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Calixto C, Taymourtash A, Karimi D, Snoussi H, Velasco-Annis C, Jaimes C, Gholipour A. Advances in Fetal Brain Imaging. Magn Reson Imaging Clin N Am 2024; 32:459-478. [PMID: 38944434 PMCID: PMC11216711 DOI: 10.1016/j.mric.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Over the last 20 years, there have been remarkable developments in fetal brain MR imaging analysis methods. This article delves into the specifics of structural imaging, diffusion imaging, functional MR imaging, and spectroscopy, highlighting the latest advancements in motion correction, fetal brain development atlases, and the challenges and innovations. Furthermore, this article explores the clinical applications of these advanced imaging techniques in comprehending and diagnosing fetal brain development and abnormalities.
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Affiliation(s)
- Camilo Calixto
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Athena Taymourtash
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Spitalgasse 23, Wien 1090, Austria
| | - Davood Karimi
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Haykel Snoussi
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Clemente Velasco-Annis
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Camilo Jaimes
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02215, USA
| | - Ali Gholipour
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
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2
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Yu WH, Chu CH, Chen LW, Lin YC, Koh CL, Huang CC. The developmental phenotype of motor delay in extremely preterm infants following early-life respiratory adversity is influenced by brain dysmaturation in the parietal lobe. J Neurodev Disord 2024; 16:38. [PMID: 39010007 PMCID: PMC11247839 DOI: 10.1186/s11689-024-09546-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/21/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Research indicates that preterm infants requiring prolonged mechanical ventilation often exhibit suboptimal neurodevelopment at follow-up, coupled with altered brain development as detected by magnetic resonance imaging (MRI) at term-equivalent age (TEA). However, specific regions of brain dysmaturation and the subsequent neurodevelopmental phenotype following early-life adverse respiratory exposures remain unclear. Additionally, it is uncertain whether brain dysmaturation mediates neurodevelopmental outcomes after respiratory adversity. This study aims to investigate the relationship between early-life adverse respiratory exposures, brain dysmaturation at TEA, and the developmental phenotype observed during follow-up in extremely preterm infants. METHODS 89 infants born < 29 weeks' gestation from 2019 to 2021 received MRI examinations at TEA for structural and lobe brain volumes, which were adjusted with sex-and-postmenstrual-age expected volumes for volume residuals. Assisted ventilation patterns in the first 8 postnatal weeks were analyzed using kmlShape analyses. Patterns for motor, cognition, and language development were evaluated from corrected age 6 to 12 months using Bayley Scales of Infant Development, third edition. Mediation effects of brain volumes between early-life respiratory exposures and neurodevelopmental phenotypes were adjusted for sex, gestational age, maternal education, and severe brain injury. RESULTS Two distinct respiratory trajectories with varying severity were identified: improving (n = 35, 39%) and delayed improvement (n = 54, 61%). Compared with the improving group, the delayed improvement group exhibited selectively reduced brain volume residuals in the parietal lobe (mean - 4.9 cm3, 95% confidence interval - 9.4 to - 0.3) at TEA and lower motor composite scores (- 8.7, - 14.2 to - 3.1) at corrected age 12 months. The association between delayed respiratory improvement and inferior motor performance (total effect - 8.7, - 14.8 to - 3.3) was partially mediated through reduced parietal lobe volume (natural indirect effect - 1.8, - 4.9 to - 0.01), suggesting a mediating effect of 20%. CONCLUSIONS Early-life adverse respiratory exposure is specifically linked to the parietal lobe dysmaturation and neurodevelopmental phenotype of motor delay at follow-up. Dysmaturation of the parietal lobe serves as a mediator in the connection between respiratory adversity and compromised motor development. Optimizing respiratory critical care may emerge as a potential avenue to mitigate the consequences of altered brain growth and motor developmental delay in this extremely preterm population.
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Affiliation(s)
- Wen-Hao Yu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Hsiang Chu
- Institute of Statistics, National University of Kaohsiung, Kaohsiung, Taiwan
| | - Li-Wen Chen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yung-Chieh Lin
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Lin Koh
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, 1 University Road, East District, Tainan City, 70101, Taiwan.
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei, 23561, Taiwan.
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3
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Pereira S, Silva A, Santos R, Costa Silva C. Assessing Postural Control From Birth to Adulthood Among Individuals Born Preterm: A Systematic Review. Motor Control 2024; 28:276-304. [PMID: 38580301 DOI: 10.1123/mc.2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/02/2024] [Accepted: 01/30/2024] [Indexed: 04/07/2024]
Abstract
Premature life exposure, meaning an immature central nervous system, presents a significant challenge for the development of postural control and, in turn, overall motor development. Preventing motor delay thus requires identifying, characterizing, and quantifying deficit in postural control as early as possible. In our study, we reviewed the procedures used in past studies to assess postural control among individuals born preterm, specifically the characterization of participants, the instruments and motor tasks involved, the types of data collected and analyzed, and the outcomes. To that end, we performed a literature search on PubMed, Wiley Online Library, Web of Science, and Scopus using Boolean logic and assessed the quality of the studies with a standardized assessment based on the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Of 35 potential studies, 24 were included; all evaluated infants born preterm, but six did not include a control group of full-term infants. Although the heterogeneity of measurements, variability of instruments, and divergence in motor tasks examined limit definitive conclusions based on quantitative synthesis and the generalization of the results, most studies revealed dysfunctional postural control among individuals born preterm.
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Disselhoff V, Jakab A, Latal B, Schnider B, Wehrle FM, Hagmann CF. Inhibition abilities and functional brain connectivity in school-aged term-born and preterm-born children. Pediatr Res 2024:10.1038/s41390-024-03241-0. [PMID: 38898110 DOI: 10.1038/s41390-024-03241-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/09/2024] [Accepted: 03/01/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Inhibition abilities are known to have impact on self-regulation, behavior, and academic success, and they are frequently impaired in children born preterm. We investigated the possible contributions of resting-state functional brain connectivity to inhibition following preterm birth. METHODS Forty-four preterm and 59 term-born participants aged 8-13 years were administered two inhibition tasks and resting-state functional MRI was performed. Functional connectivity (FC) networks were compared between groups using network-based statistics. Associations of FCNs and inhibition abilities were investigated through multivariate linear regression models accounting for the interaction between birth status and inhibition. RESULTS NBS revealed weaker FC in children born preterm compared to term-born peers in connections between motor and supplementary motor regions, frontal lobe, precuneus, and insula. Irrespective of birth status, connections between the cerebellum, frontal, and occipital lobes and inter-lobar, subcortical, intra-hemispheric long-range connections were positively correlated with one of the two inhibition tasks. CONCLUSIONS Preterm birth results in long-term alterations of FC at network level but these FCN alterations do not specifically account for inhibition problems in children born very preterm. IMPACT Irrespective of birth status, significant associations were found between the subdomain of response inhibition and functional connectivity in some subnetworks. A group comparisons of functional brain connectivity measured by rsfMRI in school-aged children born very preterm and at term. The investigation of network-level functional connectivity at rest does not appear adequate to explain differences in inhibition abilities between children born very preterm and at term, hence other imaging techniques might be more suited to explore the underlying neural mechanisms of inhibition abilities in school-aged children born very preterm.
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Affiliation(s)
- Vera Disselhoff
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Andras Jakab
- Centre for MR Research, University Children's Hospital Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Beatrice Latal
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Barbara Schnider
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Flavia M Wehrle
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Cornelia F Hagmann
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
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Boerwinkle VL, Manjón I, Sussman BL, McGary A, Mirea L, Gillette K, Broman-Fulks J, Cediel EG, Arhin M, Hunter SE, Wyckoff SN, Allred K, Tom D. Resting-State Functional Magnetic Resonance Imaging Network Association With Mortality, Epilepsy, Cognition, and Motor Two-Year Outcomes in Suspected Severe Neonatal Acute Brain Injury. Pediatr Neurol 2024; 152:41-55. [PMID: 38198979 DOI: 10.1016/j.pediatrneurol.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/14/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND AND OBJECTIVES In acute brain injury of neonates, resting-state functional magnetic resonance imaging (MRI) (RS) showed incremental association with consciousness, mortality, cognitive and motor development, and epilepsy, with correction for multiple comparisons, at six months postgestation in neonates with suspected acute brain injury (ABI). However, there are relatively few developmental milestones at six months to benchmark against, thus, we extended this cohort study to evaluate two-year outcomes. METHODS In 40 consecutive neonates with ABI and RS, ordinal scores of resting-state networks; MRI, magnetic resonance spectroscopy, and electroencephalography; and up to 42-month outcomes of mortality, general and motor development, Pediatric Cerebral Performance Category Scale (PCPC), and epilepsy informed associations between tests and outcomes. RESULTS Mean gestational age was 37.8 weeks, 68% were male, and 60% had hypoxic-ischemic encephalopathy. Three died in-hospital, four at six to 42 months, and five were lost to follow-up. Associations included basal ganglia network with PCPC (P = 0.0003), all-mortality (P = 0.005), and motor (P = 0.0004); language/frontoparietal network with developmental delay (P = 0.009), PCPC (P = 0.006), and all-mortality (P = 0.01); default mode network with developmental delay (P = 0.003), PCPC (P = 0.004), neonatal intensive care unit mortality (P = 0.01), and motor (P = 0.009); RS seizure onset zone with epilepsy (P = 0.01); and anatomic MRI with epilepsy (P = 0.01). CONCLUSION For the first time, at any age, resting state functional MRI in ABI is associated with long-term epilepsy and RSNs predicted mortality in neonates. Severity of RSN abnormality was associated with incrementally worsened neurodevelopment including cognition, language, and motor function over two years.
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Affiliation(s)
- Varina L Boerwinkle
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina.
| | - Iliana Manjón
- University of Arizona College of Medicine - Tucson, Tucson, Arizona
| | - Bethany L Sussman
- Division of Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona
| | - Alyssa McGary
- Department of Clinical Research, Phoenix Children's Hospital, Phoenix, Arizona
| | - Lucia Mirea
- Department of Clinical Research, Phoenix Children's Hospital, Phoenix, Arizona
| | - Kirsten Gillette
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Jordan Broman-Fulks
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Emilio G Cediel
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Martin Arhin
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Senyene E Hunter
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Sarah N Wyckoff
- Division of Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona
| | - Kimberlee Allred
- Division of Neonatology, Phoenix Children's Hospital, Phoenix, Arizona
| | - Deborah Tom
- Division of Neonatology, Phoenix Children's Hospital, Phoenix, Arizona
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Vallinoja J, Nurmi T, Jaatela J, Wens V, Bourguignon M, Mäenpää H, Piitulainen H. Functional connectivity of sensorimotor network is enhanced in spastic diplegic cerebral palsy: A multimodal study using fMRI and MEG. Clin Neurophysiol 2024; 157:4-14. [PMID: 38006621 DOI: 10.1016/j.clinph.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/02/2023] [Accepted: 10/15/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE To assess the effects to functional connectivity (FC) caused by lesions related to spastic diplegic cerebral palsy (CP) in children and adolescents using multiple imaging modalities. METHODS We used resting state magnetoencephalography (MEG) envelope signals in alpha, beta and gamma ranges and resting state functional magnetic resonance imaging (fMRI) signals to quantify FC between selected sensorimotor regions of interest (ROIs) in 11 adolescents with spastic diplegic cerebral palsy and 24 typically developing controls. Motor performance of the hands was quantified with gross motor, fine motor and kinesthesia tests. RESULTS In fMRI, participants with CP showed enhanced FC within posterior parietal regions; in MEG, they showed enhanced interhemispheric FC between sensorimotor regions and posterior parietal regions both in alpha and lower beta bands. There was a correlation between the kinesthesia score and fronto-parietal connectivity in the control population. CONCLUSIONS CP is associated with enhanced FC in sensorimotor network. This difference is not correlated with hand coordination performance. The effect of the lesion is likely not fully captured by temporal correlation of ROI signals. SIGNIFICANCE Brain lesions can show as increased temporal correlation of activity between remote brain areas. We suggest this effect is likely separate from typical physiological correlates of functional connectivity.
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Affiliation(s)
- Jaakko Vallinoja
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland.
| | - Timo Nurmi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. BOX 35, FI-40014 Jyväskylä, Finland
| | - Julia Jaatela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland
| | - Vincent Wens
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles (LN(2)T), UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Translational Neuroimaging, HUB - Hôpital Erasme, Brussels, Belgium
| | - Mathieu Bourguignon
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles (LN(2)T), UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Neurophysiology and Movement Biomechanics, UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium; BCBL, Basque Center on Cognition, Brain and Language, 20009 San Sebastian, Spain
| | - Helena Mäenpää
- Department of Child Neurology, New Children's Hospital, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
| | - Harri Piitulainen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. BOX 35, FI-40014 Jyväskylä, Finland; Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland
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7
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van 't Westende C, Twilhaar ES, Stam CJ, de Kieviet JF, van Elburg RM, Oosterlaan J, van de Pol LA. The influence of very preterm birth on adolescent EEG connectivity, network organization and long-term outcome. Clin Neurophysiol 2023; 154:49-59. [PMID: 37549613 DOI: 10.1016/j.clinph.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/01/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE The aim of this study was to explore differences in functional connectivity and network organization between very preterm born adolescents and term born controls and to investigate if these differences might explain the relation between preterm birth and adverse long-term outcome. METHODS Forty-seven very preterm born adolescents (53% males) and 54 controls (54% males) with matching age, sex and parental educational levels underwent high-density electroencephalography (EEG) at 13 years of age. Long-term outcome was assessed by Intelligence Quotient (IQ), motor, attentional functioning and academic performance. Two minutes of EEG data were analysed within delta, theta, lower alpha, upper alpha and beta frequency bands. Within each frequency band, connectivity was assessed using the Phase Lag Index (PLI) and Amplitude Envelope Correlation, corrected for volume conduction (AEC-c). Brain networks were constructed using the minimum spanning tree method. RESULTS Very preterm born adolescents had stronger beta PLI connectivity and less differentiated network organization. Beta AEC-c and differentiation of AEC-c based networks were negatively associated with long-term outcomes. EEG measures did not mediate the relation between preterm birth and outcomes. CONCLUSIONS This study shows that very preterm born adolescents may have altered functional connectivity and brain network organization in the beta frequency band. Alterations in measures of functional connectivity and network topologies, especially its differentiating characteristics, were associated with neurodevelopmental functioning. SIGNIFICANCE The findings indicate that EEG connectivity and network analysis is a promising tool for investigating underlying mechanisms of impaired functioning.
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Affiliation(s)
- C van 't Westende
- Amsterdam UMC, Department of Child Neurology, Amsterdam, the Netherlands
| | - E S Twilhaar
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, F-75004 Paris, France
| | - C J Stam
- Amsterdam UMC, Department of Clinical Neurophysiology, Amsterdam, the Netherlands
| | - J F de Kieviet
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands
| | - R M van Elburg
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Department of Amsterdam Gastroenterology & Metabolism, Amsterdam, the Netherlands
| | - J Oosterlaan
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands
| | - L A van de Pol
- Amsterdam UMC, Department of Child Neurology, Amsterdam, the Netherlands.
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8
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Wheelock MD, Strain JF, Mansfield P, Tu JC, Tanenbaum A, Preische O, Chhatwal JP, Cash DM, Cruchaga C, Fagan AM, Fox NC, Graff-Radford NR, Hassenstab J, Jack CR, Karch CM, Levin J, McDade EM, Perrin RJ, Schofield PR, Xiong C, Morris JC, Bateman RJ, Jucker M, Benzinger TLS, Ances BM, Eggebrecht AT, Gordon BA, Allegri R, Araki A, Barthelemy N, Bateman R, Bechara J, Benzinger T, Berman S, Bodge C, Brandon S, Brooks W, Brosch J, Buck J, Buckles V, Carter K, Cash D, Cash L, Chen C, Chhatwal J, Chrem P, Chua J, Chui H, Cruchaga C, Day GS, De La Cruz C, Denner D, Diffenbacher A, Dincer A, Donahue T, Douglas J, Duong D, Egido N, Esposito B, Fagan A, Farlow M, Feldman B, Fitzpatrick C, Flores S, Fox N, Franklin E, Friedrichsen N, Fujii H, Gardener S, Ghetti B, Goate A, Goldberg S, Goldman J, Gonzalez A, Gordon B, Gräber-Sultan S, Graff-Radford N, Graham M, Gray J, Gremminger E, Grilo M, Groves A, Haass C, Häsler L, Hassenstab J, Hellm C, Herries E, Hoechst-Swisher L, Hofmann A, Holtzman D, Hornbeck R, Igor Y, Ihara R, Ikeuchi T, Ikonomovic S, Ishii K, Jack C, Jerome G, Johnson E, Jucker M, Karch C, Käser S, Kasuga K, Keefe S, Klunk W, Koeppe R, Koudelis D, Kuder-Buletta E, Laske C, Lee JH, Levey A, Levin J, Li Y, Lopez O, Marsh J, Martinez R, Martins R, Mason NS, Masters C, Mawuenyega K, McCullough A, McDade E, Mejia A, Morenas-Rodriguez E, Mori H, Morris J, Mountz J, Mummery C, Nadkami N, Nagamatsu A, Neimeyer K, Niimi Y, Noble J, Norton J, Nuscher B, O'Connor A, Obermüller U, Patira R, Perrin R, Ping L, Preische O, Renton A, Ringman J, Salloway S, Sanchez-Valle R, Schofield P, Senda M, Seyfried N, Shady K, Shimada H, Sigurdson W, Smith J, Smith L, Snitz B, Sohrabi H, Stephens S, Taddei K, Thompson S, Vöglein J, Wang P, Wang Q, Weamer E, Xiong C, Xu J, Xu X. Brain network decoupling with increased serum neurofilament and reduced cognitive function in Alzheimer's disease. Brain 2023; 146:2928-2943. [PMID: 36625756 PMCID: PMC10316768 DOI: 10.1093/brain/awac498] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 11/21/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Neurofilament light chain, a putative measure of neuronal damage, is measurable in blood and CSF and is predictive of cognitive function in individuals with Alzheimer's disease. There has been limited prior work linking neurofilament light and functional connectivity, and no prior work has investigated neurofilament light associations with functional connectivity in autosomal dominant Alzheimer's disease. Here, we assessed relationships between blood neurofilament light, cognition, and functional connectivity in a cross-sectional sample of 106 autosomal dominant Alzheimer's disease mutation carriers and 76 non-carriers. We employed an innovative network-level enrichment analysis approach to assess connectome-wide associations with neurofilament light. Neurofilament light was positively correlated with deterioration of functional connectivity within the default mode network and negatively correlated with connectivity between default mode network and executive control networks, including the cingulo-opercular, salience, and dorsal attention networks. Further, reduced connectivity within the default mode network and between the default mode network and executive control networks was associated with reduced cognitive function. Hierarchical regression analysis revealed that neurofilament levels and functional connectivity within the default mode network and between the default mode network and the dorsal attention network explained significant variance in cognitive composite scores when controlling for age, sex, and education. A mediation analysis demonstrated that functional connectivity within the default mode network and between the default mode network and dorsal attention network partially mediated the relationship between blood neurofilament light levels and cognitive function. Our novel results indicate that blood estimates of neurofilament levels correspond to direct measurements of brain dysfunction, shedding new light on the underlying biological processes of Alzheimer's disease. Further, we demonstrate how variation within key brain systems can partially mediate the negative effects of heightened total serum neurofilament levels, suggesting potential regions for targeted interventions. Finally, our results lend further evidence that low-cost and minimally invasive blood measurements of neurofilament may be a useful marker of brain functional connectivity and cognitive decline in Alzheimer's disease.
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Affiliation(s)
- Muriah D Wheelock
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Jeremy F Strain
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - Jiaxin Cindy Tu
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Aaron Tanenbaum
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Oliver Preische
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - David M Cash
- Dementia Research Center, UCL Queen Square, London, UK.,UK Dementia Research Institute, College London, London, UK
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Nick C Fox
- Dementia Research Center, UCL Queen Square, London, UK.,UK Dementia Research Institute, College London, London, UK
| | | | - Jason Hassenstab
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - Celeste M Karch
- Department of Psychiatry, Washington University in St. Louis, MO, USA
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Eric M McDade
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Richard J Perrin
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA.,Department of Pathology & Immunology, Washington University in St. Louis, MO, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Chengjie Xiong
- Division of Biostatistics, Washington University in St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Randal J Bateman
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Tammie L S Benzinger
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Adam T Eggebrecht
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Washington University in St. Louis, MO, USA
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9
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Fenn-Moltu S, Fitzgibbon SP, Ciarrusta J, Eyre M, Cordero-Grande L, Chew A, Falconer S, Gale-Grant O, Harper N, Dimitrova R, Vecchiato K, Fenchel D, Javed A, Earl M, Price AN, Hughes E, Duff EP, O’Muircheartaigh J, Nosarti C, Arichi T, Rueckert D, Counsell S, Hajnal JV, Edwards AD, McAlonan G, Batalle D. Development of neonatal brain functional centrality and alterations associated with preterm birth. Cereb Cortex 2023; 33:5585-5596. [PMID: 36408638 PMCID: PMC10152096 DOI: 10.1093/cercor/bhac444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 11/22/2022] Open
Abstract
Formation of the functional connectome in early life underpins future learning and behavior. However, our understanding of how the functional organization of brain regions into interconnected hubs (centrality) matures in the early postnatal period is limited, especially in response to factors associated with adverse neurodevelopmental outcomes such as preterm birth. We characterized voxel-wise functional centrality (weighted degree) in 366 neonates from the Developing Human Connectome Project. We tested the hypothesis that functional centrality matures with age at scan in term-born babies and is disrupted by preterm birth. Finally, we asked whether neonatal functional centrality predicts general neurodevelopmental outcomes at 18 months. We report an age-related increase in functional centrality predominantly within visual regions and a decrease within the motor and auditory regions in term-born infants. Preterm-born infants scanned at term equivalent age had higher functional centrality predominantly within visual regions and lower measures in motor regions. Functional centrality was not related to outcome at 18 months old. Thus, preterm birth appears to affect functional centrality in regions undergoing substantial development during the perinatal period. Our work raises the question of whether these alterations are adaptive or disruptive and whether they predict neurodevelopmental characteristics that are more subtle or emerge later in life.
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Affiliation(s)
- Sunniva Fenn-Moltu
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Sean P Fitzgibbon
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Judit Ciarrusta
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Michael Eyre
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, 28040, Spain
| | - Andrew Chew
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Oliver Gale-Grant
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, United Kingdom
| | - Nicholas Harper
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Ralica Dimitrova
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Katy Vecchiato
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Daphna Fenchel
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, United Kingdom
| | - Ayesha Javed
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Megan Earl
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- Paediatric Liver, GI and Nutrition Centre and MowatLabs, King’s College London, London, SE5 9RS, United Kingdom
| | - Anthony N Price
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Emer Hughes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Eugene P Duff
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), University of Oxford, Oxford, OX3 9DU, United Kingdom
- Department of Paediatrics, University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Jonathan O’Muircheartaigh
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, United Kingdom
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, United Kingdom
- Paediatric Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, SE1 7EH, United Kingdom
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Daniel Rueckert
- Biomedical Image Analysis Group, Imperial College London, London, SW7 2AZ, United Kingdom
- Institute for AI and Informatics in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, 81675, Germany
| | - Serena Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, United Kingdom
| | - Grainne McAlonan
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, United Kingdom
| | - Dafnis Batalle
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8AF, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, United Kingdom
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10
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Bolk J, Källén K, Farooqi A, Hafström M, Fellman V, Åden U, Serenius F. Perinatal risk factors for developmental coordination disorder in children born extremely preterm. Acta Paediatr 2023; 112:675-685. [PMID: 36587369 DOI: 10.1111/apa.16651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 01/02/2023]
Abstract
AIM Children born extremely preterm frequently have developmental coordination disorder (DCD). We aimed to evaluate perinatal risk factors for DCD. METHODS Swedish national cohort study including 226 children born before 27 gestational weeks without major neurodevelopmental disabilities at 6.5 years. Outcome was DCD, defined as ≤5th percentile on the Movement Assessment Battery for Children-Second Edition. Perinatal risk factors were evaluated using multivariable logistic regression. RESULTS DCD was present in 84/226 (37.2%) children. Of the risk factors known at 40 weeks gestation, independent and significant risk factors for DCD were: mother's age at delivery (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.07-2.80); pre-eclampsia (2.79, 1.14-6.80); mother born in a non-Nordic country (2.23, 1.00-4.99); gestational age per week increase (0.70, 0.50-0.99) and retinopathy of prematurity (2.48, 1.26-4.87). Of factors known at discharge, postnatal steroids exposure (2.24, 1.13-4.46) and mechanical ventilation (1.76, 1.06-2.09) were independent risk factors when added to the model in separate analyses. CONCLUSION The risk of DCD in children born extremely preterm was multifactorial and associated with gestational age largely mediated by ROP, maternal factors, pre-eclampsia, administration of postnatal steroids and mechanical ventilation. These risk factors are common among children born extremely preterm, contributing to their high risk of DCD.
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Affiliation(s)
- Jenny Bolk
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Karin Källén
- Centre for Reproductive Epidemiology, Lund University, Lund, Sweden
| | - Aijaz Farooqi
- Unit of Pediatrics, Institute of Clinical Sciences, University of Umeå, Umeå, Sweden
| | - Maria Hafström
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden.,Angered Hospital, Angered, Sweden
| | - Vineta Fellman
- Department of Clinical Sciences, Lund, Pediatrics, Lund University, Lund, Sweden.,Folkhälsan Research Center, Helsinki, Finland.,Children's Hospital, Clinicum, University of Helsinki, Helsinki, Finland
| | - Ulrika Åden
- Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska institutet, Stockholm, Sweden
| | - Fredrik Serenius
- Unit of Pediatrics, Institute of Clinical Sciences, University of Umeå, Umeå, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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11
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Mattos DJS, Rutlin J, Hong X, Zinn K, Shimony JS, Carter AR. The Role of Extra-motor Networks in Upper Limb Motor Performance Post-stroke. Neuroscience 2023; 514:1-13. [PMID: 36736882 PMCID: PMC11009936 DOI: 10.1016/j.neuroscience.2023.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Motor improvement post-stroke may happen even if resting state functional connectivity between the ipsilesional and contralesional components of the sensorimotor network is not fully recovered. Therefore, we investigated which extra-motor networks might support upper limb motor gains in response to treatment post-stroke. METHODS Both resting state functional connectivity and upper limb capacity were measured prior to and after an 8-week intervention of task-specific training in 29 human participants [59.24 ± (SD) 10.40 yrs., 12 females and 17 males] with chronic stroke. The sensorimotor and five extra-motor networks were defined: default mode, frontoparietal, cingulo-opercular, dorsal attention network, and salience networks. The Network Level Analysis toolbox was used to identify network pairs whose connectivities were enriched in connectome-behavior relationships. RESULTS Mean upper limb capacity score increased 5.45 ± (SD) 5.55 following treatment. Baseline connectivity of some motor but mostly extra-motor network interactions of cingulo-opercular and default-mode networks were predictive of upper limb capacity following treatment. Also, changes in connectivity for extra-motor interactions of salience with default mode, cingulo-opercular, and dorsal attention networks were correlated with gains in upper limb capacity. CONCLUSIONS These connectome-behavior patterns suggest larger involvement of cingulo-opercular networks in prediction of treatment response and of salience networks in maintenance of improved skilled behavior. These results support our hypothesis that cognitive networks may contribute to recovery of motor performance after stroke and provide additional insights into the neural correlates of intensive training.
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Affiliation(s)
- Daniela J S Mattos
- Departments of Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Jerrel Rutlin
- Departments of Psychiatry, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Xin Hong
- Departments of Genetics, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Kristina Zinn
- Departments of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Joshua S Shimony
- Departments of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Alexandre R Carter
- Departments of Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA
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12
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Lear BA, Lear CA, Dhillon SK, Davidson JO, Gunn AJ, Bennet L. Evolution of grey matter injury over 21 days after hypoxia-ischaemia in preterm fetal sheep. Exp Neurol 2023; 363:114376. [PMID: 36889575 DOI: 10.1016/j.expneurol.2023.114376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/05/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
Reduced grey matter volume in preterm infants is associated with later disability, but its time course and relationship with white matter injury are not well understood. We recently showed that moderate-severe hypoxia-ischaemia (HI) in preterm fetal sheep led to severe cystic injury 2-3 weeks later. In the same cohort we now show profound hippocampal neuronal loss from 3 days after HI. By contrast, reduction in cortical area and perimeter developed much more slowly, with maximum reduction at day 21. There was transient upregulation of cleaved caspase-3-positive apoptosis in the cortex at day 3 but no change in neuronal density or macroscopic injury of the cortex. Both microglia and astrocytes were transiently upregulated in the grey matter. EEG power was initially profoundly suppressed but partially recovered by 21 days of recovery, and final power was correlated with white matter area (p < 0.001, r2 = 0.75, F = 24.19), cortical area (p = 0.004, r2 = 0.44, F = 11.90) and hippocampi area (p = 0.049, r2 = 0.23, F = 4.58). In conclusion, the present study suggests that in preterm fetal sheep, hippocampal injury is established within a few days of acute HI, but impaired cortical growth develops slowly, in a similar time course to severe white matter injury.
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Affiliation(s)
- Benjamin A Lear
- The Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Christopher A Lear
- The Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Simerdeep K Dhillon
- The Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Joanne O Davidson
- The Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Alistair J Gunn
- The Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Laura Bennet
- The Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland, New Zealand.
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13
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Hawks ZW, Todorov A, Marrus N, Nishino T, Talovic M, Nebel MB, Girault JB, Davis S, Marek S, Seitzman BA, Eggebrecht AT, Elison J, Dager S, Mosconi MW, Tychsen L, Snyder AZ, Botteron K, Estes A, Evans A, Gerig G, Hazlett HC, McKinstry RC, Pandey J, Schultz RT, Styner M, Wolff JJ, Zwaigenbaum L, Markson L, Petersen SE, Constantino JN, White DA, Piven J, Pruett JR. A Prospective Evaluation of Infant Cerebellar-Cerebral Functional Connectivity in Relation to Behavioral Development in Autism Spectrum Disorder. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:149-161. [PMID: 36712571 PMCID: PMC9874081 DOI: 10.1016/j.bpsgos.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 02/01/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder diagnosed based on social impairment, restricted interests, and repetitive behaviors. Contemporary theories posit that cerebellar pathology contributes causally to ASD by disrupting error-based learning (EBL) during infancy. The present study represents the first test of this theory in a prospective infant sample, with potential implications for ASD detection. Methods Data from the Infant Brain Imaging Study (n = 94, 68 male) were used to examine 6-month cerebellar functional connectivity magnetic resonance imaging in relation to later (12/24-month) ASD-associated behaviors and outcomes. Hypothesis-driven univariate analyses and machine learning-based predictive tests examined cerebellar-frontoparietal network (FPN; subserves error signaling in support of EBL) and cerebellar-default mode network (DMN; broadly implicated in ASD) connections. Cerebellar-FPN functional connectivity was used as a proxy for EBL, and cerebellar-DMN functional connectivity provided a comparative foil. Data-driven functional connectivity magnetic resonance imaging enrichment examined brain-wide behavioral associations, with post hoc tests of cerebellar connections. Results Cerebellar-FPN and cerebellar-DMN connections did not demonstrate associations with ASD. Functional connectivity magnetic resonance imaging enrichment identified 6-month correlates of later ASD-associated behaviors in networks of a priori interest (FPN, DMN), as well as in cingulo-opercular (also implicated in error signaling) and medial visual networks. Post hoc tests did not suggest a role for cerebellar connections. Conclusions We failed to identify cerebellar functional connectivity-based contributions to ASD. However, we observed prospective correlates of ASD-associated behaviors in networks that support EBL. Future studies may replicate and extend network-level positive results, and tests of the cerebellum may investigate brain-behavior associations at different developmental stages and/or using different neuroimaging modalities.
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Affiliation(s)
- Zoë W. Hawks
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
- Address correspondence to Zoë W. Hawks, Ph.D.
| | - Alexandre Todorov
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Muhamed Talovic
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Mary Beth Nebel
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jessica B. Girault
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Savannah Davis
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Scott Marek
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Benjamin A. Seitzman
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Adam T. Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Jed Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Stephen Dager
- Departments of Radiology, University of Washington, Seattle, Washington
| | - Matthew W. Mosconi
- Life Span Institute and Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas
| | - Lawrence Tychsen
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Abraham Z. Snyder
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kelly Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Annette Estes
- Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Alan Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Guido Gerig
- Department of Computer Science and Engineering, Tandon School of Engineering, New York University, New York, New York
| | - Heather C. Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Lonnie Zwaigenbaum
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Lori Markson
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Steven E. Petersen
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - John N. Constantino
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Desirée A. White
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
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14
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Cyr PEP, Lean RE, Kenley JK, Kaplan S, Meyer DE, Neil JJ, Alexopoulos D, Brady RG, Shimony JS, Rodebaugh TL, Rogers CE, Smyser CD. Neonatal motor functional connectivity and motor outcomes at age two years in very preterm children with and without high-grade brain injury. Neuroimage Clin 2022; 36:103260. [PMID: 36451363 PMCID: PMC9668638 DOI: 10.1016/j.nicl.2022.103260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/09/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
Abstract
Preterm-born children have high rates of motor impairments, but mechanisms for early identification remain limited. We hypothesized that neonatal motor system functional connectivity (FC) would relate to motor outcomes at age two years; currently, this relationship is not yet well-described in very preterm (VPT; born <32 weeks' gestation) infants with and without brain injury. We recruited 107 VPT infants - including 55 with brain injury (grade III-IV intraventricular hemorrhage, cystic periventricular leukomalacia, post-hemorrhagic hydrocephalus) - and collected FC data at/near term-equivalent age (35-45 weeks postmenstrual age). Correlation coefficients were used to calculate the FC between bilateral motor and visual cortices and thalami. At two years corrected-age, motor outcomes were assessed with the Bayley Scales of Infant and Toddler Development, 3rd edition. Multiple imputation was used to estimate missing data, and regression models related FC measures to motor outcomes. Within the brain-injured group only, interhemispheric motor cortex FC was positively related to gross motor outcomes. Thalamocortical and visual FC were not related to motor scores. This suggests neonatal alterations in motor system FC may provide prognostic information about impairments in children with brain injury.
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Affiliation(s)
- Peppar E P Cyr
- Washington University School of Medicine, Department of Neurology, United States.
| | - Rachel E Lean
- Washington University School of Medicine, Department of Psychiatry, United States
| | - Jeanette K Kenley
- Washington University School of Medicine, Department of Neurology, United States
| | - Sydney Kaplan
- Washington University School of Medicine, Department of Neurology, United States
| | - Dominique E Meyer
- Washington University School of Medicine, Department of Neurology, United States
| | - Jeffery J Neil
- Washington University School of Medicine, Department of Neurology, United States
| | | | - Rebecca G Brady
- Washington University School of Medicine, Department of Neurology, United States
| | - Joshua S Shimony
- Washington University School of Medicine, Mallinckrodt Institute of Radiology, United States
| | - Thomas L Rodebaugh
- Washington University in St. Louis, Department of Psychology, United States
| | - Cynthia E Rogers
- Washington University School of Medicine, Department of Psychiatry, United States; Washington University School of Medicine, Department of Pediatrics, United States
| | - Christopher D Smyser
- Washington University School of Medicine, Department of Neurology, United States; Washington University School of Medicine, Mallinckrodt Institute of Radiology, United States; Washington University School of Medicine, Department of Pediatrics, United States
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15
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Sussman BL, Wyckoff SN, Heim J, Wilfong AA, Adelson PD, Kruer MC, Gonzalez MJ, Boerwinkle VL. Is Resting State Functional MRI Effective Connectivity in Movement Disorders Helpful? A Focused Review Across Lifespan and Disease. Front Neurol 2022; 13:847834. [PMID: 35493815 PMCID: PMC9046695 DOI: 10.3389/fneur.2022.847834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
In the evolving modern era of neuromodulation for movement disorders in adults and children, much progress has been made recently characterizing the human motor network (MN) with potentially important treatment implications. Herein is a focused review of relevant resting state fMRI functional and effective connectivity of the human motor network across the lifespan in health and disease. The goal is to examine how the transition from functional connectivity to dynamic effective connectivity may be especially informative of network-targeted movement disorder therapies, with hopeful implications for children.
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Affiliation(s)
- Bethany L. Sussman
- Division of Neuroscience, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
- *Correspondence: Bethany L. Sussman
| | - Sarah N. Wyckoff
- Division of Neuroscience, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
- Department of Research, Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Jennifer Heim
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Angus A. Wilfong
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - P. David Adelson
- Division of Pediatric Neurosurgery, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Michael C. Kruer
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
- Departments of Child Health, Neurology, Genetics and Cellular & Molecular Medicine, University of Arizona College of Medicine – Phoenix, Phoenix, AZ, United States
| | | | - Varina L. Boerwinkle
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
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16
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Association of network connectivity via resting state functional MRI with consciousness, mortality, and outcomes in neonatal acute brain injury. Neuroimage Clin 2022; 34:102962. [PMID: 35152054 PMCID: PMC8851268 DOI: 10.1016/j.nicl.2022.102962] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 01/07/2023]
Abstract
Basal ganglia and seizure onset zone networks were associated with motor outcomes. Broad language/cognitive region networks were associated with developmental delay. Discharge with mortality was linked to default mode and language/cognitive networks. Exams were not linked to networks after multiple testing corrections. Lack of detection of all studied networks only occurred in those who did not survive.
Background An accurate and comprehensive test of integrated brain network function is needed for neonates during the acute brain injury period to inform on morbidity. This retrospective cohort study assessed whether integrated brain network function acquired by resting state functional MRI during the acute period in neonates with brain injury, is associated with acute exam, neonatal mortality, and 6-month outcomes. Methods Study subjects included 40 consecutive neonates with resting state functional MRI acquired within 31 days after suspected brain insult from March 2018 to July 2019 at Phoenix Children’s Hospital. Acute-period exam and test results were assigned ordinal scores based on severity as documented by respective treating specialists. Analyses (Fisher exact, Wilcoxon-rank sum test, ordinal/multinomial logistic regression) examined association of resting state networks with demographics, presentation, neurological exam, electroencephalogram, anatomical MRI, magnetic resonance spectroscopy, passive task functional MRI, and outcomes of discharge condition, outpatient development, motor tone, seizure, and mortality. Results Subjects had a mean (standard deviation) gestational age of 37.8 (2.6) weeks, a majority were male (63%), with a diagnosis of hypoxic ischemic encephalopathy (68%). Findings at birth included mild distress (48%), moderately abnormal neurological exam (33%), and consciousness characterized as awake but irritable (40%). Significant associations after multiple testing corrections were detected for resting state networks: basal ganglia with outpatient developmental delay (odds ratio [OR], 14.5; 99.4% confidence interval [CI], 2.00–105; P < .001) and motor tone/weakness (OR, 9.98; 99.4% CI, 1.72–57.9; P < .001); language/frontoparietal network with discharge condition (OR, 5.13; 99.4% CI, 1.22–21.5; P = .002) and outpatient developmental delay (OR, 4.77; 99.4% CI, 1.21–18.7; P=.002); default mode network with discharge condition (OR, 3.72; 99.4% CI, 1.01–13.78; P=.006) and neurological exam (P = .002 (FE); OR, 11.8; 99.4% CI, 0.73–191; P = .01 (OLR)); and seizure onset zone with motor tone/weakness (OR, 3.31; 99.4% CI, 1.08–10.1; P=.003). Resting state networks were not detected in three neonates, who died prior to discharge. Conclusions This study provides level 3 evidence (OCEBM Levels of Evidence Working Group) demonstrating that in neonatal acute brain injury, the degree of abnormality of resting state networks is associated with acute exam and outcomes. Total lack of brain network detection was only found in patients who did not survive.
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Differential age-dependent development of inter-area brain connectivity in term and preterm neonates. Pediatr Res 2022; 92:1017-1025. [PMID: 35094022 PMCID: PMC9586860 DOI: 10.1038/s41390-022-01939-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Among preterm infants, higher morbidities of neurological disturbances and developmental delays are critical issues. Resting-state networks (RSNs) in the brain are suitable measures for assessing higher-level neurocognition. Since investigating task-related brain activity is difficult in neonates, assessment of RSNs provides invaluable insight into their neurocognitive development. METHODS The participants, 32 term and 71 preterm neonates, were divided into three groups based on gestational age (GA) at birth. Cerebral hemodynamic activity of RSNs was measured using functional near-infrared spectroscopy in the temporal, frontal, and parietal regions. RESULTS High-GA preterm infants (GA ≥ 30 weeks) had a significantly stronger RSN than low-GA preterm infants and term infants. Regression analyses of RSNs as a function of postnatal age (PNA) revealed a steeper regression line in the high-GA preterm and term infants than in the low-GA infants, particularly for inter-area brain connectivity between the frontal and left temporal areas. CONCLUSIONS Slower PNA-dependent development of the frontal-temporal network found only in the low-GA group suggests that significant brain growth optimal in the intrauterine environment takes place before 30 weeks of gestation. The present study suggests a likely reason for the high incidence of neurodevelopmental impairment in early preterm infants. IMPACT Resting-state fNIRS measurements in three neonate groups differing in gestational age (GA) showed stronger networks in the high-GA preterm infants than in the term and low-GA infants, which was partly explained by postnatal age (PNA). Regression analyses revealed a similar PNA-dependence in the development of the inter-area networks in the frontal and temporal lobes in the high-GA and term infants, and significantly slower development in the low-GA infants. These results suggest that optimal intrauterine brain growth takes place before 30 weeks of gestation. This explains one of the reasons for the high incidence of neurodevelopmental impairment in early preterm infants.
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18
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Wang MJ, Li ZH, Gao RW, Chen QF, Lin J, Xiao ML, Zhang K, Chen C. Effects of delayed HIF-1α expression in astrocytes on myelination following hypoxia-ischaemia white matter injury in immature rats. Transl Pediatr 2022; 11:20-32. [PMID: 35242649 PMCID: PMC8825930 DOI: 10.21037/tp-21-407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/15/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The underlying cause of neurological sequelae after immature cerebral hypoxia-ischaemia (HI) white matter injury is impaired myelination. Previous studies have indicated that astrocyte activation is closely related to impaired myelination. However, the mechanism of reactive gliosis in white matter injury post-HI remains poorly understood. METHODS Studies using adult ischaemic animal models demonstrated that hypoxia inducible factor-1α (HIF-1α) expression was involved in the formation of reactive astrocytes. Here, we investigated the temporal expression of HIF-1α and its impact on reactive gliosis and further myelination using a perinatal HI white matter injury model induced in rats at postnatal day 3. The temporal pattern of HIF-1α expression post-HI injury was tested by western blotting and immunofluorescence. Rats were treated with a HIF-1α inhibitor at 72 hours post-HI injury. Reactive gliosis and myelination were assessed with western blotting, immunofluorescence and electron microscopy, and neurological functions were examined by behavioural testing. RESULTS Our results showed that the expression of HIF-1α was upregulated in neurons at 24 hours and in astrocytes at 7 days post-HI. Inhibiting delayed HIF-1α expression post-HI injury could restrain reactive gliosis, ameliorate hypomyelination, and improve the performance of rats in the Morris water maze test. CONCLUSIONS Our findings suggest that a delayed increase in HIF-1α in astrocytes is involved in glial scar formation and leads to arrested oligodendrocyte maturation, impaired myelination, and long-term neurological function after experimental white matter injury in immature rats.
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Affiliation(s)
- Min-Jie Wang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.,Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Zhi-Hua Li
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.,Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Rui-Wei Gao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.,Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Qiu-Fan Chen
- Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Jie Lin
- Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Mi-Li Xiao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.,Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Ke Zhang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.,Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Chao Chen
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.,Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
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Cardiac structure and function in very preterm-born adolescents compared to term-born controls: A longitudinal cohort study. Early Hum Dev 2021; 163:105505. [PMID: 34763163 DOI: 10.1016/j.earlhumdev.2021.105505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is emerging evidence of differences in cardiac structure and function in preterm-born adults and increased risk of heart failure. However, there is a paucity of data in populations who have been exposed to modern intensive care and the impact of perinatal factors is unclear. AIMS To compare echocardiographic measures of cardiac structure and function in a regional cohort of 17-year-olds born very preterm compared to term-born peers and the influence of perinatal factors. STUDY DESIGN Observational longitudinal cohort study. SUBJECTS A regional cohort of ninety-one 17-year-olds born at <32 weeks gestation compared to sixty-two term-born controls. OUTCOME MEASURES Echocardiographic measures of cardiac structure and function. RESULTS Left ventricular and right atrial volume and left ventricular mass, indexed to body surface area, were significantly smaller in preterm-born adolescents compared to term-born controls even when adjusted for sex. There were no between group differences in cardiac function. Within those born preterm we found a significant association between gestational age and birthweight z-score and measures of cardiac function at 17 years. Within the preterm group, those with a diagnosis of bronchopulmonary dysplasia had higher left ventricular posterior wall thickness, higher mitral deceleration time and lower left atrial area and tricuspid annular plane of systolic excursion. CONCLUSIONS Adolescents born very prematurely, who have received modern intensive care, have measurable differences in heart structure compared to their term-born peers but heart function is preserved. For those born preterm, gestational age, birthweight and bronchopulmonary dysplasia are associated with differences in cardiac function.
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20
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Uusitalo K, Haataja L, Saunavaara V, Lind A, Vorobyev V, Tilli J, Parkkola R, Setänen S. Performance in Hand Coordination Tasks and Concurrent Functional MRI Findings in 13-Year-Olds Born Very Preterm. Pediatr Neurol 2021; 123:21-29. [PMID: 34339952 DOI: 10.1016/j.pediatrneurol.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Fine motor and coordination problems are frequently reported among adolescents born preterm. We aimed to assess performance in hand coordination tasks and to compare concurrent brain activation between adolescents born very preterm and at term at 13 years. METHODS A total of 34 right-handed adolescents born very preterm (gestational age less than 32 weeks/birth weight ≤1500 grams) and 37 controls born at term during 2003 to 2006 in Turku University Hospital, Finland, were recruited. At 13 years, finger opposition and diadochokinesis were assessed, and brain functional magnetic resonance imaging data were acquired while the adolescents performed unimanual hand coordination tasks in response to visual cue. RESULTS Adolescents born very preterm performed similar to controls in hand coordination tasks. The very preterm group evoked greater brain activation than the controls in the right precentral gyrus and in the right postcentral gyrus during left-hand finger opposition and in the right postcentral gyrus during left-hand diadochokinesis. Within the very preterm group, lower gestational age was associated with reduced activation in the left superior parietal lobule during right-hand diadochokinesis. Regarding left-hand tasks, lower gestational age was associated with stronger activation in the right cerebellar lobule V and left cerebellar lobule VI during finger opposition and stronger activation in the right superior parietal lobule during diadochokinesis. CONCLUSIONS Very preterm birth affected hand coordination-related brain activation. Most of the effects were found for nondominant hand. Clinical performance during the hand coordination tasks was similar in adolescents born very preterm and controls.
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Affiliation(s)
- Karoliina Uusitalo
- Department of Pediatric Neurology, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland.
| | - Leena Haataja
- University of Helsinki and Helsinki University Hospital, Children's Hospital, and Pediatric Research Center, Helsinki, Finland
| | - Virva Saunavaara
- Division of Medical Imaging, Department of Medical Physics, Turku University Hospital, Turku, Finland; Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Annika Lind
- Attentio Ltd, Turku, Finland; Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Victor Vorobyev
- Turku University Hospital, Turku, Finland; Department of Radiology, University of Turku, Turku, Finland
| | - Joni Tilli
- Department of Pediatric Neurology, University of Turku, Turku, Finland
| | - Riitta Parkkola
- Turku University Hospital, Turku, Finland; Department of Radiology, University of Turku, Turku, Finland
| | - Sirkku Setänen
- Department of Pediatric Neurology, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland
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21
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Perino MT, Myers MJ, Wheelock MD, Yu Q, Harper JC, Manhart MF, Gordon EM, Eggebrecht AT, Pine DS, Barch DM, Luby JL, Sylvester CM. Whole-Brain Resting-State Functional Connectivity Patterns Associated With Pediatric Anxiety and Involuntary Attention Capture. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:229-238. [PMID: 36033105 PMCID: PMC9417088 DOI: 10.1016/j.bpsgos.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/22/2021] [Accepted: 05/24/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Pediatric anxiety disorders are linked to dysfunction in multiple functional brain networks, as well as to alterations in the allocation of spatial attention. We used network-level analyses to characterize resting-state functional connectivity (rs-fc) alterations associated with 1) symptoms of anxiety and 2) alterations in stimulus-driven attention associated with pediatric anxiety disorders. We hypothesized that anxiety was related to altered connectivity of the frontoparietal, default mode, cingulo-opercular, and ventral attention networks and that anxiety-related connectivity alterations that include the ventral attention network would simultaneously be related to deviations in stimulus-driven attention. METHODS A sample of children (n = 61; mean = 10.6 years of age), approximately half of whom met criteria for a current anxiety disorder, completed a clinical assay, an attention task, and rs-fc magnetic resonance imaging scans. Network-level analyses examined whole-brain rs-fc patterns associated with clinician-rated anxiety and with involuntary capture of attention. Post hoc analyses controlled for comorbid symptoms. RESULTS Elevated clinician-rated anxiety was associated with altered connectivity within the cingulo-opercular network, as well as between the cingulo-opercular network and the ventral attention, default mode, and visual networks. Connectivity between the ventral attention and cingulo-opercular networks was associated with variation in both anxiety and stimulus-driven attention. CONCLUSIONS Pediatric anxiety is related to aberrant connectivity patterns among several networks, most of which include the cingulo-opercular network. These results help clarify the within- and between-network interactions associated with pediatric anxiety and its association with altered attention, suggesting that specific network connections could be targeted to improve specific altered processes associated with anxiety.
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Affiliation(s)
- Michael T. Perino
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Michael J. Myers
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Muriah D. Wheelock
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Qiongru Yu
- Department of Psychology, San Diego State University, San Diego, California
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Jennifer C. Harper
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Megan F. Manhart
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Evan M. Gordon
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Adam T. Eggebrecht
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Daniel S. Pine
- Development & Emotion Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Deanna M. Barch
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Joan L. Luby
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Chad M. Sylvester
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
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22
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Gilbert KE, Wheelock MD, Kandala S, Eggebrecht AT, Luby JL, Barch DM. Associations of observed preschool performance monitoring with brain functional connectivity in adolescence. Cortex 2021; 142:15-27. [PMID: 34174721 PMCID: PMC8405590 DOI: 10.1016/j.cortex.2021.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/12/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
Monitoring one's performance helps detect errors and adapt to prevent future mistakes. However, elevated performance monitoring is associated with increased checking behaviors and perfectionism and is characteristic of multiple psychiatric disorders. Understanding how heightened performance monitoring in early childhood relates to subsequent brain connectivity may elucidate mechanistic risk factors that influence brain and psychiatric outcomes. The aim of this study was to examine the association between performance monitoring in preschool-aged children and functional connectivity during adolescence. In the current prospective longitudinal study, we performed seed-based functional connectivity analysis using a dorsal anterior cingulate cortex (dACC) seed to assess brain-behavior relationships between observationally coded performance monitoring in preschool-aged children and adolescent functional connectivity (n = 79). We also utilized enrichment analysis to investigate network-level connectome-wide associations. Seed-based analysis revealed negative correlations between preschool performance monitoring and adolescent fc between dACC and orbitofrontal and dorsolateral prefrontal cortex while a positive correlation was observed between dACC-occipital cortex connectivity. Enrichment analysis revealed a negative correlation between preschool performance monitoring and connectivity between motor (MOT) - cingulo-opercular (CO) and salience (SN) - Reward (REW) and a positive correlation with MOT-DMN, and cerebellum (CB) - motor connectivity. Elevated performance monitoring in early childhood is associated with functional connectivity during adolescence in regions and networks associated with cognitive control, sensorimotor processing and cortico-striatal-thalamic-cortico (CTSC) aberrations. These regions and networks are implicated in psychiatric disorders characterized by elevated performance monitoring. Findings shed light on a mechanistic risk factor in early childhood with long-term associations with neural functioning.
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Affiliation(s)
- Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Muriah D Wheelock
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sridhar Kandala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
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23
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Thomason ME, Hect JL, Waller R, Curtin P. Interactive relations between maternal prenatal stress, fetal brain connectivity, and gestational age at delivery. Neuropsychopharmacology 2021; 46:1839-1847. [PMID: 34188185 PMCID: PMC8357800 DOI: 10.1038/s41386-021-01066-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/15/2022]
Abstract
Studies reporting significant associations between maternal prenatal stress and child outcomes are frequently confounded by correlates of prenatal stress that influence the postnatal rearing environment. The major objective of this study is to identify whether maternal prenatal stress is associated with variation in human brain functional connectivity prior to birth. We utilized fetal fMRI in 118 fetuses [48 female; mean age 32.9 weeks (SD = 3.87)] to evaluate this association and further addressed whether fetal neural differences were related to maternal health behaviors, social support, or birth outcomes. Community detection was used to empirically define networks and enrichment was used to isolate differential within- or between-network connectivity effects. Significance for χ2 enrichment was determined by randomly permuting the subject pairing of fetal brain connectivity and maternal stress values 10,000 times. Mixtures modelling was used to test whether fetal neural differences were related to maternal health behaviors, social support, or birth outcomes. Increased maternal prenatal negative affect/stress was associated with alterations in fetal frontoparietal, striatal, and temporoparietal connectivity (β = 0.82, p < 0.001). Follow-up analysis demonstrated that these associations were stronger in women with better health behaviors, more positive interpersonal support, and lower overall stress (β = 0.16, p = 0.02). Additionally, magnitude of stress-related differences in neural connectivity was marginally correlated with younger gestational age at delivery (β = -0.18, p = 0.05). This is the first evidence that negative affect/stress during pregnancy is reflected in functional network differences in the human brain in utero, and also provides information about how positive interpersonal and health behaviors could mitigate prenatal brain programming.
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Affiliation(s)
- Moriah E Thomason
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA.
- Department of Population Health, New York University Medical Center, New York, NY, USA.
- Neuroscience Institute, NYU Langone Health, New York, NY, USA.
| | - Jasmine L Hect
- Medical Scientist Training Program, University of Pittsburgh & Carnegie Mellon University, Pittsburgh, PA, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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24
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Ní Bhroin M, Molloy EJ, Bokde ALW. Relationship between resting-state fMRI functional connectivity with motor and language outcome after perinatal brain injury - A systematic review. Eur J Paediatr Neurol 2021; 33:36-49. [PMID: 34058624 DOI: 10.1016/j.ejpn.2021.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/29/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022]
Abstract
Perinatal brain injury is a significant cause of adverse neurodevelopmental outcomes. The objective of this systematic review was to identify patterns of altered brain function, quantified using functional connectivity (FC) changes in resting-state fMRI (rs-fMRI) data, that were associated with motor and language outcomes in individuals with a history of perinatal brain injury. A systematic search using electronic databases was conducted to identify relevant studies. A total of 10 studies were included in the systematic review, representing 260 individuals with a history of perinatal brain injury. Motor and language outcomes were measured at time points ranging from 4 months to 29 years 1 month. Relations between FC and motor measures revealed increased intra-hemispheric FC, reduced inter-hemispheric FC and impaired lateralization of motor-related brain regions associated with motor outcomes. Altered FC within sensorimotor, visual, cerebellum and frontoparietal networks, and between sensorimotor, visual, auditory and higher-order networks, including cerebellum, frontoparietal, default-mode, salience, self-referential and attentional networks were also associated with motor outcomes. In studies assessing the relationship between rs-fMRI and language outcome, reduced intra-hemispheric FC, increased inter-hemispheric FC and right-hemisphere lateralization of language-related brain regions correlated with language outcomes. Evidence from this systematic review suggests a possible association between diaschisis and motor and language impairments in individuals after perinatal brain lesions. These findings support the need to explore the contributions of additional brain regions functionally connected but remote from the primary lesioned brain area for targeted treatments and appropriate intervention, though more studies with increased standardization across neuroimaging and neurodevelopmental assessments are needed.
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Affiliation(s)
- Megan Ní Bhroin
- Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland.
| | - Eleanor J Molloy
- Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland; Department of Neonatology, Children's Hospital Ireland at Crumlin and Tallaght, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Arun L W Bokde
- Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
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25
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Prasad JD, van de Looij Y, Gunn KC, Ranchhod SM, White PB, Berry MJ, Bennet L, Sizonenko SV, Gunn AJ, Dean JM. Long-term coordinated microstructural disruptions of the developing neocortex and subcortical white matter after early postnatal systemic inflammation. Brain Behav Immun 2021; 94:338-356. [PMID: 33307171 DOI: 10.1016/j.bbi.2020.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/16/2020] [Accepted: 12/06/2020] [Indexed: 12/21/2022] Open
Abstract
Severe postnatal systemic infection is highly associated with persistent disturbances in brain development and neurobehavioral outcomes in survivors of preterm birth. However, the contribution of less severe but prolonged postnatal infection and inflammation to such disturbances is unclear. Further, the ability of modern imaging techniques to detect the underlying changes in cellular microstructure of the brain in these infants remains to be validated. We used high-field ex-vivo MRI, neurohistopathology, and behavioral tests in newborn rats to demonstrate that prolonged postnatal systemic inflammation causes subtle, persisting disturbances in brain development, with neurodevelopmental delays and mild motor impairments. Diffusion-tensor MRI and neurite orientation dispersion and density imaging (NODDI) revealed delayed maturation of neocortical and subcortical white matter microstructure. Analysis of pyramidal neurons showed that the cortical deficits involved impaired dendritic arborization and spine formation. Analysis of oligodendrocytes showed that the white matter deficits involved impaired oligodendrocyte maturation and axonal myelination. These findings indicate that prolonged postnatal inflammation, without severe infection, may critically contribute to the diffuse spectrum of brain pathology and subtle long-term disability in preterm infants, with a cellular mechanism involving oligodendrocyte and neuronal dysmaturation. NODDI may be useful for clinical detection of these microstructural deficits.
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Affiliation(s)
- Jaya D Prasad
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Yohan van de Looij
- Division of Child Development and Growth, Department of Pediatrics and Gynecology Obstetrics, University of Geneva, Geneva, Switzerland; Center for Biomedical Imaging - Animal Imaging and Technology, Lausanne Federal Polytechnic School, Lausanne, Switzerland
| | - Katherine C Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Sonya M Ranchhod
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Petra B White
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Mary J Berry
- The Department of Pediatrics and Health Care, University of Otago, New Zealand
| | - Laura Bennet
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Stéphane V Sizonenko
- Division of Child Development and Growth, Department of Pediatrics and Gynecology Obstetrics, University of Geneva, Geneva, Switzerland
| | - Alistair J Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Justin M Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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Jequier Gygax M, Maillard AM, Favre J. Could Gait Biomechanics Become a Marker of Atypical Neuronal Circuitry in Human Development?-The Example of Autism Spectrum Disorder. Front Bioeng Biotechnol 2021; 9:624522. [PMID: 33796508 PMCID: PMC8009281 DOI: 10.3389/fbioe.2021.624522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/19/2021] [Indexed: 12/28/2022] Open
Abstract
This perspective paper presents converging recent knowledge in neurosciences (motor neurophysiology, neuroimaging and neuro cognition) and biomechanics to outline the relationships between maturing neuronal network, behavior, and gait in human development. Autism Spectrum Disorder (ASD) represents a particularly relevant neurodevelopmental disorder (NDD) to study these convergences, as an early life condition presenting with sensorimotor and social behavioral alterations. ASD diagnosis relies solely on behavioral criteria. The absence of biological marker in ASD is a main challenge, and hampers correlations between behavioral development and standardized data such as brain structure alterations, brain connectivity, or genetic profile. Gait, as a way to study motor system development, represents a well-studied, early life ability that can be characterized through standardized biomechanical analysis. Therefore, developmental gait biomechanics might appear as a possible motor phenotype and biomarker, solid enough to be correlated to neuronal network maturation, in normal and atypical developmental trajectories—like in ASD.
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Affiliation(s)
- Marine Jequier Gygax
- Service des Troubles du Spectre de l'Autisme, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne M Maillard
- Service des Troubles du Spectre de l'Autisme, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
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Norr ME, Hect JL, Lenniger CJ, Van den Heuvel M, Thomason ME. An examination of maternal prenatal BMI and human fetal brain development. J Child Psychol Psychiatry 2021; 62:458-469. [PMID: 32779186 PMCID: PMC7875456 DOI: 10.1111/jcpp.13301] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Prenatal development is a time when the brain is acutely vulnerable to insult and alteration by environmental factors (e.g., toxins, maternal health). One important risk factor is maternal obesity (Body Mass Index > 30). Recent research indicates that high maternal BMI during pregnancy is associated with increased risk for numerous physical health, cognitive, and mental health problems in offspring across the lifespan. It is possible that heightened maternal prenatal BMI influences the developing brain even before birth. METHODS The present study examines this possibility at the level of macrocircuitry in the human fetal brain. Using a data-driven strategy for parcellating the brain into subnetworks, we test whether MRI functional connectivity within or between fetal neural subnetworks varies with maternal prenatal BMI in 109 fetuses between the ages of 26 and 39weeks. RESULTS We discovered that strength of connectivity between two subnetworks, left anterior insula/inferior frontal gyrus (aIN/IFG) and bilateral prefrontal cortex (PFC), varied with maternal BMI. At the level of individual aIN/IFG-PFC connections, we observed both increased and decreased between-network connectivity with a tendency for increased within-hemisphere connectivity and reduced cross-hemisphere connectivity in higher BMI pregnancies. Maternal BMI was not associated with global differences in network topography based on network-based statistical analyses. CONCLUSIONS Overall effects were localized in regions that will later support behavioral regulation and integrative processes, regions commonly associated with obesity-related deficits. By establishing onset in neural differences prior to birth, this study supports a model in which maternal BMI-related risk is associated with fetal connectome-level brain organization with implications for offspring long-term cognitive development and mental health.
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Affiliation(s)
- Megan E. Norr
- Department of Psychology, University of California Berkeley, Berkeley, CA, USA
| | - Jasmine L. Hect
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Carly J. Lenniger
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA
| | - Martijn Van den Heuvel
- Dutch Connectome Lab, Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Moriah E. Thomason
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA
- Department of Population Health, New York Medical Center, New York University, New York, NY, USA
- Neuroscience Institute, New York Medical Center, New York University, New York, NY, USA
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Cainelli E, Vedovelli L, Wigley ILCM, Bisiacchi PS, Suppiej A. Neonatal spectral EEG is prognostic of cognitive abilities at school age in premature infants without overt brain damage. Eur J Pediatr 2021; 180:909-918. [PMID: 32989487 PMCID: PMC7886838 DOI: 10.1007/s00431-020-03818-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/25/2022]
Abstract
Prematurity is a prototype of biological risk that could affect the late neurocognitive outcome; however, the condition itself remains a non-specific marker. This longitudinal 6-year study aimed to evaluate the prognostic role of neonatal spectral EEG in premature infants without neurological complications. The study cohort was 26 children born 23-34 gestational ages; all neonates underwent multichannel EEG recordings at 35 weeks post-conception. EEG data were transformed into the frequency domain and divided into delta (0.5-4 Hz), theta (5-7 Hz), alpha (8-13 Hz), and beta (14-20 Hz) frequency bands. At 6 years, a neuropsychological and behavioral evaluation was performed. Correlations between spectral bands and neuropsychological assessments were performed with a conservative and robust Bayesian correlation model using weakly informative priors. The correlation of neuropsychological tasks to spectral frequency bands highlighted a significant association with visual and auditory attention tests. The performance on the same tests appears to be mainly impaired.Conclusions: We found that spectral EEG frequencies are independent predictors of performance in attention tasks. We hypothesized that spectral EEG might reflect early circuitries' imbalance in the reticular ascending system and cumulative effect on ongoing development, pointing to the importance of early prognostic instruments. What is Known: • Prematurity is a non-specific marker of late neurocognitive risk. • Precise prognostic instruments are lacking, mostly in patients with low-grade conditions. What is New: • Longitudinal long-term studies are scarce but crucial for the inferential attributive process. • Spectral EEG frequencies are independent predictors of performance in attention tasks.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
- Child Neurology and Clinical Neurophysiology, Padua University Hospital, via Giustiniani 3, 35133 Padova, Italy
| | - Luca Vedovelli
- Lab LeSexp, Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35131 Padova, Italy
| | | | - Patrizia Silvia Bisiacchi
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
- Padova Neuroscience Centre, PNC, Padova, Italy
| | - Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, Padua University Hospital, via Giustiniani 3, 35133 Padova, Italy
- Department of Medical Sciences, Pediatric Section, University of Ferrara, via Aldo Moro 8, 44124 Cona, Fe Italy
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29
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Wheelock MD, Lean RE, Bora S, Melzer TR, Eggebrecht AT, Smyser CD, Woodward LJ. Functional Connectivity Network Disruption Underlies Domain-Specific Impairments in Attention for Children Born Very Preterm. Cereb Cortex 2021; 31:1383-1394. [PMID: 33067997 PMCID: PMC8179512 DOI: 10.1093/cercor/bhaa303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/19/2020] [Accepted: 09/10/2020] [Indexed: 01/17/2023] Open
Abstract
Attention problems are common in school-age children born very preterm (VPT; < 32 weeks gestational age), but the contribution of aberrant functional brain connectivity to these problems is not known. As part of a prospective longitudinal study, brain functional connectivity (fc) was assessed alongside behavioral measures of selective, sustained, and executive attention in 58 VPT and 65 full-term (FT) born children at corrected-age 12 years. VPT children had poorer sustained, shifting, and divided attention than FT children. Within the VPT group, poorer attention scores were associated with between-network connectivity in ventral attention, visual, and subcortical networks, whereas between-network connectivity in the frontoparietal, cingulo-opercular, dorsal attention, salience and motor networks was associated with attention functioning in FT children. Network-level differences were also evident between VPT and FT children in specific attention domains. Findings contribute to our understanding of fc networks that potentially underlie typical attention development and suggest an alternative network architecture may help support attention in VPT children.
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Affiliation(s)
- M D Wheelock
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - R E Lean
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO 63108, USA
| | - S Bora
- Mothers, Babies, and Women’s Health Program, Mater Research Institute, University of Queensland, South Brisbane, Australia
| | - T R Melzer
- Department of Medicine, University of Otago, New Zealand Brain Research Institute, Christchurch 8011, New Zealand
| | - A T Eggebrecht
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - C D Smyser
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - L J Woodward
- School of Health Sciences and Child Wellbeing Research Institute, University of Canterbury, Christchurch 8041, New Zealand
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Scher MS. Neurologic outcome after fetal inflammatory response syndrome: Trimester-specific considerations. Semin Fetal Neonatal Med 2020; 25:101137. [PMID: 33158496 DOI: 10.1016/j.siny.2020.101137] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Clinical signs and neuroimaging patterns associated with the fetal inflammatory response syndrome (FIRS) worsen or mimic the clinical repertoire after intrapartum hypoxic-ischemic encephalopathy (HIE) during labor and/or parturition. Diagnostic considerations expressed as neonatal encephalopathy (NE) must consider chronic as well as acute factors associated with FIRS. Trimester-specific factors adversely alter the interactions of the maternal/placental/fetal (MPF) triad and influence the postnatal phenotype of FIRS. Anticipatory guidance for families by clinicians caring for survivors with FIRS, as well as researchers, must consider acute and chronic effects that influence neurologic outcome. Novel neurotherapeutic interventions must include prenatal preventive as well as peripartum/postnatal rescue and repair strategies to effectively reduce the presence and severity of sequelae from FIRS.
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Affiliation(s)
- Mark S Scher
- Emeritus Full Professor of Pediatrics and Neurology, Rainbow Babies and Children's Hospital/MacDonald Hospital for Women, University Hospitals Cleveland Medical Center, Case Western Reserve University, School of Medicine, 11100 Euclid Avenue Cleveland, Ohio, 44106, USA.
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31
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Peyton C, Einspieler C, Fjørtoft T, Adde L, Schreiber MD, Drobyshevsky A, Marks JD. Correlates of Normal and Abnormal General Movements in Infancy and Long-Term Neurodevelopment of Preterm Infants: Insights from Functional Connectivity Studies at Term Equivalence. J Clin Med 2020; 9:E834. [PMID: 32204407 PMCID: PMC7141532 DOI: 10.3390/jcm9030834] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/14/2020] [Accepted: 03/17/2020] [Indexed: 12/19/2022] Open
Abstract
Preterm infants born before 32 weeks gestation have increased risks for neurodevelopmental impairment at two years of age. How brain function differs between preterm infants with normal or impaired development is unknown. However, abnormal spontaneous motor behavior at 12-15 weeks post-term age is associated with neurodevelopmental impairment. We imaged brain blood oxygen level-dependent signals at term-equivalent age in 62 infants born at <32 weeks gestation and explored whether resting state functional connectivity (rsFC) differed with performances on the General Movement Assessment (GMA) at 12-15 weeks, and Bayley III scores at two years of corrected age. Infants with aberrant general movements exhibited decreased rsFC between the basal ganglia and regions in parietal and frontotemporal lobes. Infants with normal Bayley III cognitive scores exhibited increased rsFC between the basal ganglia and association cortices in parietal and occipital lobes compared with cognitively impaired children. Infants with normal motor scores exhibited increased rsFC between the basal ganglia and visual cortices, compared with children with motor impairment. Thus, the presence of abnormal general movements is associated with region-specific differences in rsFC at term. The association of abnormal long-term neurodevelopmental outcomes with decreased rsFC between basal ganglia and sub-score specific cortical regions may provide biomarkers of neurodevelopmental trajectory and outcome.
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Affiliation(s)
- Colleen Peyton
- Department of Pediatrics, University of Chicago, Chicago, IL 60422, USA
- Department of Physical Therapy and Human Movement Science and the Department of Pediatrics, Northwestern University, Chicago, IL 60611, USA
| | - Christa Einspieler
- Research Unit IDN, Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz 8036, Austria;
| | - Toril Fjørtoft
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway; (T.F.); (L.A.)
- Clinics of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Lars Adde
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway; (T.F.); (L.A.)
- Clinics of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | | | | | - Jeremy D. Marks
- Department of Pediatrics, University of Chicago, Chicago, IL 60422, USA
- Department of Neurology, University of Chicago, Chicago, IL 60422, USA
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32
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Fishell AK, Arbeláez AM, Valdés CP, Burns-Yocum TM, Sherafati A, Richter EJ, Torres M, Eggebrecht AT, Smyser CD, Culver JP. Portable, field-based neuroimaging using high-density diffuse optical tomography. Neuroimage 2020; 215:116541. [PMID: 31987995 DOI: 10.1016/j.neuroimage.2020.116541] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/10/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
Behavioral and cognitive tests in individuals who were malnourished as children have revealed malnutrition-related deficits that persist throughout the lifespan. These findings have motivated recent neuroimaging investigations that use highly portable functional near-infrared spectroscopy (fNIRS) instruments to meet the demands of brain imaging experiments in low-resource environments and enable longitudinal investigations of brain function in the context of long-term malnutrition. However, recent studies in healthy subjects have demonstrated that high-density diffuse optical tomography (HD-DOT) can significantly improve image quality over that obtained with sparse fNIRS imaging arrays. In studies of both task activations and resting state functional connectivity, HD-DOT is beginning to approach the data quality of fMRI for superficial cortical regions. In this work, we developed a customized HD-DOT system for use in malnutrition studies in Cali, Colombia. Our results evaluate the performance of the HD-DOT instrument for assessing brain function in a cohort of malnourished children. In addition to demonstrating portability and wearability, we show the HD-DOT instrument's sensitivity to distributed brain responses using a sensory processing task and measurements of homotopic functional connectivity. Task-evoked responses to the passive word listening task produce activations localized to bilateral superior temporal gyrus, replicating previously published work using this paradigm. Evaluating this localization performance across sparse and dense reconstruction schemes indicates that greater localization consistency is associated with a dense array of overlapping optical measurements. These results provide a foundation for additional avenues of investigation, including identifying and characterizing a child's individual malnutrition burden and eventually contributing to intervention development.
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Affiliation(s)
- Andrew K Fishell
- Washington University School of Medicine, Division of Biology and Biomedical Sciences, St. Louis, MO, USA; Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO, USA
| | - Ana María Arbeláez
- Washington University School of Medicine, Department of Pediatrics, St. Louis, MO, USA
| | | | - Tracy M Burns-Yocum
- Indiana University, Department of Psychological and Brain Sciences, Bloomington, IN, USA
| | - Arefeh Sherafati
- Washington University School of Medicine, Division of Biology and Biomedical Sciences, St. Louis, MO, USA; Washington University, Department of Physics, St. Louis, MO, USA
| | - Edward J Richter
- Washington University, Electrical and Systems Engineering, St. Louis, MO, USA
| | | | - Adam T Eggebrecht
- Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO, USA; Washington University School of Medicine, Department of Pediatrics, St. Louis, MO, USA
| | - Christopher D Smyser
- Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO, USA; Washington University School of Medicine, Department of Pediatrics, St. Louis, MO, USA; Washington University School of Medicine, Department of Neurology, St. Louis, MO, USA
| | - Joseph P Culver
- Washington University School of Medicine, Division of Biology and Biomedical Sciences, St. Louis, MO, USA; Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO, USA; Washington University, Department of Physics, St. Louis, MO, USA; Washington University, Department of Biomedical Engineering, MO, St. Louis, USA.
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33
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Thomason ME, Hect JL, Rauh VA, Trentacosta C, Wheelock MD, Eggebrecht AT, Espinoza-Heredia C, Burt SA. Prenatal lead exposure impacts cross-hemispheric and long-range connectivity in the human fetal brain. Neuroimage 2019; 191:186-192. [PMID: 30739062 PMCID: PMC6451829 DOI: 10.1016/j.neuroimage.2019.02.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 01/21/2023] Open
Abstract
Lead represents a highly prevalent metal toxicant with potential to alter human biology in lasting ways. A population segment that is particularly vulnerable to the negative consequences of lead exposure is the human fetus, as exposure events occurring before birth are linked to varied and long-ranging negative health and behavioral outcomes. An area that has yet to be addressed is the potential that lead exposure during pregnancy alters brain development even before an individual is born. Here, we combine prenatal lead exposure information extracted from newborn bloodspots with the human fetal brain functional MRI data to assess whether neural network connectivity differs between lead-exposed and lead-naïve fetuses. We found that neural connectivity patterns differed in lead-exposed and comparison groups such that fetuses that were not exposed demonstrated stronger age-related increases in cross-hemispheric connectivity, while the lead-exposed group demonstrated stronger age-related increases in posterior cingulate cortex (PCC) to lateral prefrontal cortex (PFC) connectivity. These are the first results to demonstrate metal toxicant-related alterations in human fetal neural connectivity. Remarkably, the findings point to alterations in systems that support higher-order cognitive and regulatory functions. Objectives for future work are to replicate these results in larger samples and to test the possibility that these alterations may account for significant variation in future child cognitive and behavioral outcomes.
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Affiliation(s)
- Moriah E Thomason
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, USA; Department of Population Health, New York University Medical Center, New York, NY, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
| | - Jasmine L Hect
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Virginia A Rauh
- The Heilbrunn Department of Population & Family Health, Columbia University Medical Center, New York, NY, USA
| | | | - Muriah D Wheelock
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Claudia Espinoza-Heredia
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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34
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Wheelock MD, Hect JL, Hernandez-Andrade E, Hassan SS, Romero R, Eggebrecht AT, Thomason ME. Sex differences in functional connectivity during fetal brain development. Dev Cogn Neurosci 2019; 36:100632. [PMID: 30901622 PMCID: PMC6944279 DOI: 10.1016/j.dcn.2019.100632] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 02/15/2019] [Accepted: 03/02/2019] [Indexed: 01/12/2023] Open
Abstract
Sex-related differences in brain and behavior are apparent across the life course, but the exact set of processes that guide their emergence in utero remains a topic of vigorous scientific inquiry. Here, we evaluate sex and gestational age (GA)-related change in functional connectivity (FC) within and between brain wide networks. Using resting-state functional magnetic resonance imaging we examined FC in 118 human fetuses between 25.9 and 39.6 weeks GA (70 male; 48 female). Infomap was applied to the functional connectome to identify discrete prenatal brain networks in utero. A consensus procedure produced an optimal model comprised of 16 distinct fetal neural networks distributed throughout the cortex and subcortical regions. We used enrichment analysis to assess network-level clustering of strong FC-GA correlations separately in each sex group, and to identify network pairs exhibiting distinct patterns of GA-related change in FC between males and females. We discovered both within and between network FC-GA associations that varied with sex. Specifically, associations between GA and posterior cingulate-temporal pole and fronto-cerebellar FC were observed in females only, whereas the association between GA and increased intracerebellar FC was stronger in males. These observations confirm that sexual dimorphism in functional brain systems emerges during human gestation.
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Affiliation(s)
- M D Wheelock
- Department of Psychiatry, Washington University in St. Louis, St. Louis, United States
| | - J L Hect
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, United States
| | - E Hernandez-Andrade
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI 48201, United States; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48202, United States
| | - S S Hassan
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI 48201, United States; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48202, United States; Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48202, United States
| | - R Romero
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD 20847, United States; Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI 48201, United States; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, 48104, United States; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48825, United States; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, United States
| | - A T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, United States.
| | - M E Thomason
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, United States; Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI 48201, United States; Institute for Social Research, University of Michigan, Ann Arbor, MI 48109, United States.
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35
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Rogers CE, Lean RE, Wheelock MD, Smyser CD. Aberrant structural and functional connectivity and neurodevelopmental impairment in preterm children. J Neurodev Disord 2018; 10:38. [PMID: 30541449 PMCID: PMC6291944 DOI: 10.1186/s11689-018-9253-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 11/14/2018] [Indexed: 12/15/2022] Open
Abstract
Background Despite advances in antenatal and neonatal care, preterm birth remains a leading cause of neurological disabilities in children. Infants born prematurely, particularly those delivered at the earliest gestational ages, commonly demonstrate increased rates of impairment across multiple neurodevelopmental domains. Indeed, the current literature establishes that preterm birth is a leading risk factor for cerebral palsy, is associated with executive function deficits, increases risk for impaired receptive and expressive language skills, and is linked with higher rates of co-occurring attention deficit hyperactivity disorder, anxiety, and autism spectrum disorders. These same infants also demonstrate elevated rates of aberrant cerebral structural and functional connectivity, with persistent changes evident across advanced magnetic resonance imaging modalities as early as the neonatal period. Emerging findings from cross-sectional and longitudinal investigations increasingly suggest that aberrant connectivity within key functional networks and white matter tracts may underlie the neurodevelopmental impairments common in this population. Main body This review begins by highlighting the elevated rates of neurodevelopmental disorders across domains in this clinical population, describes the patterns of aberrant structural and functional connectivity common in prematurely-born infants and children, and then reviews the increasingly established body of literature delineating the relationship between these brain abnormalities and adverse neurodevelopmental outcomes. We also detail important, typically understudied, clinical, and social variables that may influence these relationships among preterm children, including heritability and psychosocial risks. Conclusion Future work in this domain should continue to leverage longitudinal evaluations of preterm infants which include both neuroimaging and detailed serial neurodevelopmental assessments to further characterize relationships between imaging measures and impairment, information necessary for advancing our understanding of modifiable risk factors underlying these disorders and best practices for improving neurodevelopmental trajectories in this high-risk clinical population.
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Affiliation(s)
- Cynthia E Rogers
- Departments of Psychiatry and Pediatrics, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA.
| | - Rachel E Lean
- Departments of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA
| | - Muriah D Wheelock
- Departments of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA
| | - Christopher D Smyser
- Departments of Neurology, Pediatrics and Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO, 63110, USA
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