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Back SA, Riddle A, Hohimer AR. The Sheep as a Model of Brain Injury in the Premature Infant. ANIMAL MODELS OF NEURODEVELOPMENTAL DISORDERS 2015. [DOI: 10.1007/978-1-4939-2709-8_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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152
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Pieterman K, Plaisier A, Govaert P, Leemans A, Lequin MH, Dudink J. Data quality in diffusion tensor imaging studies of the preterm brain: a systematic review. Pediatr Radiol 2015; 45:1372-81. [PMID: 25820411 PMCID: PMC4526590 DOI: 10.1007/s00247-015-3307-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 01/15/2015] [Accepted: 02/05/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND To study early neurodevelopment in preterm infants, evaluation of brain maturation and injury is increasingly performed using diffusion tensor imaging, for which the reliability of underlying data is paramount. OBJECTIVE To review the literature to evaluate acquisition and processing methodology in diffusion tensor imaging studies of preterm infants. MATERIALS AND METHODS We searched the Embase, Medline, Web of Science and Cochrane databases for relevant papers published between 2003 and 2013. The following keywords were included in our search: prematurity, neuroimaging, brain, and diffusion tensor imaging. RESULTS We found 74 diffusion tensor imaging studies in preterm infants meeting our inclusion criteria. There was wide variation in acquisition and processing methodology, and we found incomplete reporting of these settings. Nineteen studies (26%) reported the use of neonatal hardware. Data quality assessment was not reported in 13 (18%) studies. Artefacts-correction and data-exclusion was not reported in 33 (45%) and 18 (24%) studies, respectively. Tensor estimation algorithms were reported in 56 (76%) studies but were often suboptimal. CONCLUSION Diffusion tensor imaging acquisition and processing settings are incompletely described in current literature, vary considerably, and frequently do not meet the highest standards.
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Affiliation(s)
- Kay Pieterman
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center - Sophia, dr. Molewaterplein 60, 3015, GJ, Rotterdam, The Netherlands,
| | - Annemarie Plaisier
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center – Sophia, dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands ,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Paul Govaert
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center – Sophia, dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands ,Department of Pediatrics, Koningin Paola Children’s Hospital, Antwerp, Belgium
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten H. Lequin
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center – Sophia, dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands ,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
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153
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Kallankari H, Kaukola T, Olsén P, Ojaniemi M, Hallman M. Very preterm birth and foetal growth restriction are associated with specific cognitive deficits in children attending mainstream school. Acta Paediatr 2015; 104:84-90. [PMID: 25272976 DOI: 10.1111/apa.12811] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/18/2014] [Accepted: 09/17/2014] [Indexed: 11/27/2022]
Abstract
AIM This study investigated the association of prenatal and neonatal factors with cognitive outcomes in schoolchildren born very preterm without impairments at the age of nine. METHODS We recruited a prospective regional cohort of 154 very low gestational age (VLGA) children of <32 weeks and 90 term-born comparison children born between November 1998 and November 2002 at Oulu University Hospital, Finland. Cognitive outcome was assessed using an inclusive neuropsychological test repertoire at the age of nine. RESULTS The final study group comprised 77 VLGA children without cerebral palsy or any cognitive impairment and 27 term-born children. VLGA was associated with a 1.5-point [95% confidence interval (CI) 0.6-2.3] reduction in visuospatial-sensorimotor processing and a 1.2-point (95% CI 0.5-1.9) reduction in attention-executive functions scores. Foetal growth restriction (FGR) was the only clinical risk factor that was associated with cognitive outcome. Children with FGR had a significant decrease in language (1.7 points, 95% CI 0.50-3.0) and memory-learning (1.6 points, 95% CI 0.4-2.8) scores. CONCLUSION Children born very preterm without impairments had poorer performance in specific neurocognitive skills than term-born children. FGR was an independent risk factor for compromised neurocognitive outcome in VLGA children and predicted difficulties in language, memory and learning.
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Affiliation(s)
- Hanna Kallankari
- Department of Paediatrics; Institute of Clinical Medicine; University of Oulu; Oulu Finland
- Department of Children and Adolescents; Oulu University Hospital; Oulu Finland
| | - Tuula Kaukola
- Department of Paediatrics; Institute of Clinical Medicine; University of Oulu; Oulu Finland
- Department of Children and Adolescents; Oulu University Hospital; Oulu Finland
| | - Päivi Olsén
- Department of Child Neurology; Oulu University Hospital; Oulu Finland
| | - Marja Ojaniemi
- Department of Paediatrics; Institute of Clinical Medicine; University of Oulu; Oulu Finland
- Department of Children and Adolescents; Oulu University Hospital; Oulu Finland
| | - Mikko Hallman
- Department of Paediatrics; Institute of Clinical Medicine; University of Oulu; Oulu Finland
- Department of Children and Adolescents; Oulu University Hospital; Oulu Finland
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154
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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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155
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Kwon SH, Scheinost D, Lacadie C, Sze G, Schneider KC, Dai F, Constable RT, Ment LR. Adaptive mechanisms of developing brain: cerebral lateralization in the prematurely-born. Neuroimage 2014; 108:144-50. [PMID: 25528658 DOI: 10.1016/j.neuroimage.2014.12.032] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/31/2014] [Accepted: 12/12/2014] [Indexed: 11/30/2022] Open
Abstract
Preterm birth results in alterations in neural connectivity, but the impact of prematurity on the functional organization of the developing brain has yet to be explored. To test the hypothesis that preterm birth alters cortical organization during the late second and third trimesters of gestation, we interrogated cerebral lateralization at rest in 26 very preterm subjects (birth weight 500-1500g) with no evidence of brain injury and 25 healthy term control subjects at term equivalent age. Employing an unbiased voxel-based measure of functional connectivity, these data demonstrated that cerebral lateralization is impaired in the prematurely-born. At term equivalent age, preterm neonates showed significantly less lateralization in regions subserving both receptive and expressive language, left Brodmann (BA) areas insula-BA22-BA21 and L BA45-BA47 (p<0.05 corrected for multiple comparisons for both). Exploratory region of interest analyses demonstrated significantly less inter-hemispheric connectivity from L BA22 to R BA22 in preterm infants compared to term controls (p<0.005) and from R BA22 to its homolog (p<0.005). L BA22, Wernicke's area, was more strongly connected to R BA39, foreshadowing neural networks for language in preterm subjects at school age, adolescence and young adulthood. For these very preterm neonates born at less than 30weeks' PMA, the degree of prematurity had no influence on lateralization in these differential regions.
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Affiliation(s)
- Soo Hyun Kwon
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
| | - Dustin Scheinost
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA
| | - Cheryl Lacadie
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA
| | - Gordon Sze
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA
| | - Karen C Schneider
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Feng Dai
- Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT, USA
| | - R Todd Constable
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA
| | - Laura R Ment
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA; Department of Neurology, Yale School of Medicine, New Haven, CT, USA
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156
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Daamen M, Bäuml JG, Scheef L, Sorg C, Busch B, Baumann N, Bartmann P, Wolke D, Wohlschläger A, Boecker H. Working memory in preterm-born adults: load-dependent compensatory activity of the posterior default mode network. Hum Brain Mapp 2014; 36:1121-37. [PMID: 25413496 DOI: 10.1002/hbm.22691] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 10/16/2014] [Accepted: 11/10/2014] [Indexed: 11/09/2022] Open
Abstract
Premature birth is associated with an increased risk of cognitive performance deficits that are dependent on working memory (WM) load in childhood. Less clear is whether preterm-born adults show similar WM impairments, or develop compensatory brain mechanisms that help to overcome prematurity-related functional deficits, for example, by a workload-dependent over-recruitment of WM-typical areas, and/or engagement of alternative brain networks. In this functional magnetic resonance imaging study, 73 adults born very preterm and/or with very low birth weight (VP/VLBW) and 73 term-born controls (CON, mean age: 26.5 years) performed a verbal N-Back paradigm with varying workload (0-back, 1-back, 2-back). Generally, both groups showed similar performance accuracy and task-typical patterns of brain activations (especially in fronto-cingulo-parietal, thalamic, and cerebellar areas) and deactivations (especially in mesial frontal and parietal aspects of the default mode network [DMN]). However, VP/VLBW adults showed significantly stronger deactivations (P < 0.05, cluster-level corrected) than CON in posterior DMN regions, including right ventral precuneus, and right parahippocampal areas (with adjacent cerebellar areas), which were specific for the most demanding 2-back condition. Consistent with a workload-dependent effect, VP/VLBW adults with stronger deactivations (1-back > 2-back) in the parahippocampal/cerebellar cluster also presented a greater slowing of response latencies with increasing WM load (2-back > 1-back), indicative of higher effort. In conclusion, VP/VLBW adults recruited similar anatomical networks as controls during N-back performance, but showed an enhanced suppression of posterior DMN regions during higher workload, which may reflect a temporary suppression of stimulus-independent thoughts that helps to maintain adequate task performance with increasing attentional demands.
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Affiliation(s)
- Marcel Daamen
- Department of Radiology, University Hospital Bonn, Bonn, Germany; Department of Neonatology, University Hospital Bonn, Bonn, Germany
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157
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Tortora D, Panara V, Mattei PA, Tartaro A, Salomone R, Domizio S, Cotroneo AR, Caulo M. Comparing 3T T1-weighted sequences in identifying hyperintense punctate lesions in preterm neonates. AJNR Am J Neuroradiol 2014; 36:581-6. [PMID: 25376807 DOI: 10.3174/ajnr.a4144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The loss of contrast on T1-weighted MR images at 3T may affect the detection of hyperintense punctate lesions indicative of periventricular leukomalacia in preterm neonates. The aim of the present study was to determine which 3T T1-weighted sequence identified the highest number of hyperintense punctate lesions and to explore the relationship between the number of hyperintense punctate lesions and clinical outcome. MATERIALS AND METHODS The presence of hyperintense punctate lesions was retrospectively evaluated in 200 consecutive preterm neonates on 4 axial T1-weighted sequences: 3-mm inversion recovery and spin-echo and 1- and 3-mm reformatted 3D-fast-field echo. Statistically significant differences in the number of hyperintense punctate lesions were evaluated by using a linear mixed-model analysis. Logistic regression analysis was used to assess the relation between the number of hyperintense punctate lesions and neuromotor outcome at 3 months. RESULTS Thirty-one neonates had at least 1 hyperintense punctate lesion indicative of periventricular leukomalacia in at least 1 of the 4 sequences. The 1-mm axial reformatted 3D-fast-field echo sequence identified the greatest number of hyperintense punctate lesions (P < .001). No statistically significant differences were found among the 3-mm T1-weighted sequences. The greater number of hyperintense punctate lesions detected by the 1-mm reformatted T1 3D-fast-field echo sequence in the central region of the brain was associated with a worse clinical outcome. CONCLUSIONS At 3T, the 1-mm axial reformatted T1 3D-fast-field echo sequence identified the greatest number of hyperintense punctate lesions in the central region of preterm neonate brains, and this number was associated with neuromotor outcome.
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Affiliation(s)
- D Tortora
- From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.)
| | - V Panara
- From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.)
| | | | - A Tartaro
- From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.) Department of Neuroscience and Imaging (A.T., A.R.C., M.C.), University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - R Salomone
- Neonatology and Neonatal Intensive Care Unit (R.S., S.D.), University Hospital of Chieti, Chieti, Italy
| | - S Domizio
- Neonatology and Neonatal Intensive Care Unit (R.S., S.D.), University Hospital of Chieti, Chieti, Italy
| | - A R Cotroneo
- From the Radiology Unit (D.T., V.P., A.R.C., M.C.) Department of Neuroscience and Imaging (A.T., A.R.C., M.C.), University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - M Caulo
- From the Radiology Unit (D.T., V.P., A.R.C., M.C.) ITAB-Institute of Advanced Biomedical Technologies (D.T., V.P., A.T., M.C.) Department of Neuroscience and Imaging (A.T., A.R.C., M.C.), University "G. d'Annunzio" of Chieti, Chieti, Italy.
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158
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Moiseev A, Doesburg SM, Herdman AT, Ribary U, Grunau RE. Altered Network Oscillations and Functional Connectivity Dynamics in Children Born Very Preterm. Brain Topogr 2014; 28:726-745. [PMID: 25370485 DOI: 10.1007/s10548-014-0416-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/28/2014] [Indexed: 11/26/2022]
Abstract
Structural brain connections develop atypically in very preterm children, and altered functional connectivity is also evident in fMRI studies. Such alterations in brain network connectivity are associated with cognitive difficulties in this population. Little is known, however, about electrophysiological interactions among specific brain networks in children born very preterm. In the present study, we recorded magnetoencephalography while very preterm children and full-term controls performed a visual short-term memory task. Regions expressing task-dependent activity changes were identified using beamformer analysis, and inter-regional phase synchrony was calculated. Very preterm children expressed altered regional recruitment in distributed networks of brain areas, across standard physiological frequency ranges including the theta, alpha, beta and gamma bands. Reduced oscillatory synchrony was observed among task-activated brain regions in very preterm children, particularly for connections involving areas critical for executive abilities, including middle frontal gyrus. These findings suggest that inability to recruit neurophysiological activity and interactions in distributed networks including frontal regions may contribute to difficulties in cognitive development in children born very preterm.
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Affiliation(s)
- Alexander Moiseev
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Vancouver, Canada.
| | - Sam M Doesburg
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Anthony T Herdman
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Vancouver, Canada
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
| | - Urs Ribary
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Vancouver, Canada
- Department of Psychology, Simon Fraser University, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, Canada
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159
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Kim DJ, Davis EP, Sandman CA, Sporns O, O'Donnell BF, Buss C, Hetrick WP. Longer gestation is associated with more efficient brain networks in preadolescent children. Neuroimage 2014; 100:619-27. [PMID: 24983711 PMCID: PMC4138264 DOI: 10.1016/j.neuroimage.2014.06.048] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 06/09/2014] [Accepted: 06/22/2014] [Indexed: 12/21/2022] Open
Abstract
Neurodevelopmental benefits of increased gestation have not been fully characterized in terms of network organization. Since brain function can be understood as an integrated network of neural information from distributed brain regions, investigation of the effects of gestational length on network properties is a critical goal of human developmental neuroscience. Using diffusion tensor imaging and fiber tractography, we investigated the effects of gestational length on the small-world attributes and rich club organization of 147 preadolescent children, whose gestational length ranged from 29 to 42 weeks. Higher network efficiency was positively associated with longer gestation. The longer gestation was correlated with increased local efficiency in the posterior medial cortex, including the precuneus, cuneus, and superior parietal regions. Rich club organization was also observed indicating the existence of highly interconnected structural hubs formed in preadolescent children. Connectivity among rich club members and from rich club regions was positively associated with the length of gestation, indicating the higher level of topological benefits of structural connectivity from longer gestation in the predominant regions of brain networks. The findings provide evidence that longer gestation is associated with improved topological organization of the preadolescent brain, characterized by the increased communication capacity of the brain network and enhanced directional strength of brain connectivity with central hub regions.
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Affiliation(s)
- Dae-Jin Kim
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN 47405, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, 2155 South Race Street, Denver, CO 80208, USA; Department of Psychiatry and Human Behavior, University of California Irvine, USA
| | - Curt A Sandman
- Department of Psychiatry and Human Behavior, University of California Irvine, USA
| | - Olaf Sporns
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN 47405, USA
| | - Brian F O'Donnell
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN 47405, USA
| | - Claudia Buss
- Institut für Medizinische Psychologie, Charité Centrum für Human-und Gesundheitswissenschaften, Charité Universitätsmedizin, Berlin, Germany
| | - William P Hetrick
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN 47405, USA.
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160
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Walsh JM, Doyle LW, Anderson PJ, Lee KJ, Cheong JLY. Moderate and Late Preterm Birth: Effect on Brain Size and Maturation at Term-Equivalent Age. Radiology 2014; 273:232-40. [DOI: 10.1148/radiol.14132410] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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161
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Allievi AG, Arichi T, Gordon AL, Burdet E. Technology-aided assessment of sensorimotor function in early infancy. Front Neurol 2014; 5:197. [PMID: 25324827 PMCID: PMC4181230 DOI: 10.3389/fneur.2014.00197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/17/2014] [Indexed: 01/31/2023] Open
Abstract
There is a pressing need for new techniques capable of providing accurate information about sensorimotor function during the first 2 years of childhood. Here, we review current clinical methods and challenges for assessing motor function in early infancy, and discuss the potential benefits of applying technology-assisted methods. We also describe how the use of these tools with neuroimaging, and in particular functional magnetic resonance imaging (fMRI), can shed new light on the intra-cerebral processes underlying neurodevelopmental impairment. This knowledge is of particular relevance in the early infant brain, which has an increased capacity for compensatory neural plasticity. Such tools could bring a wealth of knowledge about the underlying pathophysiological processes of diseases such as cerebral palsy; act as biomarkers to monitor the effects of possible therapeutic interventions; and provide clinicians with much needed early diagnostic information.
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Affiliation(s)
- Alessandro G Allievi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
| | - Tomoki Arichi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK ; Department of Perinatal Imaging and Health, King's College London , London , UK
| | - Anne L Gordon
- Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust , London , UK ; Institute of Psychiatry, Psychology and Neuroscience, Kings College London , London , UK
| | - Etienne Burdet
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
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162
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Allievi AG, Arichi T, Gordon AL, Burdet E. Technology-aided assessment of sensorimotor function in early infancy. Front Neurol 2014; 5:197. [PMID: 25324827 DOI: 10.3389/fneur.2014.00197/abstract] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/17/2014] [Indexed: 05/23/2023] Open
Abstract
There is a pressing need for new techniques capable of providing accurate information about sensorimotor function during the first 2 years of childhood. Here, we review current clinical methods and challenges for assessing motor function in early infancy, and discuss the potential benefits of applying technology-assisted methods. We also describe how the use of these tools with neuroimaging, and in particular functional magnetic resonance imaging (fMRI), can shed new light on the intra-cerebral processes underlying neurodevelopmental impairment. This knowledge is of particular relevance in the early infant brain, which has an increased capacity for compensatory neural plasticity. Such tools could bring a wealth of knowledge about the underlying pathophysiological processes of diseases such as cerebral palsy; act as biomarkers to monitor the effects of possible therapeutic interventions; and provide clinicians with much needed early diagnostic information.
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Affiliation(s)
- Alessandro G Allievi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
| | - Tomoki Arichi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK ; Department of Perinatal Imaging and Health, King's College London , London , UK
| | - Anne L Gordon
- Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust , London , UK ; Institute of Psychiatry, Psychology and Neuroscience, Kings College London , London , UK
| | - Etienne Burdet
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
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163
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Batalle D, Muñoz-Moreno E, Arbat-Plana A, Illa M, Figueras F, Eixarch E, Gratacos E. Long-term reorganization of structural brain networks in a rabbit model of intrauterine growth restriction. Neuroimage 2014; 100:24-38. [DOI: 10.1016/j.neuroimage.2014.05.065] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 05/14/2014] [Accepted: 05/25/2014] [Indexed: 10/25/2022] Open
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164
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Dubois J, Dehaene-Lambertz G, Kulikova S, Poupon C, Hüppi PS, Hertz-Pannier L. The early development of brain white matter: A review of imaging studies in fetuses, newborns and infants. Neuroscience 2014; 276:48-71. [PMID: 24378955 DOI: 10.1016/j.neuroscience.2013.12.044] [Citation(s) in RCA: 494] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 12/12/2013] [Accepted: 12/16/2013] [Indexed: 12/13/2022]
Affiliation(s)
- J Dubois
- INSERM, U992, Cognitive Neuroimaging Unit, Gif-sur-Yvette, France; CEA, NeuroSpin Center, UNICOG, Gif-sur-Yvette, France; University Paris Sud, Orsay, France.
| | - G Dehaene-Lambertz
- INSERM, U992, Cognitive Neuroimaging Unit, Gif-sur-Yvette, France; CEA, NeuroSpin Center, UNICOG, Gif-sur-Yvette, France; University Paris Sud, Orsay, France
| | - S Kulikova
- CEA, NeuroSpin Center, UNIACT, Gif-sur-Yvette, France; INSERM, U663, Child epilepsies and brain plasticity, Paris, France; University Paris Descartes, Paris, France
| | - C Poupon
- CEA, NeuroSpin Center, UNIRS, Gif-sur-Yvette, France
| | - P S Hüppi
- Geneva University Hospitals, Department of Pediatrics, Division of Development and Growth, Geneva, Switzerland; Harvard Medical School, Children's Hospital, Department of Neurology, Boston, MA, USA
| | - L Hertz-Pannier
- CEA, NeuroSpin Center, UNIACT, Gif-sur-Yvette, France; INSERM, U663, Child epilepsies and brain plasticity, Paris, France; University Paris Descartes, Paris, France
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165
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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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166
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Borradori Tolsa C, Barisnikov K, Lejeune F, Hüppi P. [Development of executive functions in preterm children]. Arch Pediatr 2014; 21:1035-40. [PMID: 25089045 DOI: 10.1016/j.arcped.2014.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 06/18/2014] [Indexed: 11/17/2022]
Abstract
The rate of children born prematurely has increased considerably in the last few decades, and their developmental outcome remains of great concern. The literature on the impact of prematurity has reported a wide range of cognitive and behavioral problems that may be related to deficits in executive function (EF) skills. EF refers to a series of high-level processes (selective attention, inhibition, set shifting, working memory, planning, goal setting) that develop throughout childhood and adolescence and play an important role in cognitive and social development as well as in school achievement. EF skills have been linked to the prefrontal cortex, as well as to other neural networks and brain regions including the basal ganglia and cerebellum. This paper focuses on studies related to the development of EF and social behavior in children born preterm. The preschool period is a critical time to perform neuropsychological assessment in addition to IQ testing, and to detect the child's specific needs in order to adapt effective intervention to enhance the development of executive processes in these high-risk children.
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Affiliation(s)
- C Borradori Tolsa
- Service du développement et de la croissance, département de l'enfant et de l'adolescent, hôpitaux universitaire de Genève, 1211 Genève, Suisse.
| | - K Barisnikov
- Unité de psychologie clinique et neuropsychologie de l'enfant, faculté de psychologie et des sciences de l'éducation, université de Genève, Genève, Suisse
| | - F Lejeune
- Unité de psychologie clinique et neuropsychologie de l'enfant, faculté de psychologie et des sciences de l'éducation, université de Genève, Genève, Suisse
| | - P Hüppi
- Service du développement et de la croissance, département de l'enfant et de l'adolescent, hôpitaux universitaire de Genève, 1211 Genève, Suisse
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167
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Kostović I, Kostović-Srzentić M, Benjak V, Jovanov-Milošević N, Radoš M. Developmental dynamics of radial vulnerability in the cerebral compartments in preterm infants and neonates. Front Neurol 2014; 5:139. [PMID: 25120530 PMCID: PMC4114264 DOI: 10.3389/fneur.2014.00139] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 07/14/2014] [Indexed: 01/06/2023] Open
Abstract
The developmental vulnerability of different classes of axonal pathways in preterm white matter is not known. We propose that laminar compartments of the developing cerebral wall serve as spatial framework for axonal growth and evaluate potential of anatomical landmarks for understanding reorganization of the cerebral wall after perinatal lesions. The 3-T MRI (in vivo) and histological analysis were performed in a series of cases ranging from 22 postconceptional weeks to 3 years. For the follow-up scans, three groups of children (control, normotypic, and preterms with lesions) were examined at the term equivalent age and after the first year of life. MRI and histological abnormalities were analyzed in the following compartments: (a) periventricular, with periventricular fiber system; (b) intermediate, with periventricular crossroads, sagittal strata, and centrum semiovale; (c) superficial, composed of gyral white matter, subplate, and cortical plate. Vulnerability of thalamocortical pathways within the crossroads and sagittal strata seems to be characteristic for early preterms, while vulnerability of long association pathways in the centrum semiovale seems to be predominant feature of late preterms. The structural indicator of the lesion of the long association pathways is the loss of delineation between centrum semiovale and subplate remnant, which is possible substrate of the diffuse periventricular leukomalacia. The enhanced difference in MR signal intensity of centrum semiovale and subplate remnant, observed in damaged children after first year, we interpret as structural plasticity of intact short cortico-cortical fibers, which grow postnatally through U-zones and enter the cortex through the subplate remnant. Our findings indicate that radial distribution of MRI signal abnormalities in the cerebral compartments may be related to lesion of different classes of axonal pathways and have prognostic value for predicting the likely outcome of prenatal and perinatal lesions.
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Affiliation(s)
- Ivica Kostović
- Croatian Institute for Brain Research, University of Zagreb School of Medicine , Zagreb , Croatia
| | | | - Vesna Benjak
- Department of Pediatrics, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine , Zagreb , Croatia
| | - Nataša Jovanov-Milošević
- Croatian Institute for Brain Research, University of Zagreb School of Medicine , Zagreb , Croatia
| | - Milan Radoš
- Croatian Institute for Brain Research, University of Zagreb School of Medicine , Zagreb , Croatia
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168
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Taylor MJ, Doesburg SM, Pang EW. Neuromagnetic vistas into typical and atypical development of frontal lobe functions. Front Hum Neurosci 2014; 8:453. [PMID: 24994980 PMCID: PMC4061489 DOI: 10.3389/fnhum.2014.00453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 06/03/2014] [Indexed: 11/24/2022] Open
Abstract
The frontal lobes are involved in many higher-order cognitive functions such as social cognition executive functions and language and speech. These functions are complex and follow a prolonged developmental course from childhood through to early adulthood. Magnetoencephalography (MEG) is ideal for the study of development of these functions, due to its combination of temporal and spatial resolution which allows the determination of age-related changes in both neural timing and location. There are several challenges for MEG developmental studies: to design tasks appropriate to capture the neurodevelopmental trajectory of these cognitive functions, and to develop appropriate analysis strategies to capture various aspects of neuromagnetic frontal lobe activity. Here, we review our MEG research on social and executive functions, and speech in typically developing children and in two clinical groups – children with autism spectrum disorder and children born very preterm. The studies include facial emotional processing, inhibition, visual short-term memory, speech production, and resting-state networks. We present data from event-related analyses as well as on oscillations and connectivity analyses and review their contributions to understanding frontal lobe cognitive development. We also discuss the challenges of testing young children in the MEG and the development of age-appropriate technologies and paradigms.
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Affiliation(s)
- Margot J Taylor
- Department of Diagnostic Imaging, Hospital for Sick Children , Toronto, ON , Canada ; Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Medical Imaging, University of Toronto , Toronto, ON , Canada ; Department of Psychology, University of Toronto , Toronto, ON , Canada ; Department of Paediatrics, University of Toronto , Toronto, ON , Canada
| | - Sam M Doesburg
- Department of Diagnostic Imaging, Hospital for Sick Children , Toronto, ON , Canada ; Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Medical Imaging, University of Toronto , Toronto, ON , Canada ; Department of Psychology, University of Toronto , Toronto, ON , Canada
| | - Elizabeth W Pang
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Paediatrics, University of Toronto , Toronto, ON , Canada ; Division of Neurology, Hospital for Sick Children , Toronto, ON , Canada
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169
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Fischi-Gómez E, Vasung L, Meskaldji DE, Lazeyras F, Borradori-Tolsa C, Hagmann P, Barisnikov K, Thiran JP, Hüppi PS. Structural Brain Connectivity in School-Age Preterm Infants Provides Evidence for Impaired Networks Relevant for Higher Order Cognitive Skills and Social Cognition. Cereb Cortex 2014; 25:2793-805. [DOI: 10.1093/cercor/bhu073] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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170
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Agematsu K, Korotcova L, Scafidi J, Gallo V, Jonas RA, Ishibashi N. Effects of preoperative hypoxia on white matter injury associated with cardiopulmonary bypass in a rodent hypoxic and brain slice model. Pediatr Res 2014; 75:618-25. [PMID: 24488087 PMCID: PMC3992169 DOI: 10.1038/pr.2014.9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/22/2013] [Indexed: 11/12/2022]
Abstract
BACKGROUND White matter (WM) injury is common after cardiopulmonary bypass or deep hypothermic circulatory arrest in neonates who have cerebral immaturity secondary to in utero hypoxia. The mechanism remains unknown. We investigated effects of preoperative hypoxia on deep hypothermic circulatory arrest-induced WM injury using a combined experimental paradigm in rodents. METHODS Mice were exposed to hypoxia (prehypoxia). Oxygen-glucose deprivation was performed under three temperatures to simulate brain conditions of deep hypothermic circulatory arrest including ischemia-reperfusion/reoxygenation under hypothermia. RESULTS WM injury in prenormoxia was identified after 35 °C-oxygen-glucose deprivation. In prehypoxia, injury was displayed in all groups. Among oligodendrocyte stages, the preoligodendrocyte was the most susceptible, while the oligodendrocyte progenitor was resistant to insult. When effects of prehypoxia were assessed, injury of mature oligodendrocytes and oligodendrocyte progenitors in prehypoxia significantly increased as compared with prenormoxia, indicating that mature oligodendrocytes and progenitors that had developed under hypoxia had greater vulnerability. Conversely, damage of oligodendrocyte progenitors in prehypoxia were not identified after 15 °C-oxygen-glucose deprivation, suggesting that susceptible oligodendrocytes exposed to hypoxia are protected by deep hypothermia. CONCLUSION Developmental alterations due to hypoxia result in an increased WM susceptibility to injury. Promoting WM regeneration by oligodendrocyte progenitors after earlier surgery using deep hypothermia is the most promising approach for successful WM development in congenital heart disease patients.
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Affiliation(s)
- Kota Agematsu
- Children’s National Heart Institute, Children’s National Medical Center, Washington, DC,Center for Neuroscience Research, Children’s National Medical Center, Washington, DC
| | - Ludmila Korotcova
- Children’s National Heart Institute, Children’s National Medical Center, Washington, DC,Center for Neuroscience Research, Children’s National Medical Center, Washington, DC
| | - Joseph Scafidi
- Center for Neuroscience Research, Children’s National Medical Center, Washington, DC
| | - Vittorio Gallo
- Center for Neuroscience Research, Children’s National Medical Center, Washington, DC
| | - Richard A. Jonas
- Children’s National Heart Institute, Children’s National Medical Center, Washington, DC,Center for Neuroscience Research, Children’s National Medical Center, Washington, DC
| | - Nobuyuki Ishibashi
- Children’s National Heart Institute, Children’s National Medical Center, Washington, DC,Center for Neuroscience Research, Children’s National Medical Center, Washington, DC,Correspondence: Nobuyuki Ishibashi, MD, Children’s National Heart Institute and Center for Neuroscience Research, Children’s National Medical Center, 111 Michigan Avenue, N.W., Washington, DC, 20010-2970. Tel: 202-476-2388, Fax: 202-476-5572,
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171
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Andrikopoulou M, Almalki A, Farzin A, Cordeiro CN, Johnston MV, Burd I. Perinatal biomarkers in prematurity: early identification of neurologic injury. Int J Dev Neurosci 2014; 36:25-31. [PMID: 24768951 DOI: 10.1016/j.ijdevneu.2014.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 04/11/2014] [Accepted: 04/12/2014] [Indexed: 01/06/2023] Open
Abstract
Over the past few decades, biomarkers have become increasingly utilized as non-invasive tools in the early diagnosis and management of various clinical conditions. In perinatal medicine, the improved survival of extremely premature infants who are at high risk for adverse neurologic outcomes has increased the demand for the discovery of biomarkers in detecting and predicting the prognosis of infants with neonatal brain injury. By enabling the clinician to recognize potential brain damage early, biomarkers could allow clinicians to intervene at the early stages of disease, and to monitor the efficacy of those interventions. This review will first examine the potential perinatal biomarkers for neurologic complications of prematurity, specifically, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and posthemorrhagic hydrocephalus (PHH). It will also evaluate knowledge gained from animal models regarding the pathogenesis of perinatal brain injury in prematurity.
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Affiliation(s)
- Maria Andrikopoulou
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ahmad Almalki
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Azadeh Farzin
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Christina N Cordeiro
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michael V Johnston
- Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Irina Burd
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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172
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Microglia toxicity in preterm brain injury. Reprod Toxicol 2014; 48:106-12. [PMID: 24768662 PMCID: PMC4155935 DOI: 10.1016/j.reprotox.2014.04.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/01/2014] [Accepted: 04/14/2014] [Indexed: 01/07/2023]
Abstract
Microglia responses in the preterm human brain in association with injury. Microglia responses in animal models of preterm brain injury. Mechanisms of microglia toxicity from in vitro primary microglia cell culture experiments.
Microglia are the resident phagocytic cells of the central nervous system. During brain development they are also imperative for apoptosis of excessive neurons, synaptic pruning, phagocytosis of debris and maintaining brain homeostasis. Brain damage results in a fast and dynamic microglia reaction, which can influence the extent and distribution of subsequent neuronal dysfunction. As a consequence, microglia responses can promote tissue protection and repair following brain injury, or become detrimental for the tissue integrity and functionality. In this review, we will describe microglia responses in the human developing brain in association with injury, with particular focus on the preterm infant. We also explore microglia responses and mechanisms of microglia toxicity in animal models of preterm white matter injury and in vitro primary microglia cell culture experiments.
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173
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Abstract
There is growing interest in the long-term mental health sequelae of extremely preterm birth. In this paper we review literature relating to mental health outcomes across the lifespan. Studies conducted in the preschool years, school age and adolescence, and adulthood show continuity in outcomes and point to an increased risk for inattention, socio-communicative problems and emotional difficulties in individuals born extremely preterm. Both behavioural and neuroimaging studies also provide evidence of a neurodevelopmental origin for mental health disorders in this population. Here we summarise contemporary evidence and highlight key methodological considerations for carrying out and interpreting studies in this field.
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174
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MRI of animal models of developmental disorders and translation to human imaging. Curr Opin Neurol 2014; 27:157-67. [DOI: 10.1097/wco.0000000000000066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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175
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Back SA, Rosenberg PA. Pathophysiology of glia in perinatal white matter injury. Glia 2014; 62:1790-815. [PMID: 24687630 DOI: 10.1002/glia.22658] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/13/2014] [Accepted: 02/27/2014] [Indexed: 12/12/2022]
Abstract
Injury to the preterm brain has a particular predilection for cerebral white matter. White matter injury (WMI) is the most common cause of brain injury in preterm infants and a major cause of chronic neurological morbidity including cerebral palsy. Factors that predispose to WMI include cerebral oxygenation disturbances and maternal-fetal infection. During the acute phase of WMI, pronounced oxidative damage occurs that targets late oligodendrocyte progenitors (pre-OLs). The developmental predilection for WMI to occur during prematurity appears to be related to both the timing of appearance and regional distribution of susceptible pre-OLs that are vulnerable to a variety of chemical mediators including reactive oxygen species, glutamate, cytokines, and adenosine. During the chronic phase of WMI, the white matter displays abberant regeneration and repair responses. Early OL progenitors respond to WMI with a rapid robust proliferative response that results in a several fold regeneration of pre-OLs that fail to terminally differentiate along their normal developmental time course. Pre-OL maturation arrest appears to be related in part to inhibitory factors that derive from reactive astrocytes in chronic lesions. Recent high field magnetic resonance imaging (MRI) data support that three distinct forms of chronic WMI exist, each of which displays unique MRI and histopathological features. These findings suggest the possibility that therapies directed at myelin regeneration and repair could be initiated early after WMI and monitored over time. These new mechanisms of acute and chronic WMI provide access to a variety of new strategies to prevent or promote repair of WMI in premature infants.
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Affiliation(s)
- Stephen A Back
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon; Department of Neurology, Oregon Health and Science University, Portland, Oregon
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176
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Soman S, Holdsworth SJ, Skare S, Andre JB, Van AT, Aksoy M, Bammer R, Rosenberg J, Barnes PD, Yeom KW. Effect of Number of Acquisitions in Diffusion Tensor Imaging of the Pediatric Brain: Optimizing Scan Time and Diagnostic Experience. J Neuroimaging 2014; 25:296-302. [DOI: 10.1111/jon.12093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/11/2013] [Accepted: 09/15/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- Salil Soman
- Department of Radiology; Stanford University; Stanford CA
| | | | - Stefan Skare
- Clinical Neuroscience; Karolinska Institute; Stockholm Sweden
| | | | - Anh T. Van
- Department of Radiology; Lucas Center; Stanford University; Stanford CA
| | - Murat Aksoy
- Department of Radiology; Lucas Center; Stanford University; Stanford CA
| | - Roland Bammer
- Department of Radiology; Lucas Center; Stanford University; Stanford CA
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177
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de Kieviet JF, Pouwels PJW, Lafeber HN, Vermeulen RJ, van Elburg RM, Oosterlaan J. A crucial role of altered fractional anisotropy in motor problems of very preterm children. Eur J Paediatr Neurol 2014; 18:126-33. [PMID: 24119780 DOI: 10.1016/j.ejpn.2013.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 08/22/2013] [Accepted: 09/14/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Very preterm children (<32 weeks of gestation) are characterized by impaired white matter development as measured by fractional anisotropy (FA). This study investigates whether altered FA values underpin the widespread motor impairments and higher incidence of developmental coordination disorder (DCD) in very preterm children at school-age. METHODS Thirty very preterm born children (mean (SD) age of 8.6 (0.3) years) and 47 term born controls (mean [SD] age 8.7 [0.5] years) participated. Motor development was measured using the Movement Assessment Battery for Children. A score below the 15th percentile was used as a research diagnosis of DCD. FA values, as measure of white matter abnormalities, were determined for 18 major white matter tracts, obtained using probabilistic diffusion tensor tractography. RESULTS Large-sized reductions in FA of the cingulum hippocampal tract right (d = 0.75, p = .003) and left (d = 0.76, p = .001), corticospinal tract right (d = 0.56, p = .02) and left (d = 0.65, p = .009), forceps major (d = 1.04, p < .001) and minor (d = 0.54, p = .02) were present in very preterms, in particular with a research diagnosis of DCD. Reduced FA values moderately to strongly related to motor impairments. A ROC curve for average FA, as calculated from tracts that significantly discriminated between very preterm children with and without a research diagnosis of DCD, showed an area under curve of 0.87 (95% CI 0.74-1.00, p = .001). CONCLUSIONS This study provides clear evidence that reduced FA values are strongly underpinning motor impairment and DCD in very preterm children at school-age. In addition, outcomes demonstrate that altered white matter FA values can potentially be used to discriminate between very preterm children at risk for motor impairments, although future studies are warranted.
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Affiliation(s)
- Jorrit F de Kieviet
- VU University Amsterdam, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
| | - Petra J W Pouwels
- VU University Medical Center, Department of Physics and Medical Technology, Amsterdam, The Netherlands
| | - Harrie N Lafeber
- VU University Medical Center, Department of Paediatrics, Amsterdam, The Netherlands
| | - R Jeroen Vermeulen
- VU University Medical Center, Department of Paediatric Neurology, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Ruurd M van Elburg
- VU University Medical Center, Department of Paediatrics, Amsterdam, The Netherlands; Danone Research Centre for Specialized Nutrition, Wageningen, The Netherlands
| | - Jaap Oosterlaan
- VU University Amsterdam, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
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178
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Back SA. Cerebral white and gray matter injury in newborns: new insights into pathophysiology and management. Clin Perinatol 2014; 41:1-24. [PMID: 24524444 PMCID: PMC3947650 DOI: 10.1016/j.clp.2013.11.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Increasing numbers of preterm neonates survive with motor and cognitive disabilities related to less destructive forms of cerebral injury that still result in reduced cerebral growth. White matter injury results in myelination disturbances related to aberrant responses to death of pre-myelinating oligodendrocytes (preOLs). PreOLs are rapidly regenerated but fail to mature to myelinating cells. Although immature projection neurons are more resistant to hypoxia-ischemia than preOLs, they display widespread disturbances in dendritic arbor maturation, which provides an explanation for impaired cerebral growth. Thus, large numbers of cells fail to fully mature during a critical window in development of neural circuitry. These recently recognized forms of cerebral gray and white matter dysmaturation suggest new therapeutic directions centered on reversal of the processes that promote dysmaturation.
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Affiliation(s)
- Stephen A. Back
- Professor of Pediatrics and Neurology Oregon Health & Science University Clyde and Elda Munson Professor of Pediatric Research Director, Neuroscience Section, Pape' Family Pediatric Research Institute
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179
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Abstract
White matter injury and hemorrhage are common findings in extremely preterm infants. Large hemorrhages and extensive cystic lesions are identified with cranial ultrasound. MRI, which is more sensitive, is especially useful in the identification of small intraventricular hemorrhage; cerebellar hemorrhage; punctate lesion in the white matter and cerebellum; and diffuse, noncystic white matter injury. Imaging sequences such as diffusion-weighted, diffusion tensor, and susceptibility weighted imaging may improve recognition and prediction of outcome. These techniques improve understanding of the underlying pathophysiology of white matter injury and its effects on brain development and neurodevelopmental outcome.
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180
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Tusor N, Arichi T, Counsell SJ, Edwards AD. Brain development in preterm infants assessed using advanced MRI techniques. Clin Perinatol 2014; 41:25-45. [PMID: 24524445 DOI: 10.1016/j.clp.2013.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Infants who are born preterm have a high incidence of neurocognitive and neurobehavioral abnormalities, which may be associated with impaired brain development. Advanced magnetic resonance imaging (MRI) approaches, such as diffusion MRI (d-MRI) and functional MRI (fMRI), provide objective and reproducible measures of brain development. Indices derived from d-MRI can be used to provide quantitative measures of preterm brain injury. Although fMRI of the neonatal brain is currently a research tool, future studies combining d-MRI and fMRI have the potential to assess the structural and functional properties of the developing brain and its response to injury.
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Affiliation(s)
- Nora Tusor
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK
| | - Tomoki Arichi
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK; Department of Bioengineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - Serena J Counsell
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK
| | - A David Edwards
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK; Department of Bioengineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
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181
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de Bruïne FT, Steggerda SJ, van den Berg-Huysmans AA, Leijser LM, Rijken M, van Buchem MA, van Wezel-Meijler G, van der Grond J. Prognostic value of gradient echo T2* sequences for brain MR imaging in preterm infants. Pediatr Radiol 2014; 44:305-12. [PMID: 24419491 DOI: 10.1007/s00247-013-2803-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 06/18/2013] [Accepted: 09/15/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Gradient echo T2*-W sequences are more sensitive than T2-W spin-echo sequences for detecting hemorrhages in the brain. OBJECTIVE The aim of this study is to correlate presence of hemosiderin deposits in the brain of very preterm infants (gestational age <32 weeks) detected by T2*-W gradient echo MRI to white matter injury and neurodevelopmental outcome at 2 years. MATERIALS AND METHODS In 101 preterm infants, presence and location of hemosiderin were assessed on T2*-W gradient echo MRI performed around term-equivalent age (range: 40-60 weeks). White matter injury was defined as the presence of >6 non-hemorrhagic punctate white matter lesions (PWML), cysts and/or ventricular dilatation. Six infants with post-hemorrhagic ventricular dilatation detected by US in the neonatal period were excluded. Infants were seen for follow-up at 2 years. Univariate and regression analysis assessed the relation between presence and location of hemosiderin, white matter injury and neurodevelopmental outcome. RESULTS In 38/95 (40%) of the infants, hemosiderin was detected. Twenty percent (19/95) of the infants were lost to follow-up. There was a correlation between hemosiderin in the ventricular wall with >6 PWML (P < 0.001) and cysts (P < 0.001) at term-equivalent age, and with a lower psychomotor development index (PDI) (P=0.02) at 2 years. After correcting for known confounders (gestational age, gender, intrauterine growth retardation and white matter injury), the correlation with PDI was no longer significant. CONCLUSION The clinical importance of detecting small hemosiderin deposits is limited as there is no independent association with neurodevelopmental outcome.
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Affiliation(s)
- Francisca T de Bruïne
- Department of Radiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands,
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182
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Abstract
Magnetic resonance imaging (MRI) is a safe and high-resolution neuroimaging modality that is increasingly used in the neonatal population to assess brain injury and its consequences on brain development. It is superior to cranial ultrasound for the definition of patterns of both white and gray matter maturation and injury and therefore has the potential to provide prognostic information on the neurodevelopmental outcomes of the preterm population. Furthermore, the development of sophisticated MRI strategies, including diffusion tensor imaging, resting state functional connectivity, and magnetic resonance spectroscopy, may increase the prognostic value, helping to guide parental counseling and allocate early intervention services.
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183
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Scafidi J, Hammond TR, Scafidi S, Ritter J, Jablonska B, Roncal M, Szigeti-Buck K, Coman D, Huang Y, McCarter RJ, Hyder F, Horvath TL, Gallo V. Intranasal epidermal growth factor treatment rescues neonatal brain injury. Nature 2014; 506:230-4. [PMID: 24390343 PMCID: PMC4106485 DOI: 10.1038/nature12880] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 11/13/2013] [Indexed: 12/19/2022]
Abstract
There are no clinically relevant treatments available that improve function in the growing population of very preterm infants (less than 32 weeks' gestation) with neonatal brain injury. Diffuse white matter injury (DWMI) is a common finding in these children and results in chronic neurodevelopmental impairments. As shown recently, failure in oligodendrocyte progenitor cell maturation contributes to DWMI. We demonstrated previously that the epidermal growth factor receptor (EGFR) has an important role in oligodendrocyte development. Here we examine whether enhanced EGFR signalling stimulates the endogenous response of EGFR-expressing progenitor cells during a critical period after brain injury, and promotes cellular and behavioural recovery in the developing brain. Using an established mouse model of very preterm brain injury, we demonstrate that selective overexpression of human EGFR in oligodendrocyte lineage cells or the administration of intranasal heparin-binding EGF immediately after injury decreases oligodendroglia death, enhances generation of new oligodendrocytes from progenitor cells and promotes functional recovery. Furthermore, these interventions diminish ultrastructural abnormalities and alleviate behavioural deficits on white-matter-specific paradigms. Inhibition of EGFR signalling with a molecularly targeted agent used for cancer therapy demonstrates that EGFR activation is an important contributor to oligodendrocyte regeneration and functional recovery after DWMI. Thus, our study provides direct evidence that targeting EGFR in oligodendrocyte progenitor cells at a specific time after injury is clinically feasible and potentially applicable to the treatment of premature children with white matter injury.
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Affiliation(s)
- Joseph Scafidi
- Center for Neuroscience Research, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
- Department of Neurology, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
| | - Timothy R. Hammond
- Center for Neuroscience Research, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
- Institute for Biomedical Sciences, The George Washington University, Washington, District of Columbia, 20052 USA
| | - Susanna Scafidi
- Department of Anesthesiology & Critical Care Medicine, John’s Hopkins University School of Medicine, Baltimore, Maryland, 21287 USA
| | - Jonathan Ritter
- Center for Neuroscience Research, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
| | - Beata Jablonska
- Center for Neuroscience Research, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
| | - Maria Roncal
- Center for Neuroscience Research, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
| | - Klara Szigeti-Buck
- Dept of Neurobiology, Yale University, New Haven, Connecticut, 06520 USA
| | - Daniel Coman
- MRRC, Department of Diagnostic Radiology, Yale University, New Haven, Connecticut, 06520, USA
| | - Yuegao Huang
- MRRC, Department of Diagnostic Radiology, Yale University, New Haven, Connecticut, 06520, USA
| | - Robert J. McCarter
- Center for Translational Science, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
| | - Fahmeed Hyder
- MRRC, Department of Diagnostic Radiology, Yale University, New Haven, Connecticut, 06520, USA
| | - Tamas L. Horvath
- Dept of Neurobiology, Yale University, New Haven, Connecticut, 06520 USA
| | - Vittorio Gallo
- Center for Neuroscience Research, Children’s National Medical Center, Washington, District of Columbia, 20010 USA
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184
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Oishi K, Faria AV, Yoshida S, Chang L, Mori S. Reprint of "Quantitative evaluation of brain development using anatomical MRI and diffusion tensor imaging". Int J Dev Neurosci 2014; 32:28-40. [PMID: 24295553 PMCID: PMC4696018 DOI: 10.1016/j.ijdevneu.2013.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 05/24/2013] [Accepted: 06/13/2013] [Indexed: 01/18/2023] Open
Abstract
The development of the brain is structure-specific, and the growth rate of each structure differs depending on the age of the subject. Magnetic resonance imaging (MRI) is often used to evaluate brain development because of the high spatial resolution and contrast that enable the observation of structure-specific developmental status. Currently, most clinical MRIs are evaluated qualitatively to assist in the clinical decision-making and diagnosis. The clinical MRI report usually does not provide quantitative values that can be used to monitor developmental status. Recently, the importance of image quantification to detect and evaluate mild-to-moderate anatomical abnormalities has been emphasized because these alterations are possibly related to several psychiatric disorders and learning disabilities. In the research arena, structural MRI and diffusion tensor imaging (DTI) have been widely applied to quantify brain development of the pediatric population. To interpret the values from these MR modalities, a "growth percentile chart," which describes the mean and standard deviation of the normal developmental curve for each anatomical structure, is required. Although efforts have been made to create such a growth percentile chart based on MRI and DTI, one of the greatest challenges is to standardize the anatomical boundaries of the measured anatomical structures. To avoid inter- and intra-reader variability about the anatomical boundary definition, and hence, to increase the precision of quantitative measurements, an automated structure parcellation method, customized for the neonatal and pediatric population, has been developed. This method enables quantification of multiple MR modalities using a common analytic framework. In this paper, the attempt to create an MRI- and a DTI-based growth percentile chart, followed by an application to investigate developmental abnormalities related to cerebral palsy, Williams syndrome, and Rett syndrome, have been introduced. Future directions include multimodal image analysis and personalization for clinical application.
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Affiliation(s)
- Kenichi Oishi
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Andreia V Faria
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shoko Yoshida
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Linda Chang
- Neuroscience and Magnetic Resonance Research Program, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Susumu Mori
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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185
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Kaur S, Powell S, He L, Pierson CR, Parikh NA. Reliability and repeatability of quantitative tractography methods for mapping structural white matter connectivity in preterm and term infants at term-equivalent age. PLoS One 2014; 9:e85807. [PMID: 24475054 PMCID: PMC3901659 DOI: 10.1371/journal.pone.0085807] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/03/2013] [Indexed: 01/08/2023] Open
Abstract
Premature infants exhibit widespread insults and delays in white matter maturation that can be sensitively detected early using diffusion tensor imaging. Diffusion tensor tractography facilitates in vivo visualization of white matter tracts and has the potential to be more sensitive than simpler two-dimensional DTI-based measures. However, the reliability and reproducibility of performing tractography for major white matter tracts in preterm infants is not known. The main objective of our study was to develop highly reliable and repeatable methods for ten white matter tracts in extremely low birth weight infants (birth weight ≤ 1000 g) at term-equivalent age. To demonstrate clinical utility, we also compared fiber microstructural and macrostructural parameters between preterm and healthy term controls. Twenty-nine ELBW infants and a control group of 15 healthy term newborns were studied. A team of researchers experienced in neuroanatomy/neuroimaging established the manual segmentation protocol based on a priori anatomical knowledge and an extensive training period to identify sources of variability. Intra- and inter-rater reliability and repeatability was tested using intra-class correlation coefficient, within-subject standard deviation (SD), repeatability, and Dice similarity index. Our results support our primary goal of developing highly reliable and reproducible comprehensive methods for manual segmentation of 10 white matter tracts in ELBW infants. The within-subject SD was within 1-2% and repeatability within 3-7% of the mean values for all 10 tracts. The intra-rater Dice index was excellent with a range of 0.97 to 0.99, and as expected, the inter-rater Dice index was lower (range: 0.80 to 0.91), but still within a very good reliability range. ELBW infants exhibited fewer fiber numbers and/or abnormal microstructure in a majority of the ten quantified tracts, consistent with injury/delayed development. This protocol could serve as a valuable tool for prompt evaluation of the impact of neuroprotective therapies and as a prognostic biomarker for neurodevelopmental impairments.
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Affiliation(s)
- Supreet Kaur
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Samuel Powell
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Lili He
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Christopher R. Pierson
- Departments of Pediatrics and Pathology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Nehal A. Parikh
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
- Departments of Pediatrics and Pathology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
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186
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Scheinost D, Lacadie C, Vohr BR, Schneider KC, Papademetris X, Constable RT, Ment LR. Cerebral Lateralization is Protective in the Very Prematurely Born. Cereb Cortex 2014; 25:1858-66. [PMID: 24451659 DOI: 10.1093/cercor/bht430] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Individuals born prematurely are at risk for developmental delay, and converging data suggest alterations in neural networks in the developing preterm brain. Nevertheless, those critical period processes such as cerebral lateralization that underlie these findings remain largely unexplored. To test the hypothesis that preterm birth alters the fundamental program of corticogenesis in the developing brain, we interrogated cerebral lateralization at rest in very prematurely born participants and term controls at young adulthood. Employing a novel, voxel-based measure of functional connectivity, these data demonstrate for the first time that cerebral lateralization of functional connectivity in right hemisphere language homologs is altered for very preterm participants. Very preterm participants with no evidence for severe brain injury exhibited a significant decrease in right hemisphere lateralization in the right parietal and temporal lobes in this data driven analysis. Further, for the very preterm participants, but not the term participants, these fundamental alterations in the cerebral lateralization for language significantly correlate with language scores. These findings provide evidence that cerebral asymmetry is both plastic and experiential, and suggest the need for further study of underlying environmental factors responsible for these changes.
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Affiliation(s)
| | | | - Betty R Vohr
- Department of Pediatrics, Warren Alpert Brown Medical School, Providence, RI, USA
| | | | | | - R Todd Constable
- Department of Diagnostic Radiology Department of Biomedical Engineering Department of Neurosurgery
| | - Laura R Ment
- Department of Pediatrics Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
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187
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Plaisier A, Pieterman K, Lequin MH, Govaert P, Heemskerk AM, Reiss IKM, Krestin GP, Leemans A, Dudink J. Choice of diffusion tensor estimation approach affects fiber tractography of the fornix in preterm brain. AJNR Am J Neuroradiol 2014; 35:1219-25. [PMID: 24407271 DOI: 10.3174/ajnr.a3830] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Neonatal DTI enables quantitative assessment of microstructural brain properties. Although its use is increasing, it is not widely known that vast differences in tractography results can occur, depending on the diffusion tensor estimation methodology used. Current clinical work appears to be insufficiently focused on data quality and processing of neonatal DTI. To raise awareness about this important processing step, we investigated tractography reconstructions of the fornix with the use of several estimation techniques. We hypothesized that the method of tensor estimation significantly affects DTI tractography results. MATERIALS AND METHODS Twenty-eight DTI scans of infants born <29 weeks of gestation, acquired at 30-week postmenstrual age and without intracranial injury observed, were prospectively collected. Four diffusion tensor estimation methods were applied: 1) linear least squares; 2) weighted linear least squares; 3) nonlinear least squares, and 4) robust estimation of tensors by outlier rejection. Quality of DTI data and tractography results were evaluated for each method. RESULTS With nonlinear least squares and robust estimation of tensors by outlier rejection, significantly lower mean fractional anisotropy values were obtained than with linear least squares and weighted linear least squares. Visualized quality of tract reconstruction was significantly higher by use of robust estimation of tensors by outlier rejection and correlated with quality of DTI data. CONCLUSIONS Quality assessment and choice of processing methodology have considerable impact on neonatal DTI analysis. Dedicated acquisition, quality assessment, and advanced processing of neonatal DTI data must be ensured before performing clinical analyses, such as associating microstructural brain properties with patient outcome.
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Affiliation(s)
- A Plaisier
- From the Division of Neonatology, Department of Pediatrics (A.P., K.P., P.G., A.M.H., J.D.), Erasmus Medical Center-Sophia, Rotterdam, The NetherlandsDepartments of Radiology (A.P., M.H.L., A.M.H., G.P.K., J.D.)
| | - K Pieterman
- From the Division of Neonatology, Department of Pediatrics (A.P., K.P., P.G., A.M.H., J.D.), Erasmus Medical Center-Sophia, Rotterdam, The Netherlands
| | - M H Lequin
- Departments of Radiology (A.P., M.H.L., A.M.H., G.P.K., J.D.)
| | - P Govaert
- From the Division of Neonatology, Department of Pediatrics (A.P., K.P., P.G., A.M.H., J.D.), Erasmus Medical Center-Sophia, Rotterdam, The NetherlandsDepartment of Pediatrics (P.G.), Koningin Paola Children's Hospital, Antwerp, Belgium
| | - A M Heemskerk
- From the Division of Neonatology, Department of Pediatrics (A.P., K.P., P.G., A.M.H., J.D.), Erasmus Medical Center-Sophia, Rotterdam, The NetherlandsDepartments of Radiology (A.P., M.H.L., A.M.H., G.P.K., J.D.)
| | - I K M Reiss
- Neonatology (I.K.M.R.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - G P Krestin
- Departments of Radiology (A.P., M.H.L., A.M.H., G.P.K., J.D.)
| | - A Leemans
- Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Dudink
- From the Division of Neonatology, Department of Pediatrics (A.P., K.P., P.G., A.M.H., J.D.), Erasmus Medical Center-Sophia, Rotterdam, The NetherlandsDepartments of Radiology (A.P., M.H.L., A.M.H., G.P.K., J.D.)
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188
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Clark CAC, Fang H, Espy KA, Filipek PA, Juranek J, Bangert B, Hack M, Taylor HG. Relation of neural structure to persistently low academic achievement: a longitudinal study of children with differing birth weights. Neuropsychology 2013; 27:364-377. [PMID: 23688218 DOI: 10.1037/a0032273] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study examined the relation of cerebral tissue reductions associated with VLBW to patterns of growth in core academic domains. METHOD Children born <750 g, 750 to 1,499 g, or >2,500 g completed measures of calculation, mathematical problem solving, and word decoding at time points spanning middle childhood and adolescence. K. A. Espy, H. Fang, D. Charak, N. M. Minich, and H. G. Taylor (2009, Growth mixture modeling of academic achievement in children of varying birth weight risk, Neuropsychology, Vol. 23, pp. 460-474) used growth mixture modeling to identify two growth trajectories (clusters) for each academic domain: an average achievement trajectory and a persistently low trajectory. In this study, 97 of the same participants underwent magnetic resonance imaging (MRI) in late adolescence, and cerebral tissue volumes were used to predict the probability of low growth cluster membership for each domain. RESULTS Adjusting for whole brain volume (wbv), each 1-cm(3) reduction in caudate volume was associated with a 1.7- to 2.1-fold increase in the odds of low cluster membership for each domain. Each 1-mm(2) decrease in corpus callosum surface area increased these odds approximately 1.02-fold. Reduced cerebellar white matter volume was associated specifically with low calculation and decoding growth, and reduced cerebral white matter volume was associated with low calculation growth. Findings were similar when analyses were confined to the VLBW groups. CONCLUSIONS Reduced volume of structures involved in connectivity, executive attention, and motor control may contribute to heterogeneous academic trajectories among children with VLBW.
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Affiliation(s)
| | - Hua Fang
- Department of Quantitative Health Sciences, University of Massachusetts Medical School
| | | | - Pauline A Filipek
- Department of Pediatrics, University of Texas Health Sciences Center at Houston
| | - Jenifer Juranek
- Department of Pediatrics, University of Texas Health Sciences Center at Houston
| | - Barbara Bangert
- Departments of Pediatrics and Radiology, Case Western Reserve University
| | - Maureen Hack
- Departments of Pediatrics and Radiology, Case Western Reserve University
| | - H Gerry Taylor
- Departments of Pediatrics and Radiology, Case Western Reserve University
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189
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Automatic segmentation of eight tissue classes in neonatal brain MRI. PLoS One 2013; 8:e81895. [PMID: 24358132 PMCID: PMC3866108 DOI: 10.1371/journal.pone.0081895] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Accepted: 10/28/2013] [Indexed: 12/05/2022] Open
Abstract
Purpose Volumetric measurements of neonatal brain tissues may be used as a biomarker for later neurodevelopmental outcome. We propose an automatic method for probabilistic brain segmentation in neonatal MRIs. Materials and Methods In an IRB-approved study axial T1- and T2-weighted MR images were acquired at term-equivalent age for a preterm cohort of 108 neonates. A method for automatic probabilistic segmentation of the images into eight cerebral tissue classes was developed: cortical and central grey matter, unmyelinated and myelinated white matter, cerebrospinal fluid in the ventricles and in the extra cerebral space, brainstem and cerebellum. Segmentation is based on supervised pixel classification using intensity values and spatial positions of the image voxels. The method was trained and evaluated using leave-one-out experiments on seven images, for which an expert had set a reference standard manually. Subsequently, the method was applied to the remaining 101 scans, and the resulting segmentations were evaluated visually by three experts. Finally, volumes of the eight segmented tissue classes were determined for each patient. Results The Dice similarity coefficients of the segmented tissue classes, except myelinated white matter, ranged from 0.75 to 0.92. Myelinated white matter was difficult to segment and the achieved Dice coefficient was 0.47. Visual analysis of the results demonstrated accurate segmentations of the eight tissue classes. The probabilistic segmentation method produced volumes that compared favorably with the reference standard. Conclusion The proposed method provides accurate segmentation of neonatal brain MR images into all given tissue classes, except myelinated white matter. This is the one of the first methods that distinguishes cerebrospinal fluid in the ventricles from cerebrospinal fluid in the extracerebral space. This method might be helpful in predicting neurodevelopmental outcome and useful for evaluating neuroprotective clinical trials in neonates.
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190
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Hemodynamic and metabolic correlates of perinatal white matter injury severity. PLoS One 2013; 8:e82940. [PMID: 24416093 PMCID: PMC3886849 DOI: 10.1371/journal.pone.0082940] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 11/07/2013] [Indexed: 11/21/2022] Open
Abstract
Background and Purpose Although the spectrum of perinatal white matter injury (WMI) in preterm infants is shifting from cystic encephalomalacia to milder forms of WMI, the factors that contribute to this changing spectrum are unclear. We hypothesized that the variability in WMI quantified by immunohistochemical markers of inflammation could be correlated with the severity of impaired blood oxygen, glucose and lactate. Methods We employed a preterm fetal sheep model of in utero moderate hypoxemia and global severe but not complete cerebral ischemia that reproduces the spectrum of human WMI. Since there is small but measurable residual brain blood flow during occlusion, we sought to determine if the metabolic state of the residual arterial blood was associated with severity of WMI. Near the conclusion of hypoxia-ischemia, we recorded cephalic arterial blood pressure, blood oxygen, glucose and lactate levels. To define the spectrum of WMI, an ordinal WMI rating scale was compared against an unbiased quantitative image analysis protocol that provided continuous histo-pathological outcome measures for astrogliosis and microgliosis derived from the entire white matter. Results A spectrum of WMI was observed that ranged from diffuse non-necrotic lesions to more severe injury that comprised discrete foci of microscopic or macroscopic necrosis. Residual arterial pressure, oxygen content and blood glucose displayed a significant inverse association with WMI and lactate concentrations were directly related. Elevated glucose levels were the most significantly associated with less severe WMI. Conclusions Our results suggest that under conditions of hypoxemia and severe cephalic hypotension, WMI severity measured using unbiased immunohistochemical measurements correlated with several physiologic parameters, including glucose, which may be a useful marker of fetal response to hypoxia or provide protection against energy failure and more severe WMI.
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191
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Kendall GS, Melbourne A, Johnson S, Price D, Bainbridge A, Gunny R, Huertas-Ceballos A, Cady EB, Ourselin S, Marlow N, Robertson NJ. White matter NAA/Cho and Cho/Cr ratios at MR spectroscopy are predictive of motor outcome in preterm infants. Radiology 2013; 271:230-8. [PMID: 24475798 DOI: 10.1148/radiol.13122679] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine (a) whether diffuse white matter injury of prematurity is associated with an increased choline (Cho)-to-creatine (Cr) ratio and a reduced N-acetylaspartate (NAA)-to-Cho ratio and whether these measures can be used as biomarkers of outcome and (b) if changes in peak area metabolite ratios at magnetic resonance (MR) spectroscopy are associated with changes in T2 and fractional anisotropy (FA) at MR imaging. MATERIALS AND METHODS The local ethics committee approved this study, and informed parental consent was obtained for each infant. At term-equivalent age, 43 infants born at less than 32 weeks gestation underwent conventional and quantitative diffusion-tensor and T2-weighted MR imaging. Single-voxel point-resolved proton (hydrogen 1) MR spectroscopy was performed from a 2-cm(3) voxel centered in the posterior periventricular white matter. Outcome was evaluated by using Bayley scales at a corrected age of 1 year. Associations were investigated with Pearson product moment or Spearman rank order correlation. Differences in ratios in infants with and infants without impairment were tested by using t tests. RESULTS NAA/Cho and Cho/Cr ratios correlated with the scaled gross motor score and the composite motor score, independent of gestational age (P < .05). FA at diffusion-tensor MR imaging and T2 at MR imaging correlated with the NAA/Cho ratio (P < .05 for both) but not with the Cho/Cr ratio. Infants with motor scores of less than 85 (impaired) had an increased Cho/Cr ratio (P < .03) and a reduced NAA/Cho ratio (P < .01) compared to those without impairment. A combination of increased Cho/Cr ratio and decreased NAA/Cho ratio predicted impaired motor outcome at a corrected age of 1 year with a sensitivity of 0.80 (95% confidence interval [CI]: 0.57, 0.94) and a specificity of 0.80 (95% CI: 0.66, 0.88). CONCLUSION The combination of Cho/Cr and NAA/Cho ratios measured in the posterior periventricular white matter at term-equivalent age is predictive of motor outcome at 1 year in infants born at less than 32 weeks gestation.
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Affiliation(s)
- Giles S Kendall
- From the Department of Academic Neonatology, EGA Institute for Women's Health (G.S.K., A.H.C., N.M., N.J.R.), and Centre for Medical Image Computing (A.M., S.O.), University College London, Medical School Building, 74 Huntley St, London WC1E 6AU, England; Department of Health Sciences, University of Leicester, Leicester, England (S.J.); Department of Medical Physics & Bioengineering, University College Hospital NHS Foundation Trust, London, England (D.P., A.B., E.B.C.); and Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Trust, London, England (R.G.)
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192
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Doesburg SM, Moiseev A, Herdman AT, Ribary U, Grunau RE. Region-Specific Slowing of Alpha Oscillations is Associated with Visual-Perceptual Abilities in Children Born Very Preterm. Front Hum Neurosci 2013; 7:791. [PMID: 24298250 PMCID: PMC3828614 DOI: 10.3389/fnhum.2013.00791] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/30/2013] [Indexed: 01/16/2023] Open
Abstract
Children born very preterm (≤32 weeks gestational age) without major intellectual or neurological impairments often express selective deficits in visual-perceptual abilities. The alterations in neurophysiological development underlying these problems, however, remain poorly understood. Recent research has indicated that spontaneous alpha oscillations are slowed in children born very preterm, and that atypical alpha-mediated functional network connectivity may underlie selective developmental difficulties in visual-perceptual ability in this group. The present study provides the first source-resolved analysis of slowing of spontaneous alpha oscillations in very preterm children, indicating alterations in a distributed set of brain regions concentrated in areas of posterior parietal and inferior temporal regions associated with visual perception, as well as prefrontal cortical regions and thalamus. We also uniquely demonstrate that slowing of alpha oscillations is associated with selective difficulties in visual-perceptual ability in very preterm children. These results indicate that region-specific slowing of alpha oscillations contribute to selective developmental difficulties prevalent in this population.
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Affiliation(s)
- Sam M. Doesburg
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
- Neurosciences & Mental Health Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Alexander Moiseev
- Behavioral and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
| | - Anthony T. Herdman
- Behavioral and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
- Department of Audiology and Speech Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Urs Ribary
- Behavioral and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
| | - Ruth E. Grunau
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
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194
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Bregant T, Rados M, Vasung L, Derganc M, Evans AC, Neubauer D, Kostovic I. Region-specific reduction in brain volume in young adults with perinatal hypoxic-ischaemic encephalopathy. Eur J Paediatr Neurol 2013; 17:608-14. [PMID: 23746926 DOI: 10.1016/j.ejpn.2013.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 04/29/2013] [Accepted: 05/09/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND A severe form of perinatal hypoxic-ischaemic encephalopathy (HIE) carries a high risk of perinatal death and severe neurological sequelae while in mild HIE only discrete cognitive disorders may occur. AIM To compare total brain volumes and region-specific cortical measurements between young adults with mild-moderate perinatal HIE and a healthy control group of the same age. METHODS MR imaging was performed in a cohort of 14 young adults (9 males, 5 females) with a history of mild or moderate perinatal HIE. The control group consisted of healthy participants, matched with HIE group by age and gender. Volumetric analysis was done after the processing of MR images using a fully automated CIVET pipeline. We measured gyrification indexes, total brain volume, volume of grey and white matter, and of cerebrospinal fluid. We also measured volume, thickness and area of the cerebral cortex in the parietal, occipital, frontal, and temporal lobe, and of the isthmus cinguli, parahippocampal and cingulated gyrus, and insula. RESULTS The HIE patient group showed smaller absolute volumetric data. Statistically significant (p < 0.05) reductions of gyrification index in the right hemisphere, of cortical areas in the right temporal lobe and parahippocampal gyrus, of cortical volumes in the right temporal lobe and of cortical thickness in the right isthmus of the cingulate gyrus were found. Comparison between the healthy group and the HIE group of the same gender showed statistically significant changes in the male HIE patients, where a significant reduction was found in whole brain volume; left parietal, bilateral temporal, and right parahippocampal gyrus cortical areas; and bilateral temporal lobe cortical volume. CONCLUSIONS Our analysis of total brain volumes and region-specific corticometric parameters suggests that mild-moderate forms of perinatal HIE lead to reductions in whole brain volumes. In the study reductions were most pronounced in temporal lobe and parahippocampal gyrus.
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Affiliation(s)
- Tina Bregant
- Department of Paediatric Neurology, University Children's Hospital, University Medical Centre Ljubljana, Bohoriceva 20, 1000 Ljubljana, Slovenia.
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195
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Omizzolo C, Thompson DK, Scratch SE, Stargatt R, Lee KJ, Cheong J, Roberts G, Doyle LW, Anderson PJ. Hippocampal volume and memory and learning outcomes at 7 years in children born very preterm. J Int Neuropsychol Soc 2013; 19:1065-75. [PMID: 23947431 PMCID: PMC3964592 DOI: 10.1017/s1355617713000891] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Using magnetic resonance imaging, this study compared hippocampal volume between 145 very preterm children and 34 children born full-term at 7 years of age. The relationship between hippocampal volume and memory and learning impairments at 7 years was also investigated. Manual hippocampal segmentation and subsequent three-dimensional volumetric analysis revealed reduced hippocampal volumes in very preterm children compared with term peers. However, this relationship did not remain after correcting for whole brain volume and neonatal brain abnormality. Contrary to expectations, hippocampal volume in the very preterm cohort was not related to memory and learning outcomes. Further research investigating the effects of very preterm birth on more extensive networks in the brain that support memory and learning in middle childhood is needed.
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Affiliation(s)
- Cristina Omizzolo
- 1 Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
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196
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Oishi K, Faria AV, Yoshida S, Chang L, Mori S. Quantitative evaluation of brain development using anatomical MRI and diffusion tensor imaging. Int J Dev Neurosci 2013; 31:512-24. [PMID: 23796902 PMCID: PMC3830705 DOI: 10.1016/j.ijdevneu.2013.06.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 05/24/2013] [Accepted: 06/13/2013] [Indexed: 01/18/2023] Open
Abstract
The development of the brain is structure-specific, and the growth rate of each structure differs depending on the age of the subject. Magnetic resonance imaging (MRI) is often used to evaluate brain development because of the high spatial resolution and contrast that enable the observation of structure-specific developmental status. Currently, most clinical MRIs are evaluated qualitatively to assist in the clinical decision-making and diagnosis. The clinical MRI report usually does not provide quantitative values that can be used to monitor developmental status. Recently, the importance of image quantification to detect and evaluate mild-to-moderate anatomical abnormalities has been emphasized because these alterations are possibly related to several psychiatric disorders and learning disabilities. In the research arena, structural MRI and diffusion tensor imaging (DTI) have been widely applied to quantify brain development of the pediatric population. To interpret the values from these MR modalities, a "growth percentile chart," which describes the mean and standard deviation of the normal developmental curve for each anatomical structure, is required. Although efforts have been made to create such a growth percentile chart based on MRI and DTI, one of the greatest challenges is to standardize the anatomical boundaries of the measured anatomical structures. To avoid inter- and intra-reader variability about the anatomical boundary definition, and hence, to increase the precision of quantitative measurements, an automated structure parcellation method, customized for the neonatal and pediatric population, has been developed. This method enables quantification of multiple MR modalities using a common analytic framework. In this paper, the attempt to create an MRI- and a DTI-based growth percentile chart, followed by an application to investigate developmental abnormalities related to cerebral palsy, Williams syndrome, and Rett syndrome, have been introduced. Future directions include multimodal image analysis and personalization for clinical application.
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Affiliation(s)
- Kenichi Oishi
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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197
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Groeschel S, Tournier JD, Northam GB, Baldeweg T, Wyatt J, Vollmer B, Connelly A. Identification and interpretation of microstructural abnormalities in motor pathways in adolescents born preterm. Neuroimage 2013; 87:209-19. [PMID: 24185027 DOI: 10.1016/j.neuroimage.2013.10.034] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 10/09/2013] [Accepted: 10/21/2013] [Indexed: 12/11/2022] Open
Abstract
There has been extensive interest in assessing the long-term effects of preterm birth on brain white matter microstructure using diffusion MRI. Our aim in this study is to explore diffusion MRI differences between adolescents born preterm and term born controls, with a specific interest in characterising how such differences are manifested in white matter regions containing predominantly single or crossing fibre populations. Probabilistic high angular resolution tractography together with large deformation spatial normalisation were used to objectively investigate diffusion tensor parameters at regular intervals along fibre tracts of 45 adolescents born before 33 weeks of gestation and 30 term-born typically developing adolescents. Diffusion parameters were significantly different between preterms and controls at several levels along the cortico-spinal, thalamo-cortical and transcallosal pathways. Within the predominantly single fibre regions of the corpus callosum and internal capsule, in the preterms mean diffusivity (MD) was found to be increased while fractional anisotropy (FA) was decreased compared to controls. In contrast, however, where these pathways traversed the centrum semiovale, FA and MD were both significantly increased. The major contributor to reduced FA in preterms in predominantly single fibre regions was the increased radial eigenvalue (i.e. increased radial diffusivity). In predominantly crossing-fibre regions, the tensor eigenvalues are not meaningful, and the observed increase in FA is likely to be due to a decrease in anisotropy in one of the contributing fibre bundles. Similar differences (although less pronounced) were observed after excluding preterms with radiological signs of preterm brain injury from the sample. In summary, white matter microstructure was found to be altered in motor pathways in adolescents born preterm. Disruption of white matter (WM) microstructure in a single fibre region with resulting higher radial diffusivity leads to lower FA, whereas selective disruption of one fibre population in a crossing fibre region is observed to lead to higher FA. These findings challenge the common simplistic interpretation of FA as a measure of WM tract integrity.
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Affiliation(s)
| | - J-Donald Tournier
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | | | | | | | - Brigitte Vollmer
- Karolinska Institutet, Stockholm, Sweden; University of Southampton, Southampton, UK
| | - Alan Connelly
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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Illa M, Eixarch E, Batalle D, Arbat-Plana A, Muñoz-Moreno E, Figueras F, Gratacos E. Long-term functional outcomes and correlation with regional brain connectivity by MRI diffusion tractography metrics in a near-term rabbit model of intrauterine growth restriction. PLoS One 2013; 8:e76453. [PMID: 24143189 PMCID: PMC3797044 DOI: 10.1371/journal.pone.0076453] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 08/27/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Intrauterine growth restriction (IUGR) affects 5-10% of all newborns and is associated with increased risk of memory, attention and anxiety problems in late childhood and adolescence. The neurostructural correlates of long-term abnormal neurodevelopment associated with IUGR are unknown. Thus, the aim of this study was to provide a comprehensive description of the long-term functional and neurostructural correlates of abnormal neurodevelopment associated with IUGR in a near-term rabbit model (delivered at 30 days of gestation) and evaluate the development of quantitative imaging biomarkers of abnormal neurodevelopment based on diffusion magnetic resonance imaging (MRI) parameters and connectivity. METHODOLOGY At +70 postnatal days, 10 cases and 11 controls were functionally evaluated with the Open Field Behavioral Test which evaluates anxiety and attention and the Object Recognition Task that evaluates short-term memory and attention. Subsequently, brains were collected, fixed and a high resolution MRI was performed. Differences in diffusion parameters were analyzed by means of voxel-based and connectivity analysis measuring the number of fibers reconstructed within anxiety, attention and short-term memory networks over the total fibers. PRINCIPAL FINDINGS The results of the neurobehavioral and cognitive assessment showed a significant higher degree of anxiety, attention and memory problems in cases compared to controls in most of the variables explored. Voxel-based analysis (VBA) revealed significant differences between groups in multiple brain regions mainly in grey matter structures, whereas connectivity analysis demonstrated lower ratios of fibers within the networks in cases, reaching the statistical significance only in the left hemisphere for both networks. Finally, VBA and connectivity results were also correlated with functional outcome. CONCLUSIONS The rabbit model used reproduced long-term functional impairments and their neurostructural correlates of abnormal neurodevelopment associated with IUGR. The description of the pattern of microstructural changes underlying functional defects may help to develop biomarkers based in diffusion MRI and connectivity analysis.
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Affiliation(s)
- Miriam Illa
- Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Hospital Clinic, Barcelona, Spain
- Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Elisenda Eixarch
- Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Hospital Clinic, Barcelona, Spain
- Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Dafnis Batalle
- Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ariadna Arbat-Plana
- Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Emma Muñoz-Moreno
- Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Francesc Figueras
- Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Hospital Clinic, Barcelona, Spain
- Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Eduard Gratacos
- Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Hospital Clinic, Barcelona, Spain
- Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
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Hoff GEAJ, Van den Heuvel MP, Benders MJNL, Kersbergen KJ, De Vries LS. On development of functional brain connectivity in the young brain. Front Hum Neurosci 2013; 7:650. [PMID: 24115929 PMCID: PMC3792361 DOI: 10.3389/fnhum.2013.00650] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 09/18/2013] [Indexed: 12/28/2022] Open
Abstract
Our brain is a complex network of structurally and functionally interconnected regions, shaped to efficiently process and integrate information. The development from a brain equipped with basic functionalities to an efficient network facilitating complex behavior starts during gestation and continues into adulthood. Resting-state functional MRI (rs-fMRI) enables the examination of developmental aspects of functional connectivity (FC) and functional brain networks. This review will discuss changes observed in the developing brain on the level of network FC from a gestational age of 20 weeks onwards. We discuss findings of resting-state fMRI studies showing that functional network development starts during gestation, creating a foundation for each of the resting-state networks (RSNs) to be established. Visual and sensorimotor areas are reported to develop first, with other networks, at different rates, increasing both in network connectivity and size over time. Reaching childhood, marked fine-tuning and specialization takes place in the regions necessary for higher-order cognitive functions.
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Affiliation(s)
- G E Anna-Jasmijn Hoff
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht Utrecht, Netherlands
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