Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study.
Sonia Khurana, Megan E Evans, Claire E Kelly and 9 others
PMID 34160340WHAT IT FOUND
Non-sedated MRI scans in very preterm infants were feasible, with high retention and image quality.
Brain white matter structure changed predictably over six months. Differences between intervention groups were inconsistent and could not determine if the therapy worked.
Key findings
01The study successfully enrolled and retained participants, achieving a 60% consent rate and obtaining high-quality images from 100% of scheduled visits.
02Across all infants, white matter structure showed a consistent longitudinal trend: fractional anisotropy and volume increased, while mean diffusivity decreased from baseline to six months.
03Exploratory analysis of three infants showed inconsistent changes in brain structure between the early intervention, late intervention, and usual care groups, preventing any conclusion about treatment efficacy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was extremely small (5 infants), which severely limits statistical power and generalizability. The study was interrupted by the COVID-19 pandemic, leading to missed visits and incomplete data for some participants. The exploratory analysis of group differences was based on only one infant per group, making it impossible to distinguish treatment effects from individual variability or chance. The study was designed to test feasibility, not efficacy, so it cannot determine if the intervention works. Brain injury severity was assessed clinically rather than with a standardized research measure, which may introduce bias.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not interpret the observed brain changes as evidence that the intervention works. The study was a feasibility pilot with only five infants, and the differences between intervention and usual care groups were inconsistent and likely due to chance or individual factors like gestational age, not the treatment itself.