{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T09:31:43Z","timestamp":1793611903351,"version":"4.5.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Extremely preterm infants are at high risk for neurodevelopmental impairment. The brainstem plays a critical role in early development. This study aimed to establish reference values for two-dimensional brainstem measurements on cerebral magnetic resonance imaging (cMRI) at term-equivalent age (TEA), assess the impact of severe neonatal brain injury, and examine associations with neurodevelopment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective cohort study, preterm infants underwent routine cMRI at TEA. Standardized midsagittal brainstem measurements were obtained. Reference values and\n                      <jats:italic>z<\/jats:italic>\n                      -scores were derived from infants without severe brain injury (high-grade IVH, CBH, or cystic WMI). In the reference cohort, associations with Bayley-III outcomes at 2 years\u2019 corrected age were evaluated using multivariable regression. Brainstem\n                      <jats:italic>z<\/jats:italic>\n                      -scores were compared between infants with and without severe brain injury.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Reference values were established for 242 infants born between 22\u2009+\u20091 and 27\u2009+\u20096 weeks\u2019 gestation. Brainstem size increased with gestational age and was significantly smaller in infants with severe brain injury. Higher brainstem\n                      <jats:italic>z<\/jats:italic>\n                      -scores were independently associated with better cognitive (adjusted\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20093.56, 95% CI: 0.44\u20136.69) and motor (adjusted\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20092.80, 95% CI: 0.39\u20135.22) outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Brainstem size was associated with neonatal brain injury and later neurodevelopment, supporting its potential as a clinically applicable cMRI biomarker in extremely preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            Reference values and\n                            <jats:italic>z<\/jats:italic>\n                            -scores for two-dimensional brainstem measurements at term-equivalent age in extremely preterm infants without severe brain injury.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Reduced brainstem size in infants with severe brain injury, and association with cognitive and motor outcomes at 2 years\u2019 corrected age.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Brainstem size is a simple and reproducible MRI biomarker.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-026-05529-9","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:44:40Z","timestamp":1790657080000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Brainstem size in extremely preterm infants: reference values and association with neurodevelopmental outcomes"],"prefix":"10.1038","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-4155","authenticated-orcid":false,"given":"Julia","family":"Buchmayer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Zeugswetter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate","family":"Fuiko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Kasprian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Kleberma\u00df-Schrehof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Schmidbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Stummer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Goeral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"5529_CR1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1097\/WCO.0b013e3282f88bb4","volume":"21","author":"MC Allen","year":"2008","unstructured":"Allen, M. 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Written informed consent was obtained from all parents prior to the routine cMRI examination.","order":2,"name":"Ethics","label":"Consent statement","group":{"name":"EthicsHeading","label":"Ethics"}}]}}