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Lenfeldt N, Johansson AM, Domellöf E, Riklund K, Rönnqvist L. Alterations in white matter microstructure are associated with goal-directed upper-limb movement segmentation in children born extremely preterm. Hum Brain Mapp 2017; 38:5051-5068. [PMID: 28685893 DOI: 10.1002/hbm.23714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 12/14/2022] Open
Abstract
Altered white matter microstructure is commonly found in children born preterm (PT), especially those born at an extremely low gestational age (GA). These children also commonly show disturbed motor function. This study explores the relation between white matter alterations and upper-limb movement segmentation in 41 children born PT (19 girls), and 41 children born at term (18 girls) at 8 years. The PT group was subdivided into extremely PT (E-PT; GA = 25-27 weeks, N = 10), very PT (V-PT; GA = 28-32 weeks, N = 13), and moderately PT (M-PT; GA = 33-35 weeks, N = 18). Arm/hand preference (preferred/non-preferred) was determined through object interactions and the brain hemispheres were designated accordingly. White matter alterations were assessed using diffusion tensor imaging in nine areas, and movement segmentation of the body-parts head, shoulder, elbow, and wrist were registered during a unimanual goal-directed task. Increased movement segmentation was demonstrated consistently on the preferred side in the E-PT group compared with the term born group. Also compared with the term born peers, the E-PT group demonstrated reduced fractional anisotropy (FA) in the cerebral peduncle (targeting the corticospinal tract) in the hemisphere on the non-preferred side and in the splenium of corpus callosum. In contrast, in the anterior internal capsule on the preferred side, the E-PT group had increased FA. Lower FA in the cerebral peduncle, but higher FA in the anterior internal capsule, was associated with increased movement segmentation across body-parts in a contralateral manner. The results suggest that impaired development of sensorimotor tracts in E-PT children could explain a sub-optimal spatiotemporal organization of upper-limb movements. Hum Brain Mapp 38:5051-5068, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Niklas Lenfeldt
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Anna-Maria Johansson
- Department of Psychology, , Umeå University, Umeå, Sweden.,Department of Community Medicine and Rehabilitation, Physiotheraphy, Umeå University, Umeå, Sweden
| | - Erik Domellöf
- Department of Psychology, , Umeå University, Umeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
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Vollmer B, Lundequist A, Mårtensson G, Nagy Z, Lagercrantz H, Smedler AC, Forssberg H. Correlation between white matter microstructure and executive functions suggests early developmental influence on long fibre tracts in preterm born adolescents. PLoS One 2017; 12:e0178893. [PMID: 28594884 PMCID: PMC5464584 DOI: 10.1371/journal.pone.0178893] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 05/19/2017] [Indexed: 12/04/2022] Open
Abstract
Main objectives Executive functions are frequently a weakness in children born preterm. We examined associations of executive functions and general cognitive abilities with brain structure in preterm born adolescents who were born with appropriate weight for gestational age and who have no radiological signs of preterm brain injury on neuroimaging. Methods The Stockholm Neonatal Project (SNP) is a longitudinal, population-based study of children born preterm (<36 weeks of gestation) with very low birth weight (<1501g) between 1988–1993. At age 18 years (mean 18 years, SD 2 weeks) 134 preterm born and 94 full term participants underwent psychological assessment (general intelligence, executive function measures). Of these, 71 preterm and 63 full term participants underwent Magnetic Resonance Imaging (MRI) at mean 15.2 years (range 12–18 years), including 3D T1-weighted images for volumetric analyses and Diffusion Tensor Imaging (DTI) for assessment of white matter microstructure. Group comparisons of regional grey and white matter volumes and fractional anisotropy (FA, as a measure of white matter microstructure) and, within each group, correlation analyses of cognitive measures with MRI metrics were carried out. Results Significant differences in grey and white matter regional volumes and widespread differences in FA were seen between the two groups. No significant correlations were found between cognitive measures and brain volumes in any group after correction for multiple comparisons. However, there were significant correlations between FA in projection fibres and long association fibres, linking frontal, temporal, parietal, and occipital lobes, and measures of executive function and general cognitive abilities in the preterm born adolescents, but not in the term born adolescents. Overall significance of the study In persons born preterm, in the absence of perinatal brain injury on visual inspection of MRI, widespread alterations in regional brain tissue volumes and microstructure are present in adolescence/young adulthood. Importantly, these alterations in WM tracts are correlated with measures of executive function and general cognitive abilities. Our findings suggest that disturbance of neural pathways, rather than changes in regional brain volumes, are involved in the impaired cognitive functions.
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Affiliation(s)
- Brigitte Vollmer
- Neuropaediatrics, Department of Women’s and Children’s Health, Karolinska Institutet, Astrid Lindgren Children’s Hospital, Stockholm, Sweden
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- * E-mail:
| | - Aiko Lundequist
- Neuropaediatrics, Department of Women’s and Children’s Health, Karolinska Institutet, Astrid Lindgren Children’s Hospital, Stockholm, Sweden
| | - Gustaf Mårtensson
- Neuropaediatrics, Department of Women’s and Children’s Health, Karolinska Institutet, Astrid Lindgren Children’s Hospital, Stockholm, Sweden
| | - Zoltan Nagy
- Department of Economics, University of Zürich, Zürich, Switzerland
| | - Hugo Lagercrantz
- Neonatal Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Astrid Lindgren Children’s Hospital, Stockholm, Sweden
| | | | - Hans Forssberg
- Neuropaediatrics, Department of Women’s and Children’s Health, Karolinska Institutet, Astrid Lindgren Children’s Hospital, Stockholm, Sweden
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Nunes RD, Schutz FD, Traebert JL. Association between the use of magnesium sulfate as neuroprotector in prematurity and the neonatal hemodynamic effects. J Matern Fetal Neonatal Med 2017; 31:1900-1905. [PMID: 28521581 DOI: 10.1080/14767058.2017.1332033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Cerebral palsy is often associated with prematurity and magnesium sulfate (MgSO4) has been used as a neuroprotector, with favorable results. However, its mechanism of action has not been fully elucidated. This study aimed to evaluate the association between MgSO4 at the imminent premature delivery and neonatal hemodynamic effects. MATERIALS AND METHODS A cross-sectional study involving 94 newborns (NB) between 24 and 32 weeks at a Brazilian hospital was performed. Bivariate analysis between the use or the non-use of MgSO4 and hemodynamic characteristics was performed, using the Chi-square test. RESULTS NB were evaluated between those who received MgSO4 (27.7) and those who did not (72.3%). Normal heart rate was verified in 62.8% of NB, normal respiratory rate in 70.2%, and normal temperature in 22.3%. Oxygen saturation higher or equal than 95% was evidenced in 85.1% of NB, normal hemoglucotest in 74.5%, and hemoglobin greater or equal than 16.4 g/dL in 30.9%. Non-invasive ventilation was performed in 48.9% of NB, while 51.1% were submitted to endotracheal ventilation. There was no significance relation detected between the use of MgSO4 and the hemodynamic characteristics. CONCLUSIONS MgSO4 does not appear to influence hemodynamic factors as a cause of the neuroprotection in premature NB.
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Affiliation(s)
- Rodrigo Dias Nunes
- a Graduate Program in Health Sciences , Universidade do Sul de Santa Catarina , Palhoca , Brazil
| | - Flávia Duarte Schutz
- a Graduate Program in Health Sciences , Universidade do Sul de Santa Catarina , Palhoca , Brazil
| | - Jefferson Luiz Traebert
- a Graduate Program in Health Sciences , Universidade do Sul de Santa Catarina , Palhoca , Brazil
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Paquette N, Shi J, Wang Y, Lao Y, Ceschin R, Nelson MD, Panigrahy A, Lepore N. Ventricular shape and relative position abnormalities in preterm neonates. NEUROIMAGE-CLINICAL 2017. [PMID: 28649491 PMCID: PMC5470570 DOI: 10.1016/j.nicl.2017.05.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Recent neuroimaging findings have highlighted the impact of premature birth on subcortical development and morphological changes in the deep grey nuclei and ventricular system. To help characterize subcortical microstructural changes in preterm neonates, we recently implemented a multivariate tensor-based method (mTBM). This method allows to precisely measure local surface deformation of brain structures in infants. Here, we investigated ventricular abnormalities and their spatial relationships with surrounding subcortical structures in preterm neonates. We performed regional group comparisons on the surface morphometry and relative position of the lateral ventricles between 19 full-term and 17 preterm born neonates at term-equivalent age. Furthermore, a relative pose analysis was used to detect individual differences in translation, rotation, and scale of a given brain structure with respect to an average. Our mTBM results revealed broad areas of alterations on the frontal horn and body of the left ventricle, and narrower areas of differences on the temporal horn of the right ventricle. A significant shift in the rotation of the left ventricle was also found in preterm neonates. Furthermore, we located significant correlations between morphology and pose parameters of the lateral ventricles and that of the putamen and thalamus. These results show that regional abnormalities on the surface and pose of the ventricles are also associated with alterations on the putamen and thalamus. The complementarity of the information provided by the surface and pose analysis may help to identify abnormal white and grey matter growth, hinting toward a pattern of neural and cellular dysmaturation.
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Affiliation(s)
- N Paquette
- Department of Radiology, University of Southern California and Children's Hospital of Los Angeles, CA, USA
| | - J Shi
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Y Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Y Lao
- Department of Radiology, University of Southern California and Children's Hospital of Los Angeles, CA, USA
| | - R Ceschin
- Department of Radiology, Children's Hospital of Pittsburgh UPMC, Pittsburgh, PA, USA
| | - M D Nelson
- Department of Radiology, University of Southern California and Children's Hospital of Los Angeles, CA, USA
| | - A Panigrahy
- Department of Radiology, Children's Hospital of Pittsburgh UPMC, Pittsburgh, PA, USA
| | - N Lepore
- Department of Radiology, University of Southern California and Children's Hospital of Los Angeles, CA, USA.
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Affeldt BM, Obenaus A, Chan J, Pardo AC. Region specific oligodendrocyte transcription factor expression in a model of neonatal hypoxic injury. Int J Dev Neurosci 2017; 61:1-11. [DOI: 10.1016/j.ijdevneu.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/11/2017] [Accepted: 05/17/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- Bethann M. Affeldt
- Department of PediatricsLoma Linda University11175 Campus St., Coleman Pavilion Room A1109Loma LindaCA92354USA
| | - Andre Obenaus
- Department of PediatricsLoma Linda University11175 Campus St., Coleman Pavilion Room A1109Loma LindaCA92354USA
- Cell, Molecular and Developmental Biology ProgramUniversity of CaliforniaRiverside, 1140 Bachelor HallRiversideCA92521USA
| | - Jonathan Chan
- Department of PediatricsLoma Linda University11175 Campus St., Coleman Pavilion Room A1109Loma LindaCA92354USA
| | - Andrea C. Pardo
- Department of PediatricsLoma Linda University11175 Campus St., Coleman Pavilion Room A1109Loma LindaCA92354USA
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Weeke LC, Brilstra E, Braun KP, Zonneveld-Huijssoon E, Salomons GS, Koeleman BP, van Gassen KL, van Straaten HL, Craiu D, de Vries LS. Punctate white matter lesions in full-term infants with neonatal seizures associated with SLC13A5 mutations. Eur J Paediatr Neurol 2017; 21:396-403. [PMID: 27913086 DOI: 10.1016/j.ejpn.2016.11.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 11/13/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Early-onset epileptic encephalopathy caused by biallelic SLC13A5 mutations is characterized by seizure onset in the first days of life, refractory epilepsy and developmental delay. Little detailed information about the brain MRI features is available in these patients. METHODS Observational study describing the neuro-imaging findings in eight patients (five families) with mutations in the SLC13A5 gene. Seven infants had an MRI in the neonatal period, two had a follow-up MRI at the age of 6 and 18 months and one only at 13 months. One patient had follow-up MRIs at 11 and 16 months and 3 and 6 years of age, but no neonatal MRI. RESULTS All patients presented with refractory neonatal seizures on the first day of life after an uncomplicated pregnancy and term delivery. Six out of seven infants with a neonatal MRI had a characteristic MRI pattern, with punctate white matter lesions (PWML), which were no longer visible at the age of 6 months, but led to gliotic scarring visible on MRI at the age of 18 months. The same pattern of gliotic scarring was seen on the MRIs of the infant without a neonatal scan. One infant had signal abnormalities in the white matter suspected of PWML on T2WI, but these could not be confirmed on other sequences. CONCLUSION In infants presenting with therapy resistant seizures in the first days after birth, without a clear history of hypoxic-ischemic encephalopathy, but with PWML on their neonatal MRI, a diagnosis of SCL13A5 related epileptic encephalopathy should be considered.
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Affiliation(s)
- Lauren C Weeke
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eva Brilstra
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kees P Braun
- Department of Pediatric Neurology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Gajja S Salomons
- Metabolic Unit, Department of Clinical Chemistry, VU University Medical Center/Neuroscience Campus, Amsterdam, The Netherlands
| | - Bobby P Koeleman
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Koen L van Gassen
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Dana Craiu
- Pediatric Neurology Discipline, Department of Clinical Neurosciences, "Carol Davila" University of Medicine, Bucharest, Romania; Pediatric Neurology Clinic, Alexandru Obregia Hospital, Bucharest, Romania
| | - Linda S de Vries
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
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White matter alterations to cingulum and fornix following very preterm birth and their relationship with cognitive functions. Neuroimage 2017; 150:373-382. [PMID: 28216430 PMCID: PMC5405171 DOI: 10.1016/j.neuroimage.2017.02.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 11/12/2016] [Accepted: 02/10/2017] [Indexed: 12/13/2022] Open
Abstract
Very preterm birth (VPT; <32 weeks of gestation) has been associated with impairments in memory abilities and functional neuroanatomical brain alterations in medial temporal and fronto-parietal areas. Here we investigated the relationship between structural connectivity in memory-related tracts and various aspects of memory in VPT adults (mean age 19) who sustained differing degrees of perinatal brain injury (PBI), as assessed by neonatal cerebral ultrasound. We showed that the neurodevelopmental consequences of VPT birth persist into young adulthood and are associated with neonatal cranial ultrasound classification. At a cognitive level, VPT young adults showed impairments specific to effective organization of verbal information and visuospatial memory, whereas at an anatomical level they displayed reduced volume of memory-related tracts, the cingulum and the fornix, with greater alterations in those individuals who experienced high-grade PBI. When investigating the association between these tracts and memory scores, perseveration errors were associated with the volume of the fornix and dorsal cingulum (connecting medial frontal and parietal lobes). Visuospatial memory scores were associated with the volume of the ventral cingulum (connecting medial parietal and temporal lobes). These results suggest that structural connectivity alterations could underlie memory difficulties in preterm born individuals. Very preterm born adults exhibit memory and learning impairments. White matter tracts implicated in memory are altered following perinatal brain injury. Structural alterations to memory tracts may underlie specific memory impairments.
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Drommelschmidt K, Serdar M, Bendix I, Herz J, Bertling F, Prager S, Keller M, Ludwig AK, Duhan V, Radtke S, de Miroschedji K, Horn PA, van de Looij Y, Giebel B, Felderhoff-Müser U. Mesenchymal stem cell-derived extracellular vesicles ameliorate inflammation-induced preterm brain injury. Brain Behav Immun 2017; 60:220-232. [PMID: 27847282 DOI: 10.1016/j.bbi.2016.11.011] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/04/2016] [Accepted: 11/12/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Preterm brain injury is a major cause of disability in later life, and may result in motor, cognitive and behavioural impairment for which no treatment is currently available. The aetiology is considered as multifactorial, and one underlying key player is inflammation leading to white and grey matter injury. Extracellular vesicles secreted by mesenchymal stem/stromal cells (MSC-EVs) have shown therapeutic potential in regenerative medicine. Here, we investigated the effects of MSC-EV treatment on brain microstructure and maturation, inflammatory processes and long-time outcome in a rodent model of inflammation-induced brain injury. METHODS 3-Day-old Wistar rats (P3) were intraperitoneally injected with 0.25mg/kg lipopolysaccharide or saline and treated with two repetitive doses of 1×108 cell equivalents of MSC-EVs per kg bodyweight. Cellular degeneration and reactive gliosis at P5 and myelination at P11 were evaluated by immunohistochemistry and western blot. Long-term cognitive and motor function was assessed by behavioural testing. Diffusion tensor imaging at P125 evaluated long-term microstructural white matter alterations. RESULTS MSC-EV treatment significantly ameliorated inflammation-induced neuronal cellular degeneration reduced microgliosis and prevented reactive astrogliosis. Short-term myelination deficits and long-term microstructural abnormalities of the white matter were restored by MSC-EV administration. Morphological effects of MSC-EV treatment resulted in improved long-lasting cognitive functions INTERPRETATION: MSC-EVs ameliorate inflammation-induced cellular damage in a rat model of preterm brain injury. MSC-EVs may serve as a novel therapeutic option by prevention of neuronal cell death, restoration of white matter microstructure, reduction of gliosis and long-term functional improvement.
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Affiliation(s)
- Karla Drommelschmidt
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Meray Serdar
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ivo Bendix
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Josephine Herz
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Frederik Bertling
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sebastian Prager
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Matthias Keller
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna-Kristin Ludwig
- Institute of Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Vikas Duhan
- Institute of Immunology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Stefan Radtke
- Institute of Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Clinical Research Division, Fred Hutchinson Cancer Research Centre, Seattle, WA 98109, USA
| | - Kyra de Miroschedji
- Institute of Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Peter A Horn
- Institute of Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Yohan van de Looij
- Division of Child Growth and Development, Department of Paediatrics, University of Geneva, Geneva, Switzerland; Laboratory of Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Bernd Giebel
- Institute of Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Ursula Felderhoff-Müser
- Department of Paediatrics I/Neonatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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Neubauer V, Djurdjevic T, Griesmaier E, Biermayr M, Gizewski ER, Kiechl-Kohlendorfer U. Routine Magnetic Resonance Imaging at Term-Equivalent Age Detects Brain Injury in 25% of a Contemporary Cohort of Very Preterm Infants. PLoS One 2017; 12:e0169442. [PMID: 28046071 PMCID: PMC5207745 DOI: 10.1371/journal.pone.0169442] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 12/16/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction In recent years, significant investigation has been undertaken by means of magnetic resonance imaging (MRI) in an attempt to identify preterm infants at risk for adverse outcome. The primary objective is to provide a comprehensive characterization of cerebral injury detected by conventional MRI at term-equivalent age in an unselected, consecutive, contemporary cohort of preterm infants born <32 gestational weeks. Secondly, this study aims to identify risk factors for the different injury types in this population. Methods Data for all preterm infants born <32 gestational weeks and admitted to Innsbruck Medical University Hospital were prospectively collected (October 2010 to December 2015). Cerebral MRI was evaluated retrospectively using a validated scoring system that incorporates intraventricular haemorrhage (IVH), white matter disease (WMD) and cerebellar haemorrhage (CBH). Results 300 infants were included in the study. MRI showed 24.7% of all infants to have some form of brain injury. The most common injury type was IVH (16.0%). WMD and CBH were seen in 10.0% and 8.0%. The prevalence of common neonatal risk factors was greater within the group of infants with CBH. In particular indicators for respiratory disease were observed more often: longer ventilation duration, more frequent need for supplemental oxygen at day 28, higher rates of hydrocortisone treatment. Catecholamine treatment was the only neonatal risk factor that was overrepresented in infants with WMD Discussion Cerebral MRI at term-equivalent age, as addition to cranial ultrasound, detected brain injury in 25% of preterm survivors. The diagnosis of IVH was already made by neonatal ultrasound in most cases. In contrast, only a minority of the CBH and none of the non-cystic WMD have been detected prior to MRI. Decreasing gestational age and neonatal complications involved with immaturity have been identified as risk factors for CBH, whereas WMD was found in relatively mature infants with circulatory disturbances.
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Affiliation(s)
- Vera Neubauer
- Department of Paediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
- * E-mail:
| | - Tanja Djurdjevic
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elke Griesmaier
- Department of Paediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Marlene Biermayr
- Department of Paediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elke Ruth Gizewski
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
- Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria
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Bruno CJ, Bengani S, Gomes WA, Brewer M, Vega M, Xie X, Kim M, Fuloria M. MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants. Neonatology 2017; 111:317-323. [PMID: 28076856 DOI: 10.1159/000453576] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis. OBJECTIVE To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age. METHODS This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants. RESULTS Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI. CONCLUSIONS Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships.
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Affiliation(s)
- Christie J Bruno
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
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Kim DY, Park HK, Kim NS, Hwang SJ, Lee HJ. Neonatal diffusion tensor brain imaging predicts later motor outcome in preterm neonates with white matter abnormalities. Ital J Pediatr 2016; 42:104. [PMID: 27906083 PMCID: PMC5134238 DOI: 10.1186/s13052-016-0309-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND White matter (WM) abnormalities associated with prematurity are one of the most important causes of neurological disability that involves spastic motor deficits in preterm newborns. This study aimed to evaluate regional microstructural changes in diffusion tensor imaging (DTI) associated with WM abnormalities. METHODS We prospectively studied extremely low birth weight (ELBW; <1000 g) preterm infants who were admitted to the Neonatal Intensive Care Unit of Hanyang University Hospital between February 2011 and February 2014. WM abnormalities were assessed with conventional magnetic resonance (MR) imaging and DTI near term-equivalent age before discharge. Region-of-interests (ROIs) measurements were performed to examine the regional distribution of fractional anisotropy (FA) values. RESULTS Thirty-two out of 72 ELBW infants underwent conventional MR imaging and DTI at term-equivalent age. Ten of these infants developed WM abnormalities associated with prematurity. Five of ten of those with WM abnormalities developed cerebral palsy (CP). DTI in the WM abnormalities with CP showed a significant reduction of mean FA in the genu of the corpus callosum (p = 0.022), the ipsilateral posterior limb of the internal capsule (p = 0.019), and the ipsilateral centrum semiovale (p = 0.012) compared to normal WM and WM abnormalities without CP. In infants having WM abnormalities with CP, early FA values in neonatal DTI revealed abnormalities of the WM regions prior to the manifestation of hemiparesis. CONCLUSIONS DTI performed at term equivalent age shows different FA values in WM regions among infants with or without WM abnormalities associated with prematurity and/or CP. Low FA values of ROIs in DTI are related with later development of spastic CP in preterm infants with WM abnormalities.
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Affiliation(s)
- Do-Yeon Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea
| | - Nam-Su Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea
| | - Se-Jin Hwang
- Division of Neuroanatomy, Department of Anatomy and Histology, Hanyang University College of Medicine, Seoul, South Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea.
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Mallas E, Carletti F, Chaddock CA, Shergill S, Woolley J, Picchioni MM, McDonald C, Toulopoulou T, Kravariti E, Kalidindi S, Bramon E, Murray R, Barker GJ, Prata DP. The impact of CACNA1C gene, and its epistasis with ZNF804A, on white matter microstructure in health, schizophrenia and bipolar disorder1. GENES BRAIN AND BEHAVIOR 2016; 16:479-488. [DOI: 10.1111/gbb.12355] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 12/16/2022]
Affiliation(s)
- E. Mallas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Department of Medicine; Imperial College London; London
| | - F. Carletti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Department of Neuroradiology, John Radcliffe Hospital; Oxford University Hospitals NHS Trust; Oxford
| | - C. A. Chaddock
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
| | - S. Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
| | - J. Woolley
- Psychological Medicine; Royal Brompton & Harefield NHS Trust; London
| | - M. M. Picchioni
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- St. Andrew's Academic Department; St Andrew's Healthcare; Northampton UK
| | - C. McDonald
- Neuroimaging, Cognition & Genomics Centre (NICOG) & NCBES Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences; National University of Ireland Galway; Galway Ireland
| | - T. Toulopoulou
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Department of Psychology; The University of Hong Kong; Hong Kong Special Administrative Region
| | - E. Kravariti
- Department of Psychology, Institute of Psychiatry; Psychology & Neuroscience King's College London
| | - S. Kalidindi
- Department of Psychology, Institute of Psychiatry; Psychology & Neuroscience King's College London
| | - E. Bramon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Mental Health Neurosciences Research Department, Division of Psychiatry; University College London
| | - R. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
| | - G. J. Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience; King's College London; London UK
| | - D. P. Prata
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience; King's College London; London UK
- Instituto de Medicina Molecular; Faculdade de Medicina da Universidade de Lisboa; Lisbon Portugal
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63
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Yawno T, Sabaretnam T, Li J, McDonald C, Lim R, Jenkin G, Wallace EM, Miller SL. Human Amnion Epithelial Cells Protect Against White Matter Brain Injury After Repeated Endotoxin Exposure in the Preterm Ovine Fetus. Cell Transplant 2016; 26:541-553. [PMID: 27938480 DOI: 10.3727/096368916x693572] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Intrauterine inflammation is a significant cause of injury to the developing fetal brain. Using a preterm fetal sheep model of in utero infection, we asked whether human amnion epithelial cells (hAECs) were able to reduce inflammation-induced fetal brain injury. Surgery was undertaken on pregnant sheep at ∼105 days gestation (term is 147 days) for implantation of vascular catheters. Lipopolysaccharide (LPS; 150 ng/kg bolus) or saline was administered IV at 109, 110, and 111 days. Sixty million fluorescent-labeled hAECs were administered at 110, 111, and 112 days gestation via the brachial artery catheter. Brains were collected at 114 days for histological assessment. hAECs were observed within the cortex, white matter, and hippocampus. Compared to control lambs, LPS administration was associated with significant and widespread fetal brain inflammation and injury as evidenced by increased number of activated microglia in the periventricular white matter (p = 0.02), increased pyknosis, cell degeneration (p = 0.01), and a nonsignificant trend of fewer oligodendrocytes in the subcortical and periventricular white matter. Administration of hAECs to LPS-treated animals was associated with a significant mitigation in both inflammation and injury as evidenced by fewer activated microglia (p = 0.03) and pyknotic cells (p = 0.03), significantly more oligodendrocytes in the subcortical and periventricular white matter (p = 0.01 and 0.02, respectively), and more myelin basic protein-positive cells within the periventricular white matter (p = 0.02). hAEC administration to fetal sheep exposed to multiple doses of LPS dampens the resultant fetal inflammatory response and mitigates associated brain injury.
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64
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Krishnan ML, Wang Z, Silver M, Boardman JP, Ball G, Counsell SJ, Walley AJ, Montana G, Edwards AD. Possible relationship between common genetic variation and white matter development in a pilot study of preterm infants. Brain Behav 2016; 6:e00434. [PMID: 27110435 PMCID: PMC4821839 DOI: 10.1002/brb3.434] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/16/2015] [Accepted: 12/19/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The consequences of preterm birth are a major public health concern with high rates of ensuing multisystem morbidity, and uncertain biological mechanisms. Common genetic variation may mediate vulnerability to the insult of prematurity and provide opportunities to predict and modify risk. OBJECTIVE To gain novel biological and therapeutic insights from the integrated analysis of magnetic resonance imaging and genetic data, informed by prior knowledge. METHODS We apply our previously validated pathway-based statistical method and a novel network-based method to discover sources of common genetic variation associated with imaging features indicative of structural brain damage. RESULTS Lipid pathways were highly ranked by Pathways Sparse Reduced Rank Regression in a model examining the effect of prematurity, and PPAR (peroxisome proliferator-activated receptor) signaling was the highest ranked pathway once degree of prematurity was accounted for. Within the PPAR pathway, five genes were found by Graph Guided Group Lasso to be highly associated with the phenotype: aquaporin 7 (AQP7), malic enzyme 1, NADP(+)-dependent, cytosolic (ME1), perilipin 1 (PLIN1), solute carrier family 27 (fatty acid transporter), member 1 (SLC27A1), and acetyl-CoA acyltransferase 1 (ACAA1). Expression of four of these (ACAA1, AQP7, ME1, and SLC27A1) is controlled by a common transcription factor, early growth response 4 (EGR-4). CONCLUSIONS This suggests an important role for lipid pathways in influencing development of white matter in preterm infants, and in particular a significant role for interindividual genetic variation in PPAR signaling.
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Affiliation(s)
- Michelle L Krishnan
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
| | - Zi Wang
- Department of Biomedical Engineering King's College London St Thomas' Hospital London SE1 7EH UK
| | - Matt Silver
- Department of Population Health London School of Hygiene and Tropical Medicine London WC1E 7HT UK
| | - James P Boardman
- MRC Centre for Reproductive Health University of Edinburgh Edinburgh EH16 4TJ UK
| | - Gareth Ball
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
| | - Serena J Counsell
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
| | - Andrew J Walley
- School of Public Health Faculty of Medicine Imperial College London Norfolk Place London W2 1PG UK
| | - Giovanni Montana
- Department of Biomedical Engineering King's College London St Thomas' Hospital London SE1 7EH UK
| | - Anthony David Edwards
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
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65
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Bäuml JG, Meng C, Daamen M, Baumann N, Busch B, Bartmann P, Wolke D, Boecker H, Wohlschläger A, Sorg C, Jaekel J. The association of children’s mathematic abilities with both adults’ cognitive abilities and intrinsic fronto-parietal networks is altered in preterm-born individuals. Brain Struct Funct 2016; 222:799-812. [DOI: 10.1007/s00429-016-1247-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 06/05/2016] [Indexed: 01/10/2023]
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66
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Rothman AL, Mangalesh S, Chen X, Toth CA. Optical coherence tomography of the preterm eye: from retinopathy of prematurity to brain development. Eye Brain 2016; 8:123-133. [PMID: 28539807 PMCID: PMC5398750 DOI: 10.2147/eb.s97660] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Preterm infants with retinopathy of prematurity are at increased risk of poor neurodevelopmental outcomes. Because the neurosensory retina is an extension of the central nervous system, anatomic abnormalities in the anterior visual pathway often relate to system and central nervous system health. We describe optical coherence tomography as a powerful imaging modality that has recently been adapted to the infant population and provides noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside. Optical coherence tomography has increased understanding of normal eye development and has identified several potential biomarkers of brain abnormalities and poorer neurodevelopment.
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Affiliation(s)
- Adam L Rothman
- Department of Ophthalmology, Duke University School of Medicine, Durham.,Department of Internal Medicine, Cone Health, Greensboro
| | - Shwetha Mangalesh
- Department of Ophthalmology, Duke University School of Medicine, Durham
| | - Xi Chen
- Department of Ophthalmology, Duke University School of Medicine, Durham
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham.,Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA
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67
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Kelly CE, Thompson DK, Chen J, Leemans A, Adamson CL, Inder TE, Cheong JLY, Doyle LW, Anderson PJ. Axon density and axon orientation dispersion in children born preterm. Hum Brain Mapp 2016; 37:3080-102. [PMID: 27133221 DOI: 10.1002/hbm.23227] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 04/12/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Very preterm birth (VPT, <32 weeks' gestation) is associated with altered white matter fractional anisotropy (FA), the biological basis of which is uncertain but may relate to changes in axon density and/or dispersion, which can be measured using Neurite Orientation Dispersion and Density Imaging (NODDI). This study aimed to compare whole brain white matter FA, axon dispersion, and axon density between VPT children and controls (born ≥37 weeks' gestation), and to investigate associations with perinatal factors and neurodevelopmental outcomes. METHODS FA, neurite dispersion, and neurite density were estimated from multishell diffusion magnetic resonance images for 145 VPT and 33 control 7-year-olds. Diffusion values were compared between groups and correlated with perinatal factors (gestational age, birthweight, and neonatal brain abnormalities) and neurodevelopmental outcomes (IQ, motor, academic, and behavioral outcomes) using Tract-Based Spatial Statistics. RESULTS Compared with controls, VPT children had lower FA and higher axon dispersion within many major white matter fiber tracts. Neonatal brain abnormalities predicted lower FA and higher axon dispersion in many major tracts in VPT children. Lower FA, higher axon dispersion, and lower axon density in various tracts correlated with poorer neurodevelopmental outcomes in VPT children. CONCLUSIONS FA and NODDI measures distinguished VPT children from controls and were associated with neonatal brain abnormalities and neurodevelopmental outcomes. This study provides a more detailed and biologically meaningful interpretation of white matter microstructure changes associated with prematurity. Hum Brain Mapp 37:3080-3102, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Claire E Kelly
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Jian Chen
- Murdoch Childrens Research Institute, Melbourne, Australia.,Department of Medicine, Monash Medical Centre, Monash University, Melbourne, Australia
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Jeanie L Y Cheong
- Murdoch Childrens Research Institute, Melbourne, Australia.,Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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68
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Travis KE, Ben-Shachar M, Myall NJ, Feldman HM. Variations in the neurobiology of reading in children and adolescents born full term and preterm. Neuroimage Clin 2016; 11:555-565. [PMID: 27158588 PMCID: PMC4845391 DOI: 10.1016/j.nicl.2016.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/05/2016] [Accepted: 04/06/2016] [Indexed: 01/18/2023]
Abstract
Diffusion properties of white matter tracts have been associated with individual differences in reading. Individuals born preterm are at risk of injury to white matter. In this study we compared the associations between diffusion properties of white matter and reading skills in children and adolescents born full term and preterm. 45 participants, aged 9-17 years, included 26 preterms (born < 36 weeks' gestation) and 19 full-terms. Tract fractional anisotropy (FA) profiles were generated for five bilateral white matter tracts previously associated with reading: anterior superior longitudinal fasciculus (aSLF), arcuate fasciculus (Arc), corticospinal tract (CST), uncinate fasciculus (UF) and inferior longitudinal fasciculus (ILF). Mean scores on reading for the two groups were in the normal range and were not statistically different. In both groups, FA was associated with measures of single word reading and comprehension in the aSLF, AF, CST, and UF. However, correlations were negative in the full term group and positive in the preterm group. These results demonstrate variations in the neurobiology of reading in children born full term and preterm despite comparable reading skills. Findings suggest that efficient information exchange required for strong reading abilities may be accomplished via a different balance of neurobiological mechanisms in different groups of readers.
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Affiliation(s)
- Katherine E Travis
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304, United States
| | - Michal Ben-Shachar
- The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel; Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Nathaniel J Myall
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Heidi M Feldman
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304, United States.
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69
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Nosarti C, Froudist‐Walsh S. Alterations in development of hippocampal and cortical memory mechanisms following very preterm birth. Dev Med Child Neurol 2016; 58 Suppl 4:35-45. [PMID: 27027606 PMCID: PMC4819886 DOI: 10.1111/dmcn.13042] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2015] [Indexed: 11/30/2022]
Abstract
Deficits in memory function have been described in children and adolescents who were born very preterm (VPT), which can have profound effects on their school achievement and everyday life. However, to date, little is known about the development of the neuroanatomical substrates of memory following VPT birth. Here we focus on episodic and working memory and highlight key recent functional and structural magnetic resonance imaging (MRI) studies that have advanced our understanding of the relationship between alterations seen in the VPT brain and typical neurodevelopment of networks supporting these memory functions. We contrast evidence from the episodic and working memory literatures and suggest that knowledge gained from these functional and neuroanatomical studies may point to specific time windows in which working memory interventions may be most effective.
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Affiliation(s)
- Chiara Nosarti
- Department of Psychosis StudiesInstitute of Psychiatry, Psychology and NeuroscienceKing's CollegeLondonUK
| | - Seán Froudist‐Walsh
- Department of Psychosis StudiesInstitute of Psychiatry, Psychology and NeuroscienceKing's CollegeLondonUK
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70
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Mallas EJ, Carletti F, Chaddock CA, Woolley J, Picchioni MM, Shergill SS, Kane F, Allin MP, Barker GJ, Prata DP. Genome-wide discovered psychosis-risk gene ZNF804A impacts on white matter microstructure in health, schizophrenia and bipolar disorder. PeerJ 2016; 4:e1570. [PMID: 26966642 PMCID: PMC4782689 DOI: 10.7717/peerj.1570] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/15/2015] [Indexed: 01/10/2023] Open
Abstract
Background. Schizophrenia (SZ) and bipolar disorder (BD) have both been associated with reduced microstructural white matter integrity using, as a proxy, fractional anisotropy (FA) detected using diffusion tensor imaging (DTI). Genetic susceptibility for both illnesses has also been positively correlated in recent genome-wide association studies with allele A (adenine) of single nucleotide polymorphism (SNP) rs1344706 of the ZNF804A gene. However, little is known about how the genomic linkage disequilibrium region tagged by this SNP impacts on the brain to increase risk for psychosis. This study aimed to assess the impact of this risk variant on FA in patients with SZ, in those with BD and in healthy controls. Methods. 230 individuals were genotyped for the rs1344706 SNP and underwent DTI. We used tract-based spatial statistics (TBSS) followed by an analysis of variance, with threshold-free cluster enhancement (TFCE), to assess underlying effects of genotype, diagnosis and their interaction, on FA. Results. As predicted, statistically significant reductions in FA across a widely distributed brain network (p < 0.05, TFCE-corrected) were positively associated both with a diagnosis of SZ or BD and with the double (homozygous) presence of the ZNF804A rs1344706 risk variant (A). The main effect of genotype was medium (d = 0.48 in a 44,054-voxel cluster) and the effect in the SZ group alone was large (d = 1.01 in a 51,260-voxel cluster), with no significant effects in BD or controls, in isolation. No areas under a significant diagnosis by genotype interaction were found. Discussion. We provide the first evidence in a predominantly Caucasian clinical sample, of an association between ZNF804A rs1344706 A-homozygosity and reduced FA, both irrespective of diagnosis and particularly in SZ (in overlapping brain areas). This suggests that the previously observed involvement of this genomic region in psychosis susceptibility, and in impaired functional connectivity, may be conferred through it inducing abnormalities in white matter microstructure.
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Affiliation(s)
- Emma-Jane Mallas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, University of London, London, United Kingdom
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Francesco Carletti
- Department of Neuroradiology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Christopher A. Chaddock
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, University of London, London, United Kingdom
| | - James Woolley
- Psychological Medicine, Royal Brompton & Harefield NHS Trust, London, United Kingdom
| | - Marco M. Picchioni
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, University of London, London, United Kingdom
- St Andrew’s Academic Department, St Andrew’s Healthcare, Northampton, United Kingdom
| | - Sukhwinder S. Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, University of London, London, United Kingdom
| | - Fergus Kane
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, University of London, London, United Kingdom
| | - Matthew P.G. Allin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, University of London, London, United Kingdom
| | - Gareth J. Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
| | - Diana P. Prata
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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71
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Rimoldi SF, Rexhaj E, Duplain H, Urben S, Billieux J, Allemann Y, Romero C, Ayaviri A, Salinas C, Villena M, Scherrer U, Sartori C. Acute and Chronic Altitude-Induced Cognitive Dysfunction in Children and Adolescents. J Pediatr 2016; 169:238-43. [PMID: 26541425 DOI: 10.1016/j.jpeds.2015.10.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/31/2015] [Accepted: 10/02/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess whether exposure to high altitude induces cognitive dysfunction in young healthy European children and adolescents during acute, short-term exposure to an altitude of 3450 m and in an age-matched European population permanently living at this altitude. STUDY DESIGN We tested executive function (inhibition, shifting, and working memory), memory (verbal, short-term visuospatial, and verbal episodic memory), and speed processing ability in: (1) 48 healthy nonacclimatized European children and adolescents, 24 hours after arrival at high altitude and 3 months after return to low altitude; (2) 21 matched European subjects permanently living at high altitude; and (3) a matched control group tested twice at low altitude. RESULTS Short-term hypoxia significantly impaired all but 2 (visuospatial memory and processing speed) of the neuropsychological abilities that were tested. These impairments were even more severe in the children permanently living at high altitude. Three months after return to low altitude, the neuropsychological performances significantly improved and were comparable with those observed in the control group tested only at low altitude. CONCLUSIONS Acute short-term exposure to an altitude at which major tourist destinations are located induces marked executive and memory deficits in healthy children. These deficits are equally marked or more severe in children permanently living at high altitude and are expected to impair their learning abilities.
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Affiliation(s)
- Stefano F Rimoldi
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland
| | - Emrush Rexhaj
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland
| | - Hervé Duplain
- Department of Internal Medicine, University Hospital, Lausanne, Switzerland
| | - Sébastien Urben
- Research Unit, Child and Adolescent Psychiatric Service, University Hospital, Lausanne, Switzerland
| | - Joël Billieux
- Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Yves Allemann
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland
| | | | | | - Carlos Salinas
- Bolivian Institute of Altitude Biology (IBBA), La Paz, Bolivia
| | | | - Urs Scherrer
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland; Department of Biology, University of Tarapacá, Arica, Chile
| | - Claudio Sartori
- Department of Internal Medicine, University Hospital, Lausanne, Switzerland.
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72
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Jurcoane A, Daamen M, Scheef L, G. Bäuml J, Meng C, M. Wohlschläger A, Sorg C, Busch B, Baumann N, Wolke D, Bartmann P, Hattingen E, Boecker H. White matter alterations of the corticospinal tract in adults born very preterm and/or with very low birth weight. Hum Brain Mapp 2016; 37:289-99. [PMID: 26487037 PMCID: PMC6867399 DOI: 10.1002/hbm.23031] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 08/14/2015] [Accepted: 10/05/2015] [Indexed: 12/20/2022] Open
Abstract
White matter (WM) injury, either visible on conventional magnetic resonance images (MRI) or measurable by diffusion tensor imaging (DTI), is frequent in preterm born individuals and often affects the corticospinal tract (CST). The relation between visible and invisible white mater alterations in the reconstructed CST of preterm subjects has so far been studied in infants, children and up to adolescence. Therefore, we probabilistically tracked the CST in 53 term-born and 56 very preterm and/or low birth weight (VP/VLBW, < 32 weeks of gestation and/or birth weight < 1,500 g) adults (mean age 26 years) and compared their DTI parameters (axial, radial, mean diffusivity--AD, RD, MD, fractional anisotropy--FA) in the whole CST and slice-wise along the CST. Additionally, we used the automatic, tract-based-spatial-statistics (TBSS) as an alternative to tractography. We compared control and VP/VLBW and subgroups with and without CST WM lesions visible on conventional MRI. Compared to controls, VP/VLBW subjects had significantly higher diffusivity (AD, RD, MD) in the whole CST, slice-wise along the CST, and in multiple regions along the TBSS skeleton. VP/VLBW subjects also had significantly lower (TBSS) and higher (tractography) FA in regions along the CST, but no different mean FA in the tracked CST as a whole. Diffusion changes were weaker, but remained significant for both, tractography and TBSS, when excluding subjects with visible CST lesions. Chronic CST injury persists in VP/VLBW adults even in the absence of visible WM lesions, indicating long-term structural WM changes induced by premature birth.
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Affiliation(s)
- Alina Jurcoane
- Department of RadiologyUniversity Hospital Bonn, Functional Neuroimaging GroupBonnGermany
- Department of RadiologyUniversity Hospital Bonn, Section of NeuroradiologyBonnGermany
- Department of NeonatologyUniversity Hospital BonnBonnGermany
- Center for Individual Development and Adaptive Education of Children at RiskFrankfurt Am MainGermany
| | - Marcel Daamen
- Department of RadiologyUniversity Hospital Bonn, Functional Neuroimaging GroupBonnGermany
- Department of NeonatologyUniversity Hospital BonnBonnGermany
| | - Lukas Scheef
- Department of RadiologyUniversity Hospital Bonn, Functional Neuroimaging GroupBonnGermany
| | - Josef G. Bäuml
- Department of NeuroradiologyKlinikum Rechts Der IsarMünchenGermany
- TUM‐NIC Neuroimaging Center, Technische Universität MünchenMünchenGermany
| | - Chun Meng
- Department of NeuroradiologyKlinikum Rechts Der IsarMünchenGermany
- TUM‐NIC Neuroimaging Center, Technische Universität MünchenMünchenGermany
| | - Afra M. Wohlschläger
- Department of NeuroradiologyKlinikum Rechts Der IsarMünchenGermany
- TUM‐NIC Neuroimaging Center, Technische Universität MünchenMünchenGermany
| | - Christian Sorg
- Department of NeuroradiologyKlinikum Rechts Der IsarMünchenGermany
- TUM‐NIC Neuroimaging Center, Technische Universität MünchenMünchenGermany
- Department of PsychiatryKlinikum Rechts Der IsarMünchenGermany
| | - Barbara Busch
- Department of NeonatologyUniversity Hospital BonnBonnGermany
| | - Nicole Baumann
- Department of PsychologyUniversity of WarwickCoventryUnited Kingdom
| | - Dieter Wolke
- Department of PsychologyUniversity of WarwickCoventryUnited Kingdom
- Warwick Medical School, University of WarwickCoventryUnited Kingdom
| | - Peter Bartmann
- Department of NeonatologyUniversity Hospital BonnBonnGermany
| | - Elke Hattingen
- Department of RadiologyUniversity Hospital Bonn, Section of NeuroradiologyBonnGermany
| | - Henning Boecker
- Department of RadiologyUniversity Hospital Bonn, Functional Neuroimaging GroupBonnGermany
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73
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Sølsnes AE, Sripada K, Yendiki A, Bjuland KJ, Østgård HF, Aanes S, Grunewaldt KH, Løhaugen GC, Eikenes L, Håberg AK, Rimol LM, Skranes J. Limited microstructural and connectivity deficits despite subcortical volume reductions in school-aged children born preterm with very low birth weight. Neuroimage 2015; 130:24-34. [PMID: 26712340 DOI: 10.1016/j.neuroimage.2015.12.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/24/2015] [Accepted: 12/16/2015] [Indexed: 12/14/2022] Open
Abstract
Preterm birth and very low birth weight (VLBW, ≤1500 g) are worldwide problems that burden survivors with lifelong cognitive, psychological, and physical challenges. In this multimodal structural magnetic resonance imaging (MRI) and diffusion MRI (dMRI) study, we investigated differences in subcortical brain volumes and white matter tract properties in children born preterm with VLBW compared to term-born controls (mean age=8 years). Subcortical brain structure volumes and cortical thickness estimates were obtained, and fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were generated for 18 white matter tracts. We also assessed structural relationships between white matter tracts and cortical thickness of the tract endpoints. Compared to controls, the VLBW group had reduced volumes of thalamus, globus pallidus, corpus callosum, cerebral white matter, ventral diencephalon, and brain stem, while the ventricular system was larger in VLBW subjects, after controlling for age, sex, IQ, and estimated total intracranial volume. For the dMRI parameters, group differences were not significant at the whole-tract level, though pointwise analysis found shorter segments affected in forceps minor and left superior longitudinal fasciculus - temporal bundle. IQ did not correlate with subcortical volumes or dMRI measures in the VLBW group. While the deviations in subcortical volumes were substantial, there were few differences in dMRI measures between the two groups, which may reflect the influence of advances in perinatal care on white matter development.
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Affiliation(s)
- Anne Elisabeth Sølsnes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kam Sripada
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Anastasia Yendiki
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Knut Jørgen Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Heidi Furre Østgård
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Synne Aanes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristine Hermansen Grunewaldt
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olav's Hospital, Trondheim, Norway
| | - Gro C Løhaugen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Live Eikenes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asta K Håberg
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Imaging, St. Olav's Hospital, Trondheim, Norway
| | - Lars M Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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van Tilborg E, Heijnen CJ, Benders MJ, van Bel F, Fleiss B, Gressens P, Nijboer CH. Impaired oligodendrocyte maturation in preterm infants: Potential therapeutic targets. Prog Neurobiol 2015; 136:28-49. [PMID: 26655283 DOI: 10.1016/j.pneurobio.2015.11.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 11/02/2015] [Accepted: 11/18/2015] [Indexed: 12/20/2022]
Abstract
Preterm birth is an evolving challenge in neonatal health care. Despite declining mortality rates among extremely premature neonates, morbidity rates remain very high. Currently, perinatal diffuse white matter injury (WMI) is the most commonly observed type of brain injury in preterm infants and has become an important research area. Diffuse WMI is associated with impaired cognitive, sensory and psychological functioning and is increasingly being recognized as a risk factor for autism-spectrum disorders, ADHD, and other psychological disturbances. No treatment options are currently available for diffuse WMI and the underlying pathophysiological mechanisms are far from being completely understood. Preterm birth is associated with maternal inflammation, perinatal infections and disrupted oxygen supply which can affect the cerebral microenvironment by causing activation of microglia, astrogliosis, excitotoxicity, and oxidative stress. This intricate interplay of events negatively influences oligodendrocyte development, causing arrested oligodendrocyte maturation or oligodendrocyte cell death, which ultimately results in myelination failure in the developing white matter. This review discusses the current state in perinatal WMI research, ranging from a clinical perspective to basic molecular pathophysiology. The complex regulation of oligodendrocyte development in healthy and pathological conditions is described, with a specific focus on signaling cascades that may play a role in WMI. Furthermore, emerging concepts in the field of WMI and issues regarding currently available animal models are put forward. Novel insights into the molecular mechanisms underlying impeded oligodendrocyte maturation in diffuse WMI may aid the development of novel treatment options which are desperately needed to improve the quality-of-life of preterm neonates.
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Affiliation(s)
- Erik van Tilborg
- Laboratory of Neuroimmunology and Developmental Origins of Disease, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cobi J Heijnen
- Laboratory of Neuroimmunology, Department of Symptom Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Manon J Benders
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank van Bel
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bobbi Fleiss
- Inserm, Paris U1141, France; Université Paris Diderot, Sorbonne Paris Cité, UMRS, Paris 1141, France; Centre for the Developing Brain, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, United Kingdom
| | - Pierre Gressens
- Inserm, Paris U1141, France; Université Paris Diderot, Sorbonne Paris Cité, UMRS, Paris 1141, France; Centre for the Developing Brain, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, United Kingdom
| | - Cora H Nijboer
- Laboratory of Neuroimmunology and Developmental Origins of Disease, University Medical Center Utrecht, Utrecht, The Netherlands.
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Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment. Am J Ophthalmol 2015; 160:1296-1308.e2. [PMID: 26386157 DOI: 10.1016/j.ajo.2015.09.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/08/2015] [Accepted: 09/09/2015] [Indexed: 01/02/2023]
Abstract
PURPOSE To assess retinal nerve fiber layer (RNFL) thickness at term-equivalent age in very preterm (<32 weeks gestational age) vs term-born infant cohorts, and compare very preterm infant RNFL thickness with brain anatomy and neurodevelopment. DESIGN Cohort study. METHODS RNFL was semi-automatically segmented (1 eye per infant) in 57 very preterm and 50 term infants with adequate images from bedside portable, handheld spectral-domain optical coherence tomography imaging at 37-42 weeks postmenstrual age. Mean RNFL thickness was calculated for the papillomacular bundle (-15 degrees to +15 degrees) and temporal quadrant (-45 degrees to +45 degrees) relative to the fovea-optic nerve axis. Brain magnetic resonance imaging (MRI) scans clinically obtained in 26 very preterm infants were scored for global structural abnormalities by an expert masked to data except for age. Cognitive, language, and motor skills were assessed in 33 of the very preterm infants at 18-24 months corrected age. RESULTS RNFL was thinner for very preterm vs term infants at the papillomacular bundle ([mean ± standard deviation] 61 ± 17 vs 72 ± 13 μm, P < .001) and temporal quadrant (72 ± 21 vs 82 ± 16 μm, P = .005). In very preterm infants, thinner papillomacular bundle RNFL correlated with higher global brain MRI lesion burden index (R(2) = 0.35, P = .001) and lower cognitive (R(2) = 0.18, P = .01) and motor (R(2) = 0.17, P = .02) scores. Relationships were similar for temporal quadrant. CONCLUSIONS Thinner RNFL in very preterm infants relative to term-born infants may relate to brain structure and neurodevelopment.
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76
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Travis KE, Adams JN, Ben-Shachar M, Feldman HM. Decreased and Increased Anisotropy along Major Cerebral White Matter Tracts in Preterm Children and Adolescents. PLoS One 2015; 10:e0142860. [PMID: 26560745 PMCID: PMC4641645 DOI: 10.1371/journal.pone.0142860] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/26/2015] [Indexed: 12/15/2022] Open
Abstract
Premature birth is highly prevalent and associated with neurodevelopmental delays and disorders. Adverse outcomes, particularly in children born before 32 weeks of gestation, have been attributed in large part to white matter injuries, often found in periventricular regions using conventional imaging. To date, tractography studies of white matter pathways in children and adolescents born preterm have evaluated only a limited number of tracts simultaneously. The current study compares diffusion properties along 18 major cerebral white matter pathways in children and adolescents born preterm (n = 27) and full term (n = 19), using diffusion magnetic resonance imaging and tractography. We found that compared to the full term group, the preterm group had significantly decreased FA in segments of the bilateral uncinate fasciculus and anterior segments of the right inferior fronto-occipital fasciculus. Additionally, the preterm group had significantly increased FA in segments of the right and left anterior thalamic radiations, posterior segments of the right inferior fronto-occipital fasciculus, and the right and left inferior longitudinal fasciculus. Increased FA in the preterm group was generally associated with decreased radial diffusivity. These findings indicate that prematurity-related white matter differences in later childhood and adolescence do not affect all tracts in the periventricular zone and can involve both decreased and increased FA. Differences in the patterns of radial diffusivity and axial diffusivity suggest that the tissue properties underlying group FA differences may vary within and across white matter tracts. Distinctive diffusion properties may relate to variations in the timing of injury in the neonatal period, extent of white matter dysmaturity and/or compensatory processes in childhood.
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Affiliation(s)
- Katherine E. Travis
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94303, United States of America
| | - Jenna N. Adams
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94303, United States of America
| | - Michal Ben-Shachar
- The Gonda Brain Research Center, Bar Ilan University, Ramat Gan, 5290002, Israel
- Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan, 5290002, Israel
| | - Heidi M. Feldman
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94303, United States of America
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77
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Murray AL, Thompson DK, Pascoe L, Leemans A, Inder TE, Doyle LW, Anderson JFI, Anderson PJ. White matter abnormalities and impaired attention abilities in children born very preterm. Neuroimage 2015; 124:75-84. [PMID: 26318524 DOI: 10.1016/j.neuroimage.2015.08.044] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/16/2015] [Accepted: 08/20/2015] [Indexed: 12/23/2022] Open
Abstract
While attention impairments are commonly observed in very preterm (<32weeks' gestational age) children, neuroanatomical correlates of these difficulties are unclear. We aimed to determine whether the microstructural organization of key white matter tracts thought to be involved in attention (cingulum bundle, superior longitudinal fasciculi, reticular activating system, and corpus callosum) were altered in very preterm children compared with term-born controls. We also aimed to determine whether alterations in microstructural organization of these tracts were associated with attention functioning in very preterm children. One hundred and forty-nine very preterm children and 36 term-born controls underwent neuroimaging and assessment of their attention abilities at 7years. Constrained spherical deconvolution and probabilistic tractography was used to identify the key white matter tracts. Altered microstructural organization and reduced tract volume within reticular activating system and corpus callosum were found in the very preterm group compared with the control group. Diffusion and volume changes in the cingulum bundle, superior longitudinal fasciculi, reticular activating system, and corpus callosum were related to variations in attention functioning in the very preterm children. These findings emphasize that white matter tract integrity is associated with later attentional abilities in very preterm children.
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Affiliation(s)
- Andrea L Murray
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Leona Pascoe
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center, Utrecht, The Netherlands
| | - Terrie E Inder
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Research Office, The Royal Women's Hospital, Grattan Street, Melbourne, Australia; Department of Obstetrics & Gynaecology, The University of Melbourne, Royal Women's Hospital, Melbourne, Australia
| | - Jacqueline F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Department of Psychology, The Alfred, Alfred Health, Melbourne, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Australia.
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78
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Darlow BA, Horwood LJ, Woodward LJ, Elliott JM, Troughton RW, Elder MJ, Epton MJ, Stanton JD, Swanney MP, Keenan R, Melzer TR, McKelvey VA, Levin K, Meeks MG, Espiner EA, Cameron VA, Martin J. The New Zealand 1986 very low birth weight cohort as young adults: mapping the road ahead. BMC Pediatr 2015; 15:90. [PMID: 26242407 PMCID: PMC4526306 DOI: 10.1186/s12887-015-0413-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 07/29/2015] [Indexed: 01/06/2023] Open
Abstract
Background Very low birth weight (less than 1500 g) is associated with increased morbidity and costs of health care in childhood. Emerging evidence suggests these infants face a range of health and social problems as young adults. We studied all New Zealand very low birth weight infants born in 1986 (when 58 % were exposed to antenatal corticosteroids) in infancy, with later follow-up at 7 to 8 years and 23 to 24 years. We now aim to assess the cohort at 26–28 years compared with controls. Methods/design The case sample will comprise a minimum of 250 members of the 1986 New Zealand national very low birth weight cohort (77 % of survivors). Outcomes will be compared with a control group of 100 young adults born at term in 1986. Following written informed consent, participants will travel to Christchurch for 2 days of assessments undertaken by experienced staff. Medical assessments include growth measures, vision, respiratory function, blood pressure and echocardiogram, renal function, dental examination and blood tests. Cognitive and neuropsychological functioning will be assessed with standard tests, and mental health and social functioning by participant interview. A telephone interview will be conducted with a parent or significant other person nominated by the respondent to gain a further perspective on the young person’s health and functioning. All those born at less than 28 weeks’ gestation, plus a random subset of the cohort to a total of 150 cases and 50 controls, will be offered cranial magnetic-resonance imaging. Statistical analysis will examine comparison with controls and long-term trajectories for the very low birth weight cohort. Discussion The research will provide crucial New Zealand data on the young adult outcomes for very low birth weight infants and address gaps in the international literature, particularly regarding cardiovascular, respiratory, visual and neurocognitive outcomes. These data will inform future neonatal care, provide evidence-based guidelines for care of preterm graduates transitioning to adult care, and help shape health education and social policies for this high risk group. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612000995875. Registered 1 October 2012 Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0413-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brian A Darlow
- Cure Kids Professor of Paediatric Research, Department of Paediatrics, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - L John Horwood
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Lianne J Woodward
- Director of Infant and Child Development Research, Department of Pediatric Newborn Medicine. Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | - John M Elliott
- Christchurch Heart Institute, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Richard W Troughton
- Christchurch Heart Institute, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Mark J Elder
- Department of Surgery, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Michael J Epton
- Canterbury Respiratory Research Group, 40 Stewart Street, Christchurch, New Zealand.
| | - Josh D Stanton
- Respiratory Services, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand.
| | - Maureen P Swanney
- Respiratory Services, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand.
| | - Ross Keenan
- New Zealand Brain Research Institute, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Tracy R Melzer
- New Zealand Brain Research Institute, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Victoria A McKelvey
- Oral Health Services, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand.
| | - Karelia Levin
- Cure Kids Professor of Paediatric Research, Department of Paediatrics, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Margaret G Meeks
- Cure Kids Professor of Paediatric Research, Department of Paediatrics, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Eric A Espiner
- Department of Medicine, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Vicky A Cameron
- Christchurch Heart Institute, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
| | - Julia Martin
- Cure Kids Professor of Paediatric Research, Department of Paediatrics, University of Otago at Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.
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79
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Smyser TA, Smyser CD, Rogers CE, Gillespie SK, Inder TE, Neil JJ. Cortical Gray and Adjacent White Matter Demonstrate Synchronous Maturation in Very Preterm Infants. Cereb Cortex 2015. [PMID: 26209848 DOI: 10.1093/cercor/bhv164] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Spatial and functional gradients of development have been described for the maturation of cerebral gray and white matter using histological and radiological approaches. We evaluated these patterns in very preterm (VPT) infants using diffusion tensor imaging. Data were obtained from 3 groups: 1) 22 VPT infants without white matter injury (WMI), of whom all had serial MRI studies during the neonatal period, 2) 19 VPT infants with WMI, of whom 3 had serial MRI studies and 3) 12 healthy, term-born infants. Regions of interest were placed in the cortical gray and adjacent white matter in primary motor, primary visual, visual association, and prefrontal regions. From the MRI data at term-equivalent postmenstrual age, differences in mean diffusivity were found in all areas between VPT infants with WMI and the other 2 groups. In contrast, minimal differences in fractional anisotropy were found between the 3 groups. These findings suggest that cortical maturation is delayed in VPT infants with WMI when compared with term control infants and VPT infants without WMI. From the serial MRI data from VPT infants, synchronous development between gray and white matter was evident in all areas and all groups, with maturation in primary motor and sensory regions preceding that of association areas. This finding highlights the regionally varying but locally synchronous nature of the development of cortical gray matter and its adjacent white matter.
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Affiliation(s)
| | - Christopher D Smyser
- Department of Neurology
- Department of Pediatrics
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | | | - Sarah K Gillespie
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
- University College, Washington University, St Louis, MO 63110, USA
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Jeffrey J Neil
- Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA
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80
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Alterations of resting state networks and structural connectivity in relation to the prefrontal and anterior cingulate cortices in late prematurity. Neuroreport 2015; 26:22-6. [PMID: 25426826 DOI: 10.1097/wnr.0000000000000296] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Late preterm birth is increasingly recognized as a risk factor for cognitive and social deficits. The prefrontal cortex is particularly vulnerable to injury in late prematurity because of its protracted development and extensive cortical connections. Our study examined children born late preterm without access to advanced postnatal care to assess structural and functional connectivity related to the prefrontal cortex. Thirty-eight preadolescents [19 born late preterm (34-36 /7 weeks gestational age) and 19 at term] were recruited from a developing community in Brazil. Participants underwent neuropsychological testing. Individuals underwent three-dimensional T1-weighted, diffusion-weighted, and resting state functional MRI. Probabilistic tractography and functional connectivity analyses were carried out using unilateral seeds combining the medial prefrontal cortex and the anterior cingulate cortex. Late preterm children showed increased functional connectivity within regions of the default mode, salience, and central-executive networks from both right and left frontal cortex seeds. Decreased functional connectivity was observed within the right parahippocampal region from left frontal seeding. Probabilistic tractography showed a pattern of decreased streamlines in frontal white matter pathways and the corpus callosum, but also increased streamlines in the left orbitofrontal white matter and the right frontal white matter when seeded from the right. Late preterm children and term control children scored similarly on neuropsychological testing. Prefrontal cortical connectivity is altered in late prematurity, with hyperconnectivity observed in key resting state networks in the absence of neuropsychological deficits. Abnormal structural connectivity indicated by probabilistic tractography suggests subtle changes in white matter development, implying disruption of normal maturation during the late gestational period.
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81
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Thompson DK, Lee KJ, van Bijnen L, Leemans A, Pascoe L, Scratch SE, Cheong J, Egan GF, Inder TE, Doyle LW, Anderson PJ. Accelerated corpus callosum development in prematurity predicts improved outcome. Hum Brain Mapp 2015; 36:3733-48. [PMID: 26108187 DOI: 10.1002/hbm.22874] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/01/2015] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To determine: (1) whether corpus callosum (CC) size and microstructure at 7 years of age or their change from infancy to 7 years differed between very preterm (VP) and full-term (FT) children; (2) perinatal predictors of CC size and microstructure at 7 years; and (3) associations between CC measures at 7 years or trajectories from infancy to 7 years and neurodevelopmental outcomes. EXPERIMENTAL DESIGN One hundred and thirty-six VP (gestational age [GA] <30 weeks and/or birth weight <1,250 g) and 33 FT children had usable magnetic resonance images at 7 years of age, and of these, 76 VP and 16 FT infants had usable data at term equivalent age. The CC was traced and divided into six sub-regions. Fractional anisotropy, mean, axial, radial diffusivity and volume were measured from tractography. Perinatal data were collected, and neurodevelopmental tests administered at 7 years' corrected age. PRINCIPAL OBSERVATIONS VP children had smaller posterior CC regions, higher diffusivity and lower fractional anisotropy compared with FT 7-year-olds. Reduction in diffusivity over time occurred faster in VP than FT children (P ≤ 0.002). Perinatal brain abnormality and earlier GA were associated with CC abnormalities. Microstructural abnormalities at 7 years or slower development of the CC were associated with motor dysfunction, poorer mathematics and visual perception. CONCLUSIONS This study is the first to demonstrate an accelerated trajectory of CC white matter diffusion following VP birth, associated with improved neurodevelopmental functioning. Findings suggest there is a window of opportunity for neurorestorative intervention to improve outcomes. Hum Brain Mapp 36:3733-3748, 2015. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine J Lee
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Loeka van Bijnen
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Alexander Leemans
- Imaging Science Institute, University Medical Center, Utrecht, Netherlands
| | - Leona Pascoe
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Shannon E Scratch
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Jeanie Cheong
- Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Gary F Egan
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Terrie E Inder
- Brigham and Women's Hospital, Boston, Massachusetts.,Department of Pediatrics, Washington University in St Louis Medical School, St Louis, Missouri
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Pediatrics, Washington University in St Louis Medical School, St Louis, Missouri
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82
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Degnan AJ, Wisnowski JL, Choi S, Ceschin R, Bhushan C, Leahy RM, Corby P, Schmithorst VJ, Panigrahy A. Altered Structural and Functional Connectivity in Late Preterm Preadolescence: An Anatomic Seed-Based Study of Resting State Networks Related to the Posteromedial and Lateral Parietal Cortex. PLoS One 2015; 10:e0130686. [PMID: 26098888 PMCID: PMC4476681 DOI: 10.1371/journal.pone.0130686] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/22/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Late preterm birth confers increased risk of developmental delay, academic difficulties and social deficits. The late third trimester may represent a critical period of development of neural networks including the default mode network (DMN), which is essential to normal cognition. Our objective is to identify functional and structural connectivity differences in the posteromedial cortex related to late preterm birth. METHODS Thirty-eight preadolescents (ages 9-13; 19 born in the late preterm period (≥32 weeks gestational age) and 19 at term) without access to advanced neonatal care were recruited from a low socioeconomic status community in Brazil. Participants underwent neurocognitive testing, 3-dimensional T1-weighted imaging, diffusion-weighted imaging and resting state functional MRI (RS-fMRI). Seed-based probabilistic diffusion tractography and RS-fMRI analyses were performed using unilateral seeds within the posterior DMN (posterior cingulate cortex, precuneus) and lateral parietal DMN (superior marginal and angular gyri). RESULTS Late preterm children demonstrated increased functional connectivity within the posterior default mode networks and increased anti-correlation with the central-executive network when seeded from the posteromedial cortex (PMC). Key differences were demonstrated between PMC components with increased anti-correlation with the salience network seen only with posterior cingulate cortex seeding but not with precuneus seeding. Probabilistic tractography showed increased streamlines within the right inferior longitudinal fasciculus and inferior fronto-occipital fasciculus within late preterm children while decreased intrahemispheric streamlines were also observed. No significant differences in neurocognitive testing were demonstrated between groups. CONCLUSION Late preterm preadolescence is associated with altered functional connectivity from the PMC and lateral parietal cortex to known distributed functional cortical networks despite no significant executive neurocognitive differences. Selective increased structural connectivity was observed in the setting of decreased posterior interhemispheric connections. Future work is needed to determine if these findings represent a compensatory adaptation employing alternate neural circuitry or could reflect subtle pathology resulting in emotional processing deficits not seen with neurocognitive testing.
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Affiliation(s)
- Andrew J. Degnan
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Radiology, University of Pittsburgh Medical Center (UPMC), 3950 Presby South Tower, 200 Lothrop Street, Pittsburgh, PA 15213, United States of America
| | - Jessica L. Wisnowski
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
| | - SoYoung Choi
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
| | - Rafael Ceschin
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Chitresh Bhushan
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Richard M. Leahy
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Patricia Corby
- Twins Institute for Genetics Research, Montes Claros, Minas Gerais 39400–115, Brazil
- New York University Bluestone Center for Clinical Research, 421 1st Ave, New York, NY 10010, United States of America
| | - Vincent J. Schmithorst
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
| | - Ashok Panigrahy
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
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83
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Li K, Sun Z, Han Y, Gao L, Yuan L, Zeng D. Fractional anisotropy alterations in individuals born preterm: a diffusion tensor imaging meta-analysis. Dev Med Child Neurol 2015; 57:328-38. [PMID: 25358534 DOI: 10.1111/dmcn.12618] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2014] [Indexed: 12/17/2022]
Abstract
AIM This meta-analysis explored cerebral microstructural changes in individuals born preterm using fractional anisotropy from diffusion tensor imaging. METHOD We used the activation likelihood estimate (ALE) method for the meta-analysis to locate anatomical regions with white matter abnormalities in a group of individuals born preterm and in term-born comparison participants. A statistical analysis of fractional anisotropy was conducted to quantitatively explore the extent of fractional anisotropy changes in the three subregions of the corpus callosum in the preterm group. RESULTS ALE analysis identified 11 regions of decreased fractional anisotropy and four regions of increased fractional anisotropy. Analysis of the corpus callosum revealed the largest decrease in fractional anisotropy in the splenium (standardized mean difference [SMD]=-0.75, 95% confidence interval [CI] -0.93 to -0.57), followed by the body (SMD=-0.73, 95% CI -1.13 to -0.32) and the genu (SMD=-0.65, 95% CI -0.97 to -0.33). INTERPRETATION Significant changes in fractional anisotropy in individuals born preterm reflect white matter abnormalities from childhood to young adulthood, and the mechanism of fractional anisotropy alterations in preterm infants may vary during different stages of white matter development. Furthermore, the variability of fractional anisotropy between studies can primarily be attributed to the age of the individuals at scanning and to the field strength of magnetic resonance scanners.
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Affiliation(s)
- Ke Li
- Key Laboratory for NeuroInformation of Ministry of Education, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
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84
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Travis KE, Leitner Y, Feldman HM, Ben‐Shachar M. Cerebellar white matter pathways are associated with reading skills in children and adolescents. Hum Brain Mapp 2015; 36:1536-53. [PMID: 25504986 PMCID: PMC4374012 DOI: 10.1002/hbm.22721] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 11/10/2014] [Accepted: 12/04/2014] [Indexed: 01/18/2023] Open
Abstract
Reading is a critical life skill in the modern world. The neural basis of reading incorporates a distributed network of cortical areas and their white matter connections. The cerebellum has also been implicated in reading and reading disabilities. However, little is known about the contribution of cerebellar white matter pathways to major component skills of reading. We used diffusion magnetic resonance imaging (dMRI) with tractography to identify the cerebellar peduncles in a group of 9- to 17-year-old children and adolescents born full term (FT, n = 19) or preterm (PT, n = 26). In this cohort, no significant differences were found between fractional anisotropy (FA) measures of the peduncles in the PT and FT groups. FA of the cerebellar peduncles correlated significantly with measures of decoding and reading comprehension in the combined sample of FT and PT subjects. Correlations were negative in the superior and inferior cerebellar peduncles and positive in the middle cerebellar peduncle. Additional analyses revealed that FT and PT groups demonstrated similar patterns of reading associations within the left superior cerebellar peduncle, middle cerebellar peduncle, and left inferior cerebellar peduncle. Partial correlation analyses showed that distinct sub-skills of reading were associated with FA in segments of different cerebellar peduncles. Overall, the present findings are the first to document associations of microstructure of the cerebellar peduncles and the component skills of reading.
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Affiliation(s)
- Katherine E. Travis
- Division of Neonatal and Developmental MedicineDepartment of PediatricsStanford University School of MedicinePalo AltoCalifornia
| | - Yael Leitner
- Child Development CenterTel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv UniversityTel AvivIsrael
| | - Heidi M. Feldman
- Division of Neonatal and Developmental MedicineDepartment of PediatricsStanford University School of MedicinePalo AltoCalifornia
| | - Michal Ben‐Shachar
- The Gonda Brain Research CenterBar Ilan UniversityRamat GanIsrael
- Department of English literature and LinguisticsBar Ilan UniversityRamat GanIsrael
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85
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Meng C, Bäuml JG, Daamen M, Jaekel J, Neitzel J, Scheef L, Busch B, Baumann N, Boecker H, Zimmer C, Bartmann P, Wolke D, Wohlschläger AM, Sorg C. Extensive and interrelated subcortical white and gray matter alterations in preterm-born adults. Brain Struct Funct 2015; 221:2109-21. [PMID: 25820473 DOI: 10.1007/s00429-015-1032-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 03/17/2015] [Indexed: 11/26/2022]
Abstract
Preterm birth is a leading cause for impaired neurocognitive development with an increased risk for persistent cognitive deficits in adulthood. In newborns, preterm birth is associated with interrelated white matter (WM) alterations and deep gray matter (GM) loss; however, little is known about the persistence and relevance of these subcortical brain changes. We tested the hypothesis that the pattern of correspondent subcortical WM and GM changes is present in preterm-born adults and has a brain-injury-like nature, i.e., it predicts lowered general cognitive performance. Eighty-five preterm-born and 69 matched term-born adults were assessed by diffusion- and T1-weighted MRI and cognitive testing. Main outcome measures were fractional anisotropy of water diffusion for WM property, GM volume for GM property, and full-scale IQ for cognitive performance. In preterm-born adults, reduced fractional anisotropy was widely distributed ranging from cerebellum to brainstem to hemispheres. GM volume was reduced in the thalamus, striatum, temporal cortices, and increased in the cingulate cortices. Fractional anisotropy reductions were specifically associated with GM loss in thalamus and striatum, with correlation patterns for both regions extensively overlapping in the WM of brainstem and hemispheres. For overlap regions, fractional anisotropy was positively related with both gestational age and full-scale IQ. Results provide evidence for extensive, interrelated, and adverse WM and GM subcortical changes in preterm-born adults. Data suggest persistent brain-injury-like changes of subcortical-cortical connectivity after preterm delivery.
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Affiliation(s)
- C Meng
- Department of Neuroradiology, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Großhaderner Strasse 2, 82152, Munich, Germany
| | - J G Bäuml
- Department of Neuroradiology, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
| | - M Daamen
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - J Jaekel
- Department of Psychology, University of Warwick, Coventry, UK
- Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany
| | - J Neitzel
- Department of Neuroradiology, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Großhaderner Strasse 2, 82152, Munich, Germany
| | - L Scheef
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - B Busch
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - N Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - H Boecker
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - C Zimmer
- Department of Neuroradiology, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
| | - P Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - D Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A M Wohlschläger
- Department of Neuroradiology, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- Department of Neurology, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany
- Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Großhaderner Strasse 2, 82152, Munich, Germany
| | - Christian Sorg
- Department of Neuroradiology, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany.
- Department of Psychiatry, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany.
- TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675, Munich, Germany.
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Vajzovic L, Rothman AL, Tran-Viet D, Cabrera MT, Freedman SF, Toth CA. Delay in retinal photoreceptor development in very preterm compared to term infants. Invest Ophthalmol Vis Sci 2015; 56:908-13. [PMID: 25587063 DOI: 10.1167/iovs.14-16021] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We compared photoreceptor development from spectral domain optical coherence tomography (SD-OCT) imaging in very preterm infants (VPT, <32 weeks gestational age) with those of term infants. METHODS The microanatomy of foveal SD-OCT images obtained at the bedside at 37 to 42 weeks term equivalent postmenstrual age (TEA) was reviewed with qualitative and quantitative analysis of retinal and especially photoreceptor layers in the macula. Measures of maturity included presence of the cone outer segment tips (COST) or the ellipsoid zone (EZ) at foveal center, distance from Bruch's membrane (BM) to the EZ at the foveal center, and radial distance from foveal center to first appearance of the EZ. RESULTS The incidence of the EZ developed at the foveal center was lower in VPT infants (9/64, 14%) versus term infants (22/47, 47%, P < 0.001) and lower in VPT infants with macular edema (3/46) versus VPT without edema (6/18, P = 0.01). Mean ± SD distance from the foveal center to the visible EZ was 783 ± 440 μm in VPT, and 492 ± 501 μm in term infants, P = 0.002. The height of the BM-to-EZ at the foveal center did not differ in VPT versus term infants. The COST band was not visible in any infant. CONCLUSIONS Photoreceptor inner and outer segment development in VPT infants appears delayed when compared to term infants, and the photoreceptor RPE junction remains immature in all infants at TEA. Delayed maturation of photoreceptors could contribute to differences in visual function in some VPT infants.
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Affiliation(s)
- Lejla Vajzovic
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States
| | - Adam L Rothman
- Duke University School of Medicine, Durham, North Carolina, United States
| | - Du Tran-Viet
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States
| | - Michelle T Cabrera
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
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Broekman BFP, Wang C, Li Y, Rifkin-Graboi A, Saw SM, Chong YS, Kwek K, Gluckman PD, Fortier MV, Meaney MJ, Qiu A. Gestational age and neonatal brain microstructure in term born infants: a birth cohort study. PLoS One 2014; 9:e115229. [PMID: 25535959 PMCID: PMC4275243 DOI: 10.1371/journal.pone.0115229] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 11/20/2014] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Understanding healthy brain development in utero is crucial in order to detect abnormal developmental trajectories due to developmental disorders. However, in most studies neuroimaging was done after a significant postnatal period, and in those studies that performed neuroimaging on fetuses, the quality of data has been affected due to complications of scanning during pregnancy. To understand healthy brain development between 37-41 weeks of gestational age, our study assessed the in utero growth of the brain in healthy term born babies with DTI scanning soon after birth. METHODS A cohort of 93 infants recruited from maternity hospitals in Singapore underwent diffusion tensor imaging between 5 to 17 days after birth. We did a cross-sectional examination of white matter microstructure of the brain among healthy term infants as a function of gestational age via voxel-based analysis on fractional anisotropy. RESULTS Greater gestational age at birth in term infants was associated with larger fractional anisotropy values in early developing brain regions, when corrected for age at scan. Specifically, it was associated with a cluster located at the corpus callosum (corrected p<0.001), as well as another cluster spanning areas of the anterior corona radiata, anterior limb of internal capsule, and external capsule (corrected p<0.001). CONCLUSIONS Our findings show variation in brain maturation associated with gestational age amongst 'term' infants, with increased brain maturation when born with a relatively higher gestational age in comparison to those infants born with a relatively younger gestational age. Future studies should explore if these differences in brain maturation between 37 and 41 weeks of gestational age will persist over time due to development outside the womb.
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Affiliation(s)
- Birit F. P. Broekman
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
| | - Changqing Wang
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Yue Li
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Anne Rifkin-Graboi
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Kenneth Kwek
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Marielle V. Fortier
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Michael J. Meaney
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
- Departments of Psychiatry and Neurology & Neurosurgery, McGill University, Montreal, Canada
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
- Clinical Imaging Research Centre, National University of Singapore, Singapore, Singapore
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Kalpakidou AK, Allin MPG, Walshe M, Giampietro V, McGuire PK, Rifkin L, Murray RM, Nosarti C. Functional neuroanatomy of executive function after neonatal brain injury in adults who were born very preterm. PLoS One 2014; 9:e113975. [PMID: 25438043 PMCID: PMC4250191 DOI: 10.1371/journal.pone.0113975] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 11/01/2014] [Indexed: 02/01/2023] Open
Abstract
Individuals who were born very preterm (VPT; <33 gestational weeks) are at risk of experiencing deficits in tasks involving executive function in childhood and beyond. In addition, the type and severity of neonatal brain injury associated with very preterm birth may exert differential effects on executive functioning by altering its neuroanatomical substrates. Here we addressed this question by investigating with functional magnetic resonance imaging (fMRI) the haemodynamic response during executive-type processing using a phonological verbal fluency and a working memory task in VPT-born young adults who had experienced differing degrees of neonatal brain injury. 12 VPT individuals with a history of periventricular haemorrhage and ventricular dilatation (PVH+VD), 17 VPT individuals with a history of uncomplicated periventricular haemorrhage (UPVH), 13 VPT individuals with no history of neonatal brain injury and 17 controls received an MRI scan whilst completing a verbal fluency task with two cognitive loads (‘easy’ and ‘hard’ letters). Two groups of VPT individuals (PVH+VD; n = 10, UPVH; n = 8) performed an n-back task with three cognitive loads (1-, 2-, 3-back). Results demonstrated that VPT individuals displayed hyperactivation in frontal, temporal, and parietal cortices and in caudate nucleus, insula and thalamus compared to controls, as demands of the verbal fluency task increased, regardless of type of neonatal brain injury. On the other hand, during the n-back task and as working memory load increased, the PVH+VD group showed less engagement of the frontal cortex than the UPVH group. In conclusion, this study suggests that the functional neuroanatomy of different executive-type processes is altered following VPT birth and that neural activation associated with specific aspects of executive function (i.e., working memory) may be particularly sensitive to the extent of neonatal brain injury.
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Affiliation(s)
- Anastasia K. Kalpakidou
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
- * E-mail:
| | - Matthew P. G. Allin
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Muriel Walshe
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Philip K. McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Larry Rifkin
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Chiara Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
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89
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Rothman AL, Tran-Viet D, Gustafson KE, Goldstein RF, Maguire MG, Tai V, Sarin N, Tong AY, Huang J, Kupper L, Cotten CM, Freedman SF, Toth CA. Poorer neurodevelopmental outcomes associated with cystoid macular edema identified in preterm infants in the intensive care nursery. Ophthalmology 2014; 122:610-9. [PMID: 25439600 DOI: 10.1016/j.ophtha.2014.09.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/18/2014] [Accepted: 09/15/2014] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To evaluate the association between cystoid macular edema (CME) observed in very preterm infants and developmental outcomes at 18 to 24 months corrected age. DESIGN Cohort study. PARTICIPANTS Infants born at or less than 1500 g or at or less than 30 weeks postmenstrual age who underwent screening for retinopathy of prematurity (ROP) in an intensive care nursery. METHODS Bedside handheld spectral-domain optical coherence tomography (SD OCT; Envisu, Bioptigen, Inc, Research Triangle Park, NC) imaging was obtained from preterm infants who were being screened for ROP and graded for presence of CME, central foveal thickness (CFT), inner nuclear layer thickness, and foveal-to-parafoveal thickness ratio. At 18 to 24 months corrected age, the children were assessed with the Bayley Scales of Infant and Toddler Development, Third Edition. MAIN OUTCOME MEASURES Scores on the Bayley cognitive, language, and motor subscales. RESULTS Among 77 children with SD OCT imaging, 53 were evaluated with the Bayley Scales. Compared with children who did not have CME as infants (n=22), the mean score for children who had CME (n=31) was 7.3 points (95% confidence interval [CI], -15.5 to 0.9; P=0.08) lower on the cognitive subscale, 14.1 points (95% CI, -22.7 to -5.5; P=0.002) lower for the language subscale, and 11.5 points (95% CI, -21.6 to -1.3; P=0.03) lower for the motor subscale. Differences were maintained after adjusting for gestational age and birth weight. Severity of CME, as assessed by foveal-to-parafoveal thickness ratio, within the CME group correlated with poorer cognitive (R2=0.16, P=0.03) and motor (R2=0.15, P=0.03) development. CONCLUSIONS Cystoid macular edema observed on SD OCT in very preterm infants screened for ROP is associated with poorer language and motor skills at 18 to 24 months corrected age. Evaluation of the retina with SD-OCT may serve as an indicator of neurodevelopmental health for very preterm infants in the intensive care nursery.
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Affiliation(s)
- Adam L Rothman
- Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina
| | - Du Tran-Viet
- Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina
| | - Kathryn E Gustafson
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Ricki F Goldstein
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Maureen G Maguire
- Department of Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Vincent Tai
- Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina
| | - Neeru Sarin
- Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina
| | - Amy Y Tong
- Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina
| | - Jiayan Huang
- Department of Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Laura Kupper
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - C Michael Cotten
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina; Department of Biomedical Engineering, Duke University, Durham, North Carolina.
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Grunewaldt KH, Fjørtoft T, Bjuland KJ, Brubakk AM, Eikenes L, Håberg AK, Løhaugen GCC, Skranes J. Follow-up at age 10 years in ELBW children - functional outcome, brain morphology and results from motor assessments in infancy. Early Hum Dev 2014; 90:571-8. [PMID: 25103790 DOI: 10.1016/j.earlhumdev.2014.07.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/08/2014] [Accepted: 07/09/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Extremely-low-birth-weight (ELBW) children without severe brain injury or CP are at high risk of developing deficits within cognition, attention, behavior and motor function. Assessing the quality of an infant's spontaneous motor-repertoire included in Prechtl's General-Movement-Assessment (GMA) has been shown to relate to later motor and cognitive functioning in preterm children without CP. AIMS To investigate functional outcome and cerebral MRI morphometry at 10 years in ELBW children without CP compared to healthy controls and to examine any relationship with the quality of infant-motor-repertoire included in the GMA. STUDY DESIGN A cohort-study-design. SUBJECTS 31 ELBW children (mean birth-weight: 773 g, SD 146, mean gestational age 26.1 weeks, SD 1.8) and 33 term-born, age-matched controls. OUTCOME MEASURES GMA was performed in ELBW children at 3 months corrected age. At 10 years the children underwent comprehensive motor, cognitive, behavioral assessments and cerebral MRI. RESULTS The non-CP ELBW children had similar full-IQ but poorer working memory, poorer motor skills, and more attentional and behavioral problems compared to controls. On cerebral MRI reduced volumes of globus pallidus, cerebellar white matter and posterior corpus callosum were found. Cortical surface-area was reduced in temporal, parietal and anterior-medial-frontal areas. Poorer test-results and reduced brain volumes were mainly found in ELBW children with fidgety movements combined with abnormal motor-repertoire in infancy. CONCLUSION Non-CP ELBW children have poorer functional outcomes, reduced brain volumes and cortical surface-area compared with term-born controls at 10 years. ELBW children with abnormal infant motor-repertoire seem to be at increased risk of later functional deficits and brain pathology.
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Affiliation(s)
- Kristine Hermansen Grunewaldt
- Dept of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Dept of Pediatrics, St. Olav University Hospital, Trondheim, Norway.
| | - Toril Fjørtoft
- Dept of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Dept of Clinical Services, St. Olav University Hospital, Trondheim, Norway
| | - Knut Jørgen Bjuland
- Dept of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Mari Brubakk
- Dept of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Dept of Pediatrics, St. Olav University Hospital, Trondheim, Norway
| | - Live Eikenes
- Dept of Circulation and Medical Imaging, St. Olav University Hospital, Trondheim, Norway
| | - Asta K Håberg
- Dept of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gro C C Løhaugen
- Dept of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Dept of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Dept of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Dept of Pediatrics, Sørlandet Hospital, Arendal, Norway
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91
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Muller M, Sigurdsson S, Kjartansson O, Jonsson PV, Garcia M, von Bonsdorff MB, Gunnarsdottir I, Thorsdottir I, Harris TB, van Buchem M, Gudnason V, Launer LJ. Birth size and brain function 75 years later. Pediatrics 2014; 134:761-70. [PMID: 25180277 PMCID: PMC4179101 DOI: 10.1542/peds.2014-1108] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND There are several lines of evidence pointing to fetal and other early origins of diseases of the aging brain, but there are no data directly addressing the hypotheses in an older population. We investigated the association of fetal size to late-age measures of brain structure and function in a large cohort of older men and women and explored the modifying effect of education on these associations. METHODS Within the AGES (Age Gene/Environment Susceptibility)-Reykjavik population-based cohort (born between 1907 and 1935), archived birth records were abstracted for 1254 men and women who ∼75 years later underwent an examination that included brain MRI and extensive cognitive assessment. RESULTS Adjustment for intracranial volume, demographic and medical history characteristics, and lower Ponderal index at birth (per kg/m(3)), an indicator of third-trimester fetal wasting, was significantly associated with smaller volumes of total brain and white matter; βs (95% confidence intervals) were -1.0 (-1.9 to -0.0) and -0.5 (-1.0 to -0.0) mL. Furthermore, lower Ponderal index was associated with slower processing speed and reduced executive functioning but only in those with low education (β [95% confidence interval]: -0.136 [-0.235 to -0.036] and -0.077 [-0.153 to -0.001]). CONCLUSIONS This first study of its kind provides clinical measures suggesting that smaller birth size, as an indicator of a suboptimal intrauterine environment, is associated with late-life alterations in brain tissue volume and function. In addition, it shows that the effects of a suboptimal intrauterine environment on late-life cognitive function were present only in those with lower educational levels.
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Affiliation(s)
- Majon Muller
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland;,Departments of Gerontology and Geriatrics, and
| | | | - Olafur Kjartansson
- The Icelandic Heart Association, Kopavogur, Iceland;,Departments of Neurology and Radiology, and
| | - Palmi V. Jonsson
- The Icelandic Heart Association, Kopavogur, Iceland;,Department of Geriatrics, and
| | - Melissa Garcia
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
| | - Mikaela B. von Bonsdorff
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland;,Department of Health Sciences, Gerontology Research Centre, University of Jyväskylä, Jyväskylä, Finland
| | | | - Inga Thorsdottir
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
| | - Mark van Buchem
- Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Lenore J. Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
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92
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Brain volumes and cognitive function in very-low-birth-weight (VLBW) young adults. Eur J Paediatr Neurol 2014; 18:578-90. [PMID: 24775377 DOI: 10.1016/j.ejpn.2014.04.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 02/12/2014] [Accepted: 04/04/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Preterm born very-low-birth-weight (VLBW: birth weight ≤1500 g) survivors have increased risk of perinatal brain injury that may cause deviant brain development and later neuroimpairments, including reduced cognitive functioning. AIMS In this long-term follow up study of three year-cohorts (birth years 1986-88) of VLBW subjects and term born controls with normal birth weight, the aim was to examine differences in brain volumes at age 20 years. In addition, the relationships between brain volumes and cognitive abilities and perinatal variables were explored. METHODS Forty-four VLBW subjects and 60 controls were assessed with cognitive testing (Wechsler Adult Intelligence Scale - WAIS-III) and structural MRI at 1.5 T, using the FreeSurfer 5.1 software for volumetric analysis. A subpopulation had MRI performed also at age 15, and for this group changes in brain volumes with age were examined. RESULTS The VLBW subjects had smaller brain volumes, especially of thalamus, globus pallidus and parts of the corpus callosum, and larger lateral ventricles than controls at age 20. However, no significant group differences in longitudinal change from age 15 to 20 were observed. The most immature and smallest VLBW subjects at birth, and those with the highest perinatal morbidity, showed most pronounced volume deviations. Positive associations between several brain volumes and full IQ, as well as three of four IQ indices in the VLBW group, were observed. CONCLUSION Reduced volumes of grey and white matter and ventricular dilatation in VLBW young adults may indicate permanent effects on brain development from perinatal brain injury with influence on later cognitive function.
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93
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Nosarti C, Nam KW, Walshe M, Murray RM, Cuddy M, Rifkin L, Allin MPG. Preterm birth and structural brain alterations in early adulthood. NEUROIMAGE-CLINICAL 2014; 6:180-91. [PMID: 25379430 PMCID: PMC4215396 DOI: 10.1016/j.nicl.2014.08.005] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 08/05/2014] [Accepted: 08/10/2014] [Indexed: 12/15/2022]
Abstract
Alterations in cortical development and impaired neurodevelopmental outcomes have been described following very preterm (VPT) birth in childhood and adolescence, but only a few studies to date have investigated grey matter (GM) and white matter (WM) maturation in VPT samples in early adult life. Using voxel-based morphometry (VBM) we studied regional GM and WM volumes in 68 VPT-born individuals (mean gestational age 30 weeks) and 43 term-born controls aged 19–20 years, and their association with cognitive outcomes (Hayling Sentence Completion Test, Controlled Oral Word Association Test, Visual Reproduction test of the Wechsler Memory Scale-Revised) and gestational age. Structural MRI data were obtained with a 1.5 Tesla system and analysed using the VBM8 toolbox in SPM8 with a customized study-specific template. Similarly to results obtained at adolescent assessment, VPT young adults compared to controls demonstrated reduced GM volume in temporal, frontal, insular and occipital areas, thalamus, caudate nucleus and putamen. Increases in GM volume were noted in medial/anterior frontal gyrus. Smaller subcortical WM volume in the VPT group was observed in temporal, parietal and frontal regions, and in a cluster centred on posterior corpus callosum/thalamus/fornix. Larger subcortical WM volume was found predominantly in posterior brain regions, in areas beneath the parahippocampal and occipital gyri and in cerebellum. Gestational age was associated with GM and WM volumes in areas where VPT individuals demonstrated GM and WM volumetric alterations, especially in temporal, parietal and occipital regions. VPT participants scored lower than controls on measures of IQ, executive function and non-verbal memory. When investigating GM and WM alterations and cognitive outcome scores, subcortical WM volume in an area beneath the left inferior frontal gyrus accounted for 14% of the variance of full-scale IQ (F = 12.9, p < 0.0001). WM volume in posterior corpus callosum/thalamus/fornix and GM volume in temporal gyri bilaterally, accounted for 21% of the variance of executive function (F = 9.9, p < 0.0001) and WM in the posterior corpus callosum/thalamus/fornix alone accounted for 17% of the variance of total non-verbal memory scores (F = 9.9, p < 0.0001). These results reveal that VPT birth continues to be associated with altered structural brain anatomy in early adult life, although it remains to be ascertained whether these changes reflect neurodevelopmental delays or long lasting structural alterations due to prematurity. GM and WM alterations correlate with length of gestation and mediate cognitive outcome. Preterm birth is associated with brain alterations in early adulthood Preterm birth affects maturation of both white and grey matter Volume alterations are observed in temporal, frontal, parietal and occipital areas Regional alterations mediate the effects of preterm birth on cognitive functioning
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Affiliation(s)
- Chiara Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, SE58AF London, UK
| | - Kie Woo Nam
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, SE58AF London, UK
| | - Muriel Walshe
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, SE58AF London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, SE58AF London, UK
| | - Marion Cuddy
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, SE58AF London, UK
| | - Larry Rifkin
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, SE58AF London, UK
| | - Matthew P G Allin
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, SE58AF London, UK
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94
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A crucial role for white matter alterations in interference control problems of very preterm children. Pediatr Res 2014; 75:731-7. [PMID: 24695275 DOI: 10.1038/pr.2014.31] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 11/22/2013] [Indexed: 01/15/2023]
Abstract
BACKGROUND Attention problems are among the most prominent behavioral deficits reported in very preterm children (below 32 wk of gestation) at school age. In this study, we aimed to elucidate the brain abnormalities underlying attention problems in very preterm children by investigating the role of abnormalities in white and gray brain matter during interference control, using functional magnetic resonance imaging (fMRI)-guided probabilistic diffusion tensor tractography. METHODS Twenty-nine very preterm children (mean (SD) age: 8.6 (0.3) y), and 47 term controls (mean (SD) age: 8.7 (0.5) y), performed a fMRI version of the Eriksen Flanker task measuring interference control. RESULTS Very preterm children showed slower reaction times than term controls when interfering stimuli were presented, indicating poorer interference control. Very preterm children and term controls did not differ in mean activation of the cortical regions involved in interference control. However, impaired fractional anisotropy (FA) was found in very preterm children in specifically those fiber tracts that innervate the cortical regions involved in interference control. Lower FA was related to poorer interference control in very preterm children. CONCLUSION White matter alterations have a crucial role in the interference control problems of very preterm children at school age.
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95
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Polglase GR, Miller SL, Barton SK, Kluckow M, Gill AW, Hooper SB, Tolcos M. Respiratory support for premature neonates in the delivery room: effects on cardiovascular function and the development of brain injury. Pediatr Res 2014; 75:682-8. [PMID: 24614803 DOI: 10.1038/pr.2014.40] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 12/16/2013] [Indexed: 02/02/2023]
Abstract
The transition to newborn life in preterm infants is complicated by immature cardiovascular and respiratory systems. Consequently, preterm infants often require respiratory support immediately after birth. Although aeration of the lung underpins the circulatory transition at birth, positive pressure ventilation can adversely affect cardiorespiratory function during this vulnerable period, reducing pulmonary blood flow and left ventricular output. Furthermore, pulmonary volutrauma is known to initiate pulmonary inflammatory responses, resulting in remote systemic involvement. This review focuses on the downstream consequences of positive pressure ventilation, in particular, interactions between cardiovascular output and the initiation of a systemic inflammatory cascade, on the immature brain. Recent studies have highlighted that positive pressure ventilation strategies are precursors of cerebral injury, probably mediated through cerebral blood flow instability. The presence of, or initiation of, an inflammatory cascade accentuates adverse cerebral blood flow, in addition to being a direct source of brain injury. Importantly, the degree of brain injury is dependent on the nature of the initial ventilation strategy used.
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Affiliation(s)
- Graeme R Polglase
- 1] The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, Australia [2] Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia
| | - Suzanne L Miller
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, Australia
| | - Samantha K Barton
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, Australia
| | - Martin Kluckow
- Department of Neonatalogy, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew W Gill
- Centre for Neonatal Research and Education, The University of Western Australia, Western Australia, Australia
| | - Stuart B Hooper
- 1] The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, Australia [2] Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia
| | - Mary Tolcos
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, Australia
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96
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Vinall J, Miller SP, Bjornson BH, Fitzpatrick KP, Poskitt KJ, Brant R, Synnes AR, Cepeda IL, Grunau RE. Invasive procedures in preterm children: brain and cognitive development at school age. Pediatrics 2014; 133:412-21. [PMID: 24534406 PMCID: PMC3934331 DOI: 10.1542/peds.2013-1863] [Citation(s) in RCA: 168] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Very preterm infants (born 24-32 weeks' gestation) undergo numerous invasive procedures during neonatal care. Repeated skin-breaking procedures in rodents cause neuronal cell death, and in human preterm neonates higher numbers of invasive procedures from birth to term-equivalent age are associated with abnormal brain development, even after controlling for other clinical risk factors. It is unknown whether higher numbers of invasive procedures are associated with long-term alterations in brain microstructure and cognitive outcome at school age in children born very preterm. METHODS Fifty children born very preterm underwent MRI and cognitive testing at median age 7.6 years (interquartile range, 7.5-7.7). T1- and T2-weighted images were assessed for the severity of brain injury. Magnetic resonance diffusion tensor sequences were used to measure fractional anisotropy (FA), an index of white matter (WM) maturation, from 7 anatomically defined WM regions. Child cognition was assessed using the Wechsler Intelligence Scale for Children-IV. Multivariate modeling was used to examine relationships between invasive procedures, brain microstructure, and cognition, adjusting for clinical confounders (eg, infection, ventilation, brain injury). RESULTS Greater numbers of invasive procedures were associated with lower FA values of the WM at age 7 years (P = .01). The interaction between the number of procedures and FA was associated with IQ (P = .02), such that greater numbers of invasive procedures and lower FA of the superior WM were related to lower IQ. CONCLUSIONS Invasive procedures during neonatal care contribute to long-term abnormalities in WM microstructure and lower IQ.
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Affiliation(s)
- Jillian Vinall
- Departments of Neuroscience,,Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Steven P. Miller
- Pediatrics,,Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | - Bruce H. Bjornson
- Pediatrics,,Developmental Neurosciences and Child Health, Child & Family Research Institute,,British Columbia Children’s and Women’s Hospitals, Vancouver, British Columbia, Canada
| | | | - Kenneth J. Poskitt
- Pediatrics,,Radiology, and,Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Rollin Brant
- Statistics, University of British Columbia, Vancouver, British Columbia, Canada;,Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Anne R. Synnes
- Pediatrics,,Developmental Neurosciences and Child Health, Child & Family Research Institute,,British Columbia Children’s and Women’s Hospitals, Vancouver, British Columbia, Canada
| | - Ivan L. Cepeda
- Developmental Neurosciences and Child Health, Child & Family Research Institute
| | - Ruth E. Grunau
- Departments of Neuroscience,,Pediatrics,,Developmental Neurosciences and Child Health, Child & Family Research Institute,,British Columbia Children’s and Women’s Hospitals, Vancouver, British Columbia, Canada;,School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland; and
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97
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Murray AD, McNeil CJ, Salarirad S, Whalley LJ, Staff RT. Early life socioeconomic circumstance and late life brain hyperintensities--a population based cohort study. PLoS One 2014; 9:e88969. [PMID: 24558456 PMCID: PMC3928340 DOI: 10.1371/journal.pone.0088969] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/14/2014] [Indexed: 11/28/2022] Open
Abstract
CONTEXT There have been many reports confirming the association between lower childhood socioeconomic circumstance and cardiovascular disease but evidence for links with cerebrovascular disease is contradictory. Hyperintensities on brain magnetic resonance imaging are associated with vascular risk factors, cognitive decline, dementia and death. However, the relationship between childhood socioeconomic circumstance and these lesions is unclear. OBJECTIVE To test the hypothesis that childhood socioeconomic circumstance is associated with late life hyperintensity burden and that neither adult socioeconomic circumstance nor change in socioeconomic circumstance during life influence this effect. DESIGN Cohort study. SETTING Community. PARTICIPANTS 227 community dwelling members of the 1936 Aberdeen Birth Cohort aged 68 years, who were free from dementia. MAIN OUTCOME MEASURES Relationship between early life socioeconomic circumstance (paternal occupation) and abundance of late life brain hyperintensities. RESULTS We find significant negative correlations between childhood socioeconomic circumstance and white matter hyperintensities (ρ = -0.18, P<0.01), and periventricular hyperintensities (ρ = -0.15, P<0.05), between educational attainment and white matter hyperintensities (ρ = -0.15, P<0.05) and periventricular hyperintensities (ρ = -0.17, P<0.05), and between childhood intelligence and periventricular hyperintensities (ρ = -0.14, P<0.05). The relationship is strongest for childhood socioeconomic circumstance and regional white matter hyperintensities, where there is a step change in increased burden from paternal occupation grades equivalent to a shift from "white collar" to "blue collar" paternal occupation. Significant correlations were also found between hypertension and hyperintensity burden in all brain regions (ρ = 0.15-0.24, P<0.05). In models that include hypertension, the magnitude of the effect of childhood socioeconomic circumstance is similar to and independent from that of hypertension. CONCLUSIONS Childhood socioeconomic circumstance predicts the burden of brain white matter hyperintensities aged 68 years. The mechanism underlying this effect is unknown, but may act through fetal and/or early life programming of cerebrovascular disease. Future work to understand this vulnerability will inform strategies to reduce dementia and stroke.
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Affiliation(s)
- Alison D. Murray
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Christopher J. McNeil
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Sima Salarirad
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Lawrence J. Whalley
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Roger T. Staff
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
- Department of Nuclear Medicine, NHS Grampian, Aberdeen, United Kingdom
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98
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White TP, Symington I, Castellanos NP, Brittain PJ, Froudist Walsh S, Nam KW, Sato JR, Allin MPG, Shergill SS, Murray RM, Williams SCR, Nosarti C. Dysconnectivity of neurocognitive networks at rest in very-preterm born adults. NEUROIMAGE-CLINICAL 2014; 4:352-65. [PMID: 24567907 PMCID: PMC3930099 DOI: 10.1016/j.nicl.2014.01.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 11/28/2013] [Accepted: 01/12/2014] [Indexed: 12/03/2022]
Abstract
Advances in neonatal medicine have resulted in a larger proportion of preterm-born individuals reaching adulthood. Their increased liability to psychiatric illness and impairments of cognition and behaviour intimate lasting cerebral consequences; however, the central physiological disturbances remain unclear. Of fundamental importance to efficient brain function is the coordination and contextually-relevant recruitment of neural networks. Large-scale distributed networks emerge perinatally and increase in hierarchical complexity through development. Preterm-born individuals exhibit systematic reductions in correlation strength within these networks during infancy. Here, we investigate resting-state functional connectivity in functional magnetic resonance imaging data from 29 very-preterm (VPT)-born adults and 23 term-born controls. Neurocognitive networks were identified with spatial independent component analysis conducted using the Infomax algorithm and employing Icasso procedures to enhance component robustness. Network spatial focus and spectral power were not generally significantly affected by preterm birth. By contrast, Granger-causality analysis of the time courses of network activity revealed widespread reductions in between-network connectivity in the preterm group, particularly along paths including salience-network features. The potential clinical relevance of these Granger-causal measurements was suggested by linear discriminant analysis of topological representations of connection strength, which classified individuals by group with a maximal accuracy of 86%. Functional connections from the striatal salience network to the posterior default mode network informed this classification most powerfully. In the VPT-born group it was additionally found that perinatal factors significantly moderated the relationship between executive function (which was reduced in the VPT-born as compared with the term-born group) and generalised partial directed coherence. Together these findings show that resting-state functional connectivity of preterm-born individuals remains compromised in adulthood; and present consistent evidence that the striatal salience network is preferentially affected. Therapeutic practices directed at strengthening within-network cohesion and fine-tuning between-network inter-relations may have the potential to mitigate the cognitive, behavioural and psychiatric repercussions of preterm birth. Functional connectivity was investigated using fMRI in preterm-born adults at rest. Generalised partial directed coherence was assessed between neurocognitive networks. Preterm-born adults exhibited widespread reductions in connection strength. Coherence-derived graph topology permitted identification of preterm-born adults.
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Affiliation(s)
- Thomas P White
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Iona Symington
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Nazareth P Castellanos
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Philip J Brittain
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Seán Froudist Walsh
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Kie-Woo Nam
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - João R Sato
- Centre of Mathematics, Computation and Cognition, Universidade Federal do ABC, Av. dos Estados, 5001 Bairro Bangu, Santo André, SP CEP 09210-580, Brazil
| | - Matthew P G Allin
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Sukhi S Shergill
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Steve C R Williams
- Department of Neuroimaging, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
| | - Chiara Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London SE5 8AF, UK
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99
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Padilla N, Junqué C, Figueras F, Sanz-Cortes M, Bargalló N, Arranz A, Donaire A, Figueras J, Gratacos E. Differential vulnerability of gray matter and white matter to intrauterine growth restriction in preterm infants at 12 months corrected age. Brain Res 2013; 1545:1-11. [PMID: 24361462 DOI: 10.1016/j.brainres.2013.12.007] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 11/26/2013] [Accepted: 12/06/2013] [Indexed: 01/29/2023]
Abstract
Intrauterine growth restriction (IUGR) is associated with a high risk of abnormal neurodevelopment. Underlying neuroanatomical substrates are partially documented. We hypothesized that at 12 months preterm infants would evidence specific white-matter microstructure alterations and gray-matter differences induced by severe IUGR. Twenty preterm infants with IUGR (26-34 weeks of gestation) were compared with 20 term-born infants and 20 appropriate for gestational age preterm infants of similar gestational age. Preterm groups showed no evidence of brain abnormalities. At 12 months, infants were scanned sleeping naturally. Gray-matter volumes were studied with voxel-based morphometry. White-matter microstructure was examined using tract-based spatial statistics. The relationship between diffusivity indices in white matter, gray matter volumes, and perinatal data was also investigated. Gray-matter decrements attributable to IUGR comprised amygdala, basal ganglia, thalamus and insula bilaterally, left occipital and parietal lobes, and right perirolandic area. Gray-matter volumes positively correlated with birth weight exclusively. Preterm infants had reduced FA in the corpus callosum, and increased FA in the anterior corona radiata. Additionally, IUGR infants had increased FA in the forceps minor, internal and external capsules, uncinate and fronto-occipital white matter tracts. Increased axial diffusivity was observed in several white matter tracts. Fractional anisotropy positively correlated with birth weight and gestational age at birth. These data suggest that IUGR differentially affects gray and white matter development preferentially affecting gray matter. At 12 months IUGR is associated with a specific set of structural gray-matter decrements. White matter follows an unusual developmental pattern, and is apparently affected by IUGR and prematurity combined.
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Affiliation(s)
- Nelly Padilla
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain.
| | - Carme Junqué
- Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, Universidad de Barcelona, C/ Casanova 143, 08036 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain
| | - Francesc Figueras
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Magdalena Sanz-Cortes
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Núria Bargalló
- Department of Radiology, Centre de Diagnòstic per la Imatge (CDIC), Hospital Clínic, Universidad de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain
| | - Angela Arranz
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Antonio Donaire
- Department of Neurology, Institute of Neuroscience, Hospital Clínic, Universidad de Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Josep Figueras
- Department of Neonatology, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, 08028, Barcelona, Spain
| | - Eduard Gratacos
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
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Thompson DK, Lee KJ, Egan GF, Warfield SK, Doyle LW, Anderson PJ, Inder TE. Regional white matter microstructure in very preterm infants: predictors and 7 year outcomes. Cortex 2013; 52:60-74. [PMID: 24405815 DOI: 10.1016/j.cortex.2013.11.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 10/18/2013] [Accepted: 11/27/2013] [Indexed: 02/01/2023]
Abstract
The aims of this study were to investigate regional white matter microstructural differences between very preterm (VPT) (<30 weeks' gestational age and/or <1250 g) and full term (FT) (≥37 weeks' gestational age) infants at term corrected age with diffusion tensor imaging, and to explore perinatal predictors of diffusion measures, and the relationship between regional diffusion measures and neurodevelopmental outcomes at age 7 years in VPT children. Mean (MD) (p = .003), axial (AD) (p = .008), and radial diffusivity (RD) (p = .003) in total white matter were increased in VPT compared with FT infants, with similar fractional anisotropy (FA) in the two groups. There was little evidence that group-wise differences were specific to any of the 8 regions studied for each hemisphere. Perinatal white matter abnormality and intraventricular hemorrhage (grade III or IV) were associated with increased diffusivity in the white matter of VPT infants. Higher white matter diffusivity measures of the inferior occipital and cerebellar region at term-equivalent age were associated with increased risk of impairments in motor and executive function at 7 years in VPT children, but there was little evidence for associations with IQ or memory impairment. In conclusion, myelination is likely disrupted or delayed in VPT infants, especially those with perinatal brain abnormality (BA). Altered diffusivity at term-equivalent age helps explain impaired functioning at 7 years. This study defines the nature of microstructural alterations in VPT infant white matter, assists in understanding the associated risk factors, and is the first study to reveal an important link between inferior occipital and cerebellar white matter disorganization in infancy, and executive and motor functioning 7 years later.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Carlton, Vic, Australia.
| | - Katherine J Lee
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Carlton, Vic, Australia
| | - Gary F Egan
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Carlton, Vic, Australia; Monash Biomedical Imaging, Monash University, Clayton, Vic, Australia
| | - Simon K Warfield
- Department of Radiology, Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, The University of Melbourne, Carlton, Vic, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Carlton, Vic, Australia
| | - Terrie E Inder
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic, Australia; Department of Pediatrics, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO, USA
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