The Necessity and Difficulty of Conducting Magnetic Resonance Imaging Studies on Infant Brain Development

Decision-making in the care of gravely ill, prematurely born infants must balance the long-term effects of numerous medical complications with those of their treatments. Antenatal and postnatal administration of glucocorticoids clearly enhance fetal lung maturation and survival,1–3 and yet growing clinical and preclinical data suggest that these therapies may be associated with disturbances in long-term brain development and cognition.4–6 The article by Murphy and colleagues7 in the February 2001 issue of Pediatrics contributed importantly to this growing evidence by showing that postnatal glucocorticoid administration is associated with a reduced volume of cortical gray matter in preterm infants. This article is the latest in a series of studies from this investigational team that has helped to characterize normal and pathologic infant brain development.8–13 The work from this group has been bold, pioneering, and (given the innumerable technical difficulties associated with scanning infants) nothing short of heroic. Because of the potential implications of this particular study for clinical decision-making, it is important to note its limitations and the inherent difficulties of interpreting findings from …