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McNaughton R, Pieper C, Sakai O, Rollins JV, Zhang X, Kennedy DN, Frazier JA, Douglass L, Heeren T, Fry RC, O'Shea TM, Kuban KK, Jara H. Quantitative MRI Characterization of the Extremely Preterm Brain at Adolescence: Atypical versus Neurotypical Developmental Pathways. Radiology 2022; 304:419-428. [PMID: 35471112 PMCID: PMC9340244 DOI: 10.1148/radiol.210385] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 01/27/2022] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
Background Extremely preterm (EP) birth is associated with higher risks of perinatal white matter (WM) injury, potentially causing abnormal neurologic and neurocognitive outcomes. MRI biomarkers distinguishing individuals with and without neurologic disorder guide research on EP birth antecedents, clinical correlates, and prognoses. Purpose To compare multiparametric quantitative MRI (qMRI) parameters of EP-born adolescents with autism spectrum disorder, cerebral palsy, epilepsy, or cognitive impairment (ie, atypically developing) with those without (ie, neurotypically developing), characterizing sex-stratified brain development. Materials and Methods This prospective multicenter study included individuals aged 14-16 years born EP (Extremely Low Gestational Age Newborns-Environmental Influences on Child Health Outcomes Study, or ELGAN-ECHO). Participants underwent 3.0-T MRI evaluation from 2017 to 2019. qMRI outcomes were compared for atypically versus neurotypically developing adolescents and for girls versus boys. Sex-stratified multiple regression models were used to examine associations between spatial entropy density (SEd) and T1, T2, and cerebrospinal fluid (CSF)-normalized proton density (nPD), and between CSF volume and T2. Interaction terms modeled differences in slopes between atypically versus neurotypically developing adolescents. Results A total of 368 adolescents were classified as 116 atypically (66 boys) and 252 neurotypically developing (125 boys) participants. Atypically versus neurotypically developing girls had lower nPD (mean, 557 10 × percent unit [pu] ± 46 [SD] vs 573 10 × pu ± 43; P = .04), while atypically versus neurotypically developing boys had longer T1 (814 msec ± 57 vs 789 msec ± 82; P = .01). Atypically developing girls versus boys had lower nPD and shorter T2 (eg, in WM, 557 10 × pu ± 46 vs 580 10 × pu ± 39 for nPD [P = .006] and 86 msec ± 3 vs 88 msec ± 4 for T2 [P = .003]). Atypically versus neurotypically developing boys had a more moderate negative association between T1 and SEd (slope, -32.0 msec per kB/cm3 [95% CI: -49.8, -14.2] vs -62.3 msec per kB/cm3 [95% CI: -79.7, -45.0]; P = .03). Conclusion Atypically developing participants showed sexual dimorphisms in the cerebrospinal fluid-normalized proton density (nPD) and T2 of both white matter (WM) and gray matter. Atypically versus neurotypically developing girls had lower WM nPD, while atypically versus neurotypically developing boys had longer WM T1 and more moderate T1 associations with microstructural organization in WM. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Ryan McNaughton
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Chris Pieper
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Osamu Sakai
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Julie V. Rollins
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Xin Zhang
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - David N. Kennedy
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Jean A. Frazier
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Laurie Douglass
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Timothy Heeren
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Rebecca C. Fry
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - T. Michael O'Shea
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Karl K. Kuban
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
| | - Hernán Jara
- From the Departments of Mechanical Engineering (R.M., X.Z.) and
Biomedical Engineering (H.J.), Boston University College of Engineering, Boston,
Mass; Department of Radiology, Boston University School of Medicine, 670 Albany
St, Boston, MA 02118 (C.P., O.S., H.J.); Department of Pediatrics, University of
North Carolina School of Medicine, Chapel Hill, NC (J.V.R., T.M.O.); Department
of Psychiatry, University of Massachusetts Medical School, Worcester, Mass
(D.N.K., J.A.F.); Department of Pediatrics, Boston University School of
Medicine, Boston, Mass (L.D.); Department of Biostatistics, Boston University
School of Public Health, Boston, Mass (T.H.); and Department of Environmental
Sciences & Engineering, University of North Carolina Gillings School of
Global Public Health, Chapel Hill, NC (R.C.F.)
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Huang S, Li S, Feng H, Chen Y. Iron Metabolism Disorders for Cognitive Dysfunction After Mild Traumatic Brain Injury. Front Neurosci 2021; 15:587197. [PMID: 33796002 PMCID: PMC8007909 DOI: 10.3389/fnins.2021.587197] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 02/10/2021] [Indexed: 01/25/2023] Open
Abstract
Traumatic brain injury (TBI) is one of the most harmful forms of acute brain injury and predicted to be one of the three major neurological diseases that cause neurological disabilities by 2030. A series of secondary injury cascades often cause cognitive dysfunction of TBI patients leading to poor prognosis. However, there are still no effective intervention measures, which drive us to explore new therapeutic targets. In this process, the most part of mild traumatic brain injury (mTBI) is ignored because its initial symptoms seemed not serious. Unfortunately, the ignored mTBI accounts for 80% of the total TBI, and a large part of the patients have long-term cognitive dysfunction. Iron deposition has been observed in mTBI patients and accompanies the whole pathological process. Iron accumulation may affect long-term cognitive dysfunction from three pathways: local injury, iron deposition induces tau phosphorylation, the formation of neurofibrillary tangles; neural cells death; and neural network damage, iron deposition leads to axonal injury by utilizing the iron sensibility of oligodendrocytes. Thus, iron overload and metabolism dysfunction was thought to play a pivotal role in mTBI pathophysiology. Cerebrospinal fluid-contacting neurons (CSF-cNs) located in the ependyma have bidirectional communication function between cerebral-spinal fluid and brain parenchyma, and may participate in the pathway of iron-induced cognitive dysfunction through projected nerve fibers and transmitted factor, such as 5-hydroxytryptamine, etc. The present review provides an overview of the metabolism and function of iron in mTBI, and to seek a potential new treatment target for mTBI with a novel perspective through combined iron and CSF-cNs.
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Affiliation(s)
- Suna Huang
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Third Military Medical University (Army Military Medical University), Chongqing, China
| | - Su Li
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Third Military Medical University (Army Military Medical University), Chongqing, China
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Third Military Medical University (Army Military Medical University), Chongqing, China
| | - Yujie Chen
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.,Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Third Military Medical University (Army Military Medical University), Chongqing, China
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