and poor cognitive and motor outcomes at 2 years. 


This data-driven approach defined novel and clinically relevant imaging markers of cerebral maldevelopment, which offer new insights into the nature of preterm brain injury. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)233-246
Number of pages14
JournalAnnals of Neurology
Issue number2
Early online date19 Aug 2017
Publication statusPublished - Aug 2017


  • Journal Article


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