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Iron levels in Deep Grey Matter Structures in Preterm Infants as a Marker for Cognitive Decline following Brain Injury

Poster Session D - Monday, March 9, 2026, 8:00 – 10:00 am PDT, Fairview/Kitsilano Ballrooms

Ran Mo¹ (ran.mo@bcchr.ca), Floria Lu¹, Cecil Chau¹, Steven Ufkes¹, Jessie van Dyk¹, Steven Miller¹, Ruth Grunau¹, Alexander Mark Weber¹; ¹BC Children's Hospital Research Institute

Abnormal brain iron accumulation following brain injury in preterm infants is known to lead to poor neurodevelopmental outcomes later in life, highlighting the importance of detecting these changes early in the infant’s life. Quantitative susceptibility mapping (QSM), a non-invasive MRI technique, can quantify brain iron levels, allowing for the rapid identification of these iron accumulations. We hypothesized that deep grey matter (DGM) structures served as sites of iron accumulation following brain injury in preterm infants, increasing susceptibility to cognitive disorders. 110 subjects (GA range: 24-32 weeks) underwent MRI scans following brain injury and 57 scans with clear visibility of the ROIs (thalamus and caudate nucleus) were selected for QSM analysis. Veins and brain bleeds interfering with the ROI values were masked out, and the mean chi values (proportional to iron levels) of the ROIs were recorded and interactively compared with gestational age (GA), postmenstrual age (PMA), and the sum of brain injuries (IVH + WM injuries + ventriculomegaly) via a mixed effects linear regression model (Chi ROI ~ PMA + Injuries + GA + (1 | Subject)). While chi values in the caudate nucleus did not significantly interact with injuries (p > 0.05), the left thalamus showed significant interactions with injury (ß = 0.0007691, p = 0.013046), suggesting that the thalamus may serve as a site of iron accumulation following brain injury in preterm infants, potentially making the thalamus more susceptible to neurodegeneration. These results suggest the potential for thalamic iron levels to serve as a marker for cognitive disorders.

Topic Area: METHODS: Neuroimaging