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Konrad J, Guo T, Ufkes S, Selvanathan T, Sheng M, Al-Ajmi E, Branson HM, Chau V, Ly LG, Kelly EN, Grunau RE, Miller SP. Socioeconomic status moderates associations between hippocampal development and cognition in preterms. Ann Clin Transl Neurol 2024. [PMID: 39116913 DOI: 10.1002/acn3.52168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 07/06/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVE The hippocampus plays a critical role in cognitive networks. The anterior hippocampus is vulnerable to early-life stress and socioeconomic status (SES) with alterations persisting beyond childhood. How SES modifies the relationship between early hippocampal development and cognition remains poorly understood. This study examined associations between SES, structural and functional development of neonatal hippocampus, and 18-month cognition in very preterm neonates. METHODS In total, 179 preterm neonates were followed prospectively. Structural and resting-state functional MRI were obtained early-in-life and at term-equivalent age (median 32.9 and 41.1 weeks post-menstrual age) to calculate anterior and posterior hippocampal volumes and hippocampal functional connectivity strength. Eighteen-month cognition was assessed via Bayley-III. Longitudinal statistical analysis using generalized estimating equations, accounting for birth gestational age, post-menstrual age at scan, sex, and motion, was performed. RESULTS SES, measured as maternal education level, modified associations between anterior but not posterior hippocampal volumes and 18-month cognition (interaction term p = 0.005), and between hippocampal connectivity and cognition (interaction term p = 0.05). Greater anterior hippocampal volumes and hippocampal connectivity were associated with higher cognitive scores only in the lowest SES group. Maternal education alone did not predict neonatal hippocampal volume from early-in-life and term. INTERPRETATION SES modified the relationship between neonatal hippocampal development and 18-month cognition in very preterm neonates. The lack of direct association between maternal education and neonatal hippocampal volumes indicates that socio-environmental factors beyond the neonatal period contribute to modifying the relationship between hippocampal development and cognition. These findings point toward opportunities to more equitably promote optimal neurodevelopmental outcomes in very preterm infants.
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Affiliation(s)
- Julia Konrad
- Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Children's Hospital Dritter Orden, Munich, Germany
| | - Ting Guo
- Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Neurosciences & Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Steven Ufkes
- Department of Pediatrics, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Thiviya Selvanathan
- Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Min Sheng
- Neurosciences & Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Diagnostic Imaging, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Eiman Al-Ajmi
- Department of Diagnostic Imaging, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
| | - Helen M Branson
- Department of Diagnostic Imaging, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Vann Chau
- Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Linh G Ly
- Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Edmond N Kelly
- Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Neonatology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ruth E Grunau
- Department of Pediatrics, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Steven P Miller
- Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Neurosciences & Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Pediatrics, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
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2
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McCall DM, Homayouni R, Yu Q, Raz S, Ofen N. Meta-Analysis of Hippocampal Volume and Episodic Memory in Preterm and Term Born Individuals. Neuropsychol Rev 2024; 34:478-495. [PMID: 37060422 DOI: 10.1007/s11065-023-09583-6] [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: 09/01/2021] [Accepted: 12/22/2022] [Indexed: 04/16/2023]
Abstract
Preterm birth (< 37 weeks gestation) has been associated with memory deficits, which has prompted investigation of possible alterations in hippocampal volume in this population. However, existing literature reports varying effects of premature birth on hippocampal volume. Specifically, it is unclear whether smaller hippocampal volume in preterm-born individuals is merely reflective of smaller total brain volume. Further, it is not clear if hippocampal volume is associated with episodic memory functioning in preterm-born individuals. Meta-analysis was used to investigate the effects of premature birth on hippocampal volume and episodic memory from early development to young adulthood (birth to 26). PubMed, PsychINFO, and Web of Science were searched for English peer-reviewed articles that included hippocampal volume of preterm and term-born individuals. Thirty articles met the inclusion criteria. Separate meta-analyses were used to evaluate standardized mean differences between preterm and term-born individuals in uncorrected and corrected hippocampal volume, as well as verbal and visual episodic memory. Both uncorrected and corrected hippocampal volume were smaller in preterm-born compared to term-born individuals. Although preterm-born individuals had lower episodic memory performance than term-born individuals, the limited number of studies only permitted a qualitative review of the association between episodic memory performance and hippocampal volume. Tested moderators included mean age, pre/post-surfactant era, birth weight, gestational age, demarcation method, magnet strength, and slice thickness. With this meta-analysis, we provide novel evidence of the effects of premature birth on hippocampal volume.
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Affiliation(s)
- Dana M McCall
- Institute of Gerontology, Wayne State University, Detroit, MI, USA.
- Department of Neuropsychology, Gundersen Health System, La Crosse, WI, USA.
| | - Roya Homayouni
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Qijing Yu
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Sarah Raz
- Department of Psychology, Wayne State University, Detroit, MI, USA
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA
| | - Noa Ofen
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
- Department of Psychology, Wayne State University, Detroit, MI, USA
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA
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3
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Hurtado H, Hansen M, Strack J, Vainik U, Decker AL, Khundrakpam B, Duncan K, Finn AS, Mabbott DJ, Merz EC. Polygenic risk for depression and anterior and posterior hippocampal volume in children and adolescents. J Affect Disord 2024; 344:619-627. [PMID: 37858734 PMCID: PMC10842073 DOI: 10.1016/j.jad.2023.10.068] [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: 04/07/2023] [Revised: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Depression has frequently been associated with smaller hippocampal volume. The hippocampus varies in function along its anterior-posterior axis, with the anterior hippocampus more strongly associated with stress and emotion processing. The goals of this study were to examine the associations among parental history of anxiety/depression, polygenic risk scores for depression (PGS-DEP), and anterior and posterior hippocampal volumes in children and adolescents. To examine specificity to PGS-DEP, we examined associations of educational attainment polygenic scores (PGS-EA) with anterior and posterior hippocampal volume. METHODS Participants were 350 3- to 21-year-olds (46 % female). PGS-DEP and PGS-EA were computed based on recent, large-scale genome-wide association studies. High-resolution, T1-weighted magnetic resonance imaging (MRI) data were acquired, and a semi-automated approach was used to segment the hippocampus into anterior and posterior subregions. RESULTS Children and adolescents with higher polygenic risk for depression were more likely to have a parent with a history of anxiety/depression. Higher polygenic risk for depression was significantly associated with smaller anterior but not posterior hippocampal volume. PGS-EA was not associated with anterior or posterior hippocampal volumes. LIMITATIONS Participants in these analyses were all of European ancestry. CONCLUSIONS Polygenic risk for depression may lead to smaller anterior but not posterior hippocampal volume in children and adolescents, and there may be specificity of these effects to PGS-DEP rather than PGS-EA. These findings may inform the earlier identification of those in need of support and the design of more effective, personalized treatment strategies. DECLARATIONS OF INTEREST none. DECLARATIONS OF INTEREST None.
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Affiliation(s)
- Hailee Hurtado
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Melissa Hansen
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Jordan Strack
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Uku Vainik
- University of Tartu, Tartu, Estonia; Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Alexandra L Decker
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Katherine Duncan
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Amy S Finn
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Donald J Mabbott
- Department of Psychology, University of Toronto, Toronto, ON, Canada.; Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada.; Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada
| | - Emily C Merz
- Department of Psychology, Colorado State University, Fort Collins, CO, USA.
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4
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Fel JT, Ellis CT, Turk-Browne NB. Automated and manual segmentation of the hippocampus in human infants. Dev Cogn Neurosci 2023; 60:101203. [PMID: 36791555 PMCID: PMC9957787 DOI: 10.1016/j.dcn.2023.101203] [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: 07/15/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 01/30/2023] Open
Abstract
The hippocampus, critical for learning and memory, undergoes substantial changes early in life. Investigating the developmental trajectory of hippocampal structure and function requires an accurate method for segmenting this region from anatomical MRI scans. Although manual segmentation is regarded as the "gold standard" approach, it is laborious and subjective. This has fueled the pursuit of automated segmentation methods in adults. However, little is known about the reliability of these automated protocols in infants, particularly when anatomical scan quality is degraded by head motion or the use of shorter and quieter infant-friendly sequences. During a task-based fMRI protocol, we collected quiet T1-weighted anatomical scans from 42 sessions with awake infants aged 4-23 months. Two expert tracers first segmented the hippocampus in both hemispheres manually. The resulting inter-rater reliability (IRR) was only moderate, reflecting the difficulty of infant segmentation. We then used four protocols to predict these manual segmentations: average adult template, average infant template, FreeSurfer software, and Automated Segmentation of Hippocampal Subfields (ASHS) software. ASHS generated the most reliable hippocampal segmentations in infants, exceeding the manual IRR of experts. Automated methods thus provide robust hippocampal segmentations of noisy T1-weighted infant scans, opening new possibilities for interrogating early hippocampal development.
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Affiliation(s)
- J T Fel
- Department of Psychology, Yale University, New Haven, CT 06511, USA
| | - C T Ellis
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - N B Turk-Browne
- Department of Psychology, Yale University, New Haven, CT 06511, USA; Wu Tsai Institute, Yale University, New Haven, CT 06511, USA.
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5
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Sheng M, Guo T, Mabbott C, Chau V, Synnes A, de Vries LS, Grunau RE, Miller SP. Ventricular Volume in Infants Born Very Preterm: Relationship with Brain Maturation and Neurodevelopment at Age 4.5 Years. J Pediatr 2022; 248:51-58.e2. [PMID: 35561806 DOI: 10.1016/j.jpeds.2022.05.003] [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: 10/27/2021] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the relationship of quantitative ventricular volume with brain maturation and neurodevelopmental outcomes at age 4.5 years in children born very preterm. STUDY DESIGN T1-weighted imaging, diffusion tensor imaging, and magnetic resonance spectroscopy were performed shortly after birth (n = 212) and at term-equivalent age (TEA) (n = 194). Intraventricular hemorrhage (IVH) grade and white matter injury (WMI) volume were measured on early T1-weighted magnetic resonance imaging (MRI) scans. Total cerebral volume and ventricular volume were quantified using the Multiple Automatically Generated Templates-Brain pipeline. At age 4.5 years, 178 children (84%) underwent cognitive and motor assessments. Multivariable linear regression was used to examine the relationships between ventricular volume and neurodevelopmental outcomes. Generalized estimating equations were used to account for repeated measures when analyzing neonatal MRI data. All models accounted for sex, postmenstrual age at scan, WMI volume, IVH grade, and total cerebral volume and were corrected for multiple comparisons. RESULTS On early MRI, 97 infants had IVH (grade 1, n = 22; grade 2, n = 66; grade 3, n = 9), and 68 had WMI (median, 44 mm3; IQR, 21-296 mm3). IQ at 4.5 years was associated with MRI ventricular volume at the early (β = -0.64; P < .001) and TEA (β = -0.44, P < .001) time points. Motor outcomes were associated with ventricular volume at TEA (β = -0.84, P = .01). Greater ventricular volume independently predicted lower fractional anisotropy in corpus callosum (genu: β = -0.0008, P = .002; splenium: β = -0.003, P < .001) and optic radiations (β = -0.001, P = .004); ventricular volume did not predict the N-acetylaspartate/choline ratio. CONCLUSIONS In children born very preterm, neonatal ventricular size was associated with 4.5-year neurodevelopmental outcomes. Our findings suggest that white matter maturation may be abnormal in the setting of enlarged ventricular size beyond that expected from concurrent brain injuries.
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Affiliation(s)
- Min Sheng
- Department of Paediatrics, University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ting Guo
- Department of Paediatrics, University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Connor Mabbott
- Department of Paediatrics, University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vann Chau
- Department of Paediatrics, University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne Synnes
- Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Steven P Miller
- Department of Paediatrics, University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
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6
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MRI based radiomics enhances prediction of neurodevelopmental outcome in very preterm neonates. Sci Rep 2022; 12:11872. [PMID: 35831452 PMCID: PMC9279296 DOI: 10.1038/s41598-022-16066-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/04/2022] [Indexed: 12/04/2022] Open
Abstract
To predict adverse neurodevelopmental outcome of very preterm neonates. A total of 166 preterm neonates born between 24–32 weeks’ gestation underwent brain MRI early in life. Radiomics features were extracted from T1- and T2- weighted images. Motor, cognitive, and language outcomes were assessed at a corrected age of 18 and 33 months and 4.5 years. Elastic Net was implemented to select the clinical and radiomic features that best predicted outcome. The area under the receiver operating characteristic (AUROC) curve was used to determine the predictive ability of each feature set. Clinical variables predicted cognitive outcome at 18 months with AUROC 0.76 and motor outcome at 4.5 years with AUROC 0.78. T1-radiomics features showed better prediction than T2-radiomics on the total motor outcome at 18 months and gross motor outcome at 33 months (AUROC: 0.81 vs 0.66 and 0.77 vs 0.7). T2-radiomics features were superior in two 4.5-year motor outcomes (AUROC: 0.78 vs 0.64 and 0.8 vs 0.57). Combining clinical parameters and radiomics features improved model performance in motor outcome at 4.5 years (AUROC: 0.84 vs 0.8). Radiomic features outperformed clinical variables for the prediction of adverse motor outcomes. Adding clinical variables to the radiomics model enhanced predictive performance.
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7
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Selvanathan T, Guo T, Kwan E, Chau V, Brant R, Synnes AR, Grunau RE, Miller SP. Head circumference, total cerebral volume and neurodevelopment in preterm neonates. Arch Dis Child Fetal Neonatal Ed 2022; 107:181-187. [PMID: 34261769 DOI: 10.1136/archdischild-2020-321397] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/25/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the association of head circumference (HC) <10th percentile at birth and discharge from the neonatal intensive care unit (NICU) with neurodevelopment in very preterm (24-32 weeks' gestational age) neonates, and to compare the association of HC and total cerebral volume (TCV) with neurodevelopmental outcomes. DESIGN In a prospective cohort, semiautomatically segmented TCV and manually segmented white matter injury (WMI) volumes were obtained. Multivariable regressions were used to study the association of HC and TCV with neurodevelopmental outcomes, accounting for birth gestational age, WMI and postnatal illness. SETTING Participants born in 2006-2013 at British Columbia Women's Hospital were recruited. PATIENTS 168 neonates had HC measurements at birth and discharge and MRI at term-equivalent age (TEA). 143 children were assessed at 4.5 years. MAIN OUTCOME MEASURES Motor, cognitive and language outcomes at 4.5 years were assessed using the Movement Assessment Battery for Children Second Edition (M-ABC) and Wechsler Preschool and Primary Scale of Intelligence Third Edition Full Scale IQ (FSIQ) and Verbal IQ (VIQ). RESULTS Small birth HC was associated with lower M-ABC and FSIQ scores. In children with small birth HC, small discharge HC was associated with lower M-ABC, FSIQ and VIQ scores, while normal HC at discharge was no longer associated with adverse outcomes. HC strongly correlated with TCV at TEA. TCV did not correlate with outcomes. CONCLUSIONS Small birth HC is associated with poorer neurodevelopment, independent of postnatal illness and WMI. Normalisation of HC during NICU care appears to moderate this risk.
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Affiliation(s)
- Thiviya Selvanathan
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Ting Guo
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Eddie Kwan
- Department of Pharmacy, University of British Columbia, Vancouver, British Columbia, Canada.,BC Women's Hospital and Health Centre and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Vann Chau
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Rollin Brant
- Department of Statistics, The University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Anne R Synnes
- BC Women's Hospital and Health Centre and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Pediatrics (Neonatology), The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ruth E Grunau
- BC Women's Hospital and Health Centre and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Pediatrics (Neonatology), The University of British Columbia, Vancouver, British Columbia, Canada
| | - Steven P Miller
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada .,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
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8
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Cayam-Rand D, Guo T, Synnes A, Chau V, Mabbott C, Benavente-Fernández I, Grunau RE, Miller SP. Interaction between Preterm White Matter Injury and Childhood Thalamic Growth. Ann Neurol 2021; 90:584-594. [PMID: 34436793 DOI: 10.1002/ana.26201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/09/2021] [Accepted: 08/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to determine how preterm white matter injury (WMI) and long-term thalamic growth interact to predict 8-year neurodevelopmental outcomes. METHODS A prospective cohort of 114 children born at 24 to 32 weeks' gestational age (GA) underwent structural and diffusion tensor magnetic resonance imaging early in life (median 32 weeks), at term-equivalent age and at 8 years. Manual segmentation of neonatal WMI was performed on T1-weighted images and thalamic volumes were obtained using the MAGeT brain segmentation pipeline. Cognitive, motor, and visual-motor outcomes were evaluated at 8 years of age. Multivariable regression was used to examine the relationship among neonatal WMI volume, school-age thalamic volume, and neurodevelopmental outcomes. RESULTS School-age thalamic volumes were predicted by neonatal thalamic growth rate, GA, sex, and neonatal WMI volume (p < 0.0001). After accounting for total cerebral volume, WMI volume remained associated with school-age thalamic volume (β = -0.31, p = 0.005). In thalamocortical tracts, fractional anisotropy (FA) at term-equivalent age interacted with early WMI volume to predict school-age thalamic volumes (all p < 0.02). School-age thalamic volumes and neonatal WMI interacted to predict full-scale IQ (p = 0.002) and adverse motor scores among those with significant WMI (p = 0.01). Visual-motor scores were predicted by thalamic volumes (p = 0.04). INTERPRETATION In very preterm-born children, neonatal thalamic growth and WMI volume predict school-age thalamic volumes. The emergence at term of an interaction between FA and WMI to impact school-age thalamic volume indicates dysmaturation as a mechanism of thalamic growth failure. Cognition is predicted by the interaction of WMI and thalamic growth, highlighting the need to consider multiple dimensions of brain injury in these children. ANN NEUROL 2021;90:584-594.
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Affiliation(s)
- Dalit Cayam-Rand
- Department of Paediatrics, Hospital for Sick Children & University of Toronto, Toronto, ON, Canada
| | - Ting Guo
- Department of Paediatrics, Hospital for Sick Children & University of Toronto, Toronto, ON, Canada
| | - Anne Synnes
- Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Vann Chau
- Department of Paediatrics, Hospital for Sick Children & University of Toronto, Toronto, ON, Canada
| | - Connor Mabbott
- Department of Paediatrics, Hospital for Sick Children & University of Toronto, Toronto, ON, Canada.,Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Isabel Benavente-Fernández
- Department of Paediatrics, Hospital for Sick Children & University of Toronto, Toronto, ON, Canada.,Department of Neonatology & Biomedical Research and Innovation Institute of Cadiz, University Hospital Puerta del Mar, Cadiz, Spain
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Steven P Miller
- Department of Paediatrics, Hospital for Sick Children & University of Toronto, Toronto, ON, Canada
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Bisiacchi P, Cainelli E. Structural and functional brain asymmetries in the early phases of life: a scoping review. Brain Struct Funct 2021; 227:479-496. [PMID: 33738578 PMCID: PMC8843922 DOI: 10.1007/s00429-021-02256-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/07/2021] [Indexed: 12/13/2022]
Abstract
Asymmetry characterizes the brain in both structure and function. Anatomical asymmetries explain only a fraction of functional variability in lateralization, with structural and functional asymmetries developing at different periods of life and in different ways. In this work, we perform a scoping review of the cerebral asymmetries in the first brain development phases. We included all English-written studies providing direct evidence of hemispheric asymmetries in full-term neonates, foetuses, and premature infants, both at term post-conception and before. The final analysis included 57 studies. The reviewed literature shows large variability in the used techniques and methodological procedures. Most structural studies investigated the temporal lobe, showing a temporal planum more pronounced on the left than on the right (although not all data agree), a morphological asymmetry already present from the 29th week of gestation. Other brain structures have been poorly investigated, and the results are even more discordant. Unlike data on structural asymmetries, functional data agree with each other, identifying a leftward dominance for speech stimuli and an overall dominance of the right hemisphere in all other functional conditions. This generalized dominance of the right hemisphere for all conditions (except linguistic stimuli) is in line with theories stating that the right hemisphere develops earlier and that its development is less subject to external influences because it sustains functions necessary to survive.
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Affiliation(s)
- Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy. .,Padova Neuroscience Centre, PNC, Padova, Italy.
| | - Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy
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10
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Walnut Kernel administration to mothers during pregnancy and lactation improve learning of their pups. Changes in number of neurons and gene expression of NMDA receptor and BDNF in hippocampus in 80 days rat pups. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2021. [DOI: 10.2478/cipms-2020-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Walnut (Juglans regia) from the Juglandaceae family contains high levels of omega 3 fatty acid, vitamin E and melatonin, hence its consumption is beneficial to would be mothers and their offspring. The current study was designed to determine the possible mechanism of walnut consumption by mothers during pregnancy and lactation and the positive effects on learning and memory processes in their offspring. Wistar adult female rats were placed into three groups: control (fed with pellet, 20 g daily during pregnancy and lactation), CASE 1 [fed with Walnut Kernel (WK) 6% of food intake during pregnancy and lactation] and CASE 2 (fed with WK, 9% of food intake during gestation and lactation). In order to evaluate offspring learning and memory, the Morris Water Maze (MWM) test was performed for their adult offspring at 80 days of age. Histological and molecular studies were utilized in order to discover the protective mechanism and efficacy of WK consumption. The results revealed that learning was significantly improved in the females of CASE 2, in comparison to controls, while there was no difference in memory among the different groups. In addition, the number of neurons significantly increased in the CASE 2 group compared to the control group. However, the molecular study demonstrated that there was no significant difference among the study groups. The results herein show that feeding mothers with WK may improve the learning competence of their pups and increase the number of neurons in both sexes.
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11
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Duerden EG, Grunau RE, Chau V, Groenendaal F, Guo T, Chakravarty MM, Benders M, Wagenaar N, Eijsermans R, Koopman C, Synnes A, Vries LD, Miller SP. Association of early skin breaks and neonatal thalamic maturation: A modifiable risk? Neurology 2020; 95:e3420-e3427. [PMID: 33087497 DOI: 10.1212/wnl.0000000000010953] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/17/2020] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To test the hypothesis that a strategy of prolonged arterial line (AL) and central venous line (CVL) use is associated with reduced neonatal invasive procedures and improved growth of the thalamus in extremely preterm neonates (<28 weeks' gestation). METHODS Two international cohorts of very preterm neonates (n = 143) with prolonged (≥14 days) or restricted (<14 days) use of AL/CVL were scanned serially with MRI. General linear models were used to determine the association between skin breaks and thalamic volumes, accounting for clinical confounders and site differences. Children were assessed at preschool age on standardized tests of motor and cognitive function. Outcome scores were assessed in relation to neonatal thalamic growth. RESULTS Prolonged AL/CVL use in neonates (n = 86) was associated with fewer skin breaks (median 34) during the hospital stay compared to restricted AL/CVL use (n = 57, median 91, 95% confidence interval [CI] 60.35-84.89). Neonates with prolonged AL/CVL use with fewer skin breaks had significantly larger thalamic volumes early in life compared to neonates with restricted line use (B = 121.8, p = 0.001, 95% CI 48.48-195.11). Neonatal thalamic growth predicted preschool-age cognitive (B = 0.001, 95% CI 0.0003-0.001, p = 0.002) and motor scores (B = 0.01, 95% CI 0.001-0.10, p = 0.02). Prolonged AL/CVL use was not associated with greater incidence of sepsis or multiple infections. CONCLUSIONS Prolonged AL/CVL use in preterm neonates may provide an unprecedented opportunity to reduce invasive procedures in preterm neonates. Pain reduction in very preterm neonates is associated with optimal thalamic growth and neurodevelopment.
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Affiliation(s)
- Emma G Duerden
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Ruth E Grunau
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Vann Chau
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Floris Groenendaal
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Ting Guo
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - M Mallar Chakravarty
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Manon Benders
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Nienke Wagenaar
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Rian Eijsermans
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Corine Koopman
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Anne Synnes
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Linda de Vries
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Steven P Miller
- From the Department of Paediatrics (E.G.D., V.C., T.G., S.P.M.), the Hospital for Sick Children and the University of Toronto; Faculty of Education (E.G.D.), Western University, London; Department of Pediatrics (R.E.G., A.S.), University of British Columbia, Vancouver, Canada; Department of Neonatology (F.G., M.B., N.W., C.K., L.d.V.), Utrecht Brain Center (F.G., M.B., L.d.V.), and Child Development and Exercise Center (R.E.), University Medical Center Utrecht, Utrecht University, the Netherlands; Cerebral Imaging Centre (M.M.C.), Douglas Institute, Verdun; and Departments of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada.
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12
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Mechanical Ventilation Duration, Brainstem Development, and Neurodevelopment in Children Born Preterm: A Prospective Cohort Study. J Pediatr 2020; 226:87-95.e3. [PMID: 32454115 DOI: 10.1016/j.jpeds.2020.05.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/22/2020] [Accepted: 05/18/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To determine, in children born preterm, the association of mechanical ventilation duration with brainstem development, white matter maturation, and neurodevelopmental outcomes at preschool age. STUDY DESIGN This prospective cohort study included 144 neonates born at <30 weeks of gestation (75 male, mean gestational age 27.1 weeks, SD 1.6) with regional brainstem volumes automatically segmented on magnetic resonance imaging at term-equivalent age (TEA). The white matter maturation was assessed by diffusion tensor imaging and tract-based spatial statistics. Neurodevelopmental outcomes were assessed at 4.5 years of age using the Movement Assessment Battery for Children, 2nd Edition, and the Wechsler Primary and Preschool Scale of Intelligence, 4th Edition, full-scale IQ. The association between the duration of mechanical ventilation and brainstem development was validated in an independent cohort of children born very preterm. RESULTS Each additional day of mechanical ventilation predicted lower motor scores (0.5-point decrease in the Movement Assessment Battery for Children, 2nd Edition, score by day of mechanical ventilation, 95% CI -0.6 to -0.3, P < .0001). Prolonged exposure to mechanical ventilation was associated with smaller pons and medulla volumes at TEA in 2 independent cohorts, along with widespread abnormalities in white matter maturation. Pons and medulla volumes at TEA predicted motor outcomes at 4.5 years of age. CONCLUSIONS In neonates born very preterm, prolonged mechanical ventilation is associated with impaired brainstem development, abnormal white matter maturation, and lower motor scores at preschool age. Further research is needed to better understand the neural pathological mechanisms involved.
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13
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Garfinkle J, Guo T, Synnes A, Chau V, Branson HM, Ufkes S, Tam EWY, Grunau RE, Miller SP. Location and Size of Preterm Cerebellar Hemorrhage and Childhood Development. Ann Neurol 2020; 88:1095-1108. [PMID: 32920831 DOI: 10.1002/ana.25899] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/27/2020] [Accepted: 09/06/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine the association between cerebellar hemorrhage (CBH) size and location and preschool-age neurodevelopment in very preterm neonates. METHODS Preterm magnetic resonance images of 221 very preterm neonates (median gestational age = 27.9 weeks) were manually segmented for CBH quantification and location. Neurodevelopmental assessments at chronological age 4.5 years included motor (Movement Assessment Battery for Children, 2nd Edition [MABC-2]), visuomotor integration (Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition), cognitive (Wechsler Primary and Preschool Scale of Intelligence, 3rd Edition), and behavioral (Child Behavior Checklist) outcomes. Multivariable linear regression models examined the association between CBH size and 4.5-year outcomes accounting for sex, gestational age, and supratentorial injury. Probabilistic maps assessed CBH location and likelihood of a lesion to predict adverse outcome. RESULTS Thirty-six neonates had CBH: 14 (6%) with only punctate CBH and 22 (10%) with ≥1 larger CBH. CBH occurred mostly in the inferior aspect of the posterior lobes. CBH total volume was independently associated with MABC-2 motor scores at 4.5 years (β = -0.095, 95% confidence interval = -0.184 to -0.005), with a standardized β coefficient (-0.16) that was similar to that of white matter injury volume (standardized β = -0.22). CBH size was similarly associated with visuomotor integration and externalizing behavior but not cognition. Voxelwise odds ratio and lesion-symptom maps demonstrated that CBH extending more deeply into the cerebellum predicted adverse motor, visuomotor, and behavioral outcomes. INTERPRETATION CBH size and location on preterm magnetic resonance imaging were associated with reduced preschool motor and visuomotor function and more externalizing behavior independent of supratentorial brain injury in a dose-dependent fashion. The volumetric quantification and localization of CBH, even when punctate, may allow opportunity to improve motor and behavioral outcomes by providing targeted intervention. ANN NEUROL 2020;88:1095-1108.
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Affiliation(s)
- Jarred Garfinkle
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Ting Guo
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Anne Synnes
- Department of Paediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Vann Chau
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Helen M Branson
- Department of Radiology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Steven Ufkes
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Emily W Y Tam
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Ruth E Grunau
- Department of Paediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Steven P Miller
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
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14
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Decker AL, Duncan K, Finn AS, Mabbott DJ. Children's family income is associated with cognitive function and volume of anterior not posterior hippocampus. Nat Commun 2020; 11:4040. [PMID: 32788583 PMCID: PMC7423938 DOI: 10.1038/s41467-020-17854-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 07/13/2020] [Indexed: 11/09/2022] Open
Abstract
Children from lower income backgrounds tend to have poorer memory and language abilities than their wealthier peers. It has been proposed that these cognitive gaps reflect the effects of income-related stress on hippocampal structure, but the empirical evidence for this relationship has not been clear. Here, we examine how family income gaps in cognition relate to the anterior hippocampus, given its high sensitivity to stress, versus the posterior hippocampus. We find that anterior (but not posterior) hippocampal volumes positively correlate with family income up to an annual income of ~$75,000. Income-related differences in the anterior (but not posterior) hippocampus also predicted the strength of the gaps in memory and language. These findings add anatomical specificity to current theories by suggesting a stronger relationship between family income and anterior than posterior hippocampal volumes and offer a potential mechanism through which children from different income homes differ cognitively.
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Affiliation(s)
| | - Katherine Duncan
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Amy S Finn
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Donald J Mabbott
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada
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15
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Yaakub SN, Heckemann RA, Keller SS, McGinnity CJ, Weber B, Hammers A. On brain atlas choice and automatic segmentation methods: a comparison of MAPER & FreeSurfer using three atlas databases. Sci Rep 2020; 10:2837. [PMID: 32071355 PMCID: PMC7028906 DOI: 10.1038/s41598-020-57951-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 11/27/2019] [Indexed: 11/09/2022] Open
Abstract
Several automatic image segmentation methods and few atlas databases exist for analysing structural T1-weighted magnetic resonance brain images. The impact of choosing a combination has not hitherto been described but may bias comparisons across studies. We evaluated two segmentation methods (MAPER and FreeSurfer), using three publicly available atlas databases (Hammers_mith, Desikan-Killiany-Tourville, and MICCAI 2012 Grand Challenge). For each combination of atlas and method, we conducted a leave-one-out cross-comparison to estimate the segmentation accuracy of FreeSurfer and MAPER. We also used each possible combination to segment two datasets of patients with known structural abnormalities (Alzheimer's disease (AD) and mesial temporal lobe epilepsy with hippocampal sclerosis (HS)) and their matched healthy controls. MAPER was better than FreeSurfer at modelling manual segmentations in the healthy control leave-one-out analyses in two of the three atlas databases, and the Hammers_mith atlas database transferred to new datasets best regardless of segmentation method. Both segmentation methods reliably identified known abnormalities in each patient group. Better separation was seen for FreeSurfer in the AD and left-HS datasets, and for MAPER in the right-HS dataset. We provide detailed quantitative comparisons for multiple anatomical regions, thus enabling researchers to make evidence-based decisions on their choice of atlas and segmentation method.
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Affiliation(s)
- Siti Nurbaya Yaakub
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Rolf A Heckemann
- MedTech West at Sahlgrenska University Hospital Gothenburg, Gothenburg, Sweden
- Department of Radiation Physics, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden
- Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Simon S Keller
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Colm J McGinnity
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Bernd Weber
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Alexander Hammers
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.
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16
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Tam EWY, Chau V, Lavoie R, Chakravarty MM, Guo T, Synnes A, Zwicker J, Grunau R, Miller SP. Neurologic Examination Findings Associated With Small Cerebellar Volumes After Prematurity. J Child Neurol 2019; 34:586-592. [PMID: 31111765 DOI: 10.1177/0883073819847925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To help clinicians understand what to expect from small cerebellar volumes after prematurity, this study aims to characterize the specific impacts of small cerebellar volumes on the infant neurologic examination. A prospective cohort of preterm newborns (<32 weeks' gestational age) had brain magnetic resonance imaging (MRI) studies at term-equivalent age. Cerebellar volumes were compared with neurologic examination findings in follow-up, adjusting for severity of intraventricular hemorrhage, white matter injury, and cerebellar hemorrhage. Deformation-based analyses delineated regional morphometric differences in the cerebellum associated with these findings. Of 119 infants with MRI scans, 109 (92%) had follow-up at 19.0±1.7 months corrected age. Smaller cerebellar volume at term was associated with increased odds of truncal hypotonia, postural instability on standing, and patellar hyperreflexia (P < .03). Small cerebellar volume defined as <19 cm3 by 40 weeks was associated with 7.5-fold increased odds of truncal hypotonia (P < .001), 8.9-fold odds postural instability (P < .001), and 9.7-fold odds of patellar hyperreflexia (P < .001). Voxel-based deformation-based morphometry showed postural instability associated with paravermian regions. Small cerebellar volume is associated with specific abnormalities on neurologic examination by 18 months of age, including truncal tone, reflexes, and postural stability.
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Affiliation(s)
- Emily W Y Tam
- 1 Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.,2 Department of Pediatrics, University of Toronto, Ontario, Canada
| | - Vann Chau
- 1 Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.,2 Department of Pediatrics, University of Toronto, Ontario, Canada
| | - Raphaël Lavoie
- 3 Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - M Mallar Chakravarty
- 3 Douglas Mental Health University Institute, Montreal, Quebec, Canada.,4 Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,5 Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Ting Guo
- 1 Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne Synnes
- 6 Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jill Zwicker
- 6 Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,7 Department of Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ruth Grunau
- 6 Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steven P Miller
- 1 Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.,2 Department of Pediatrics, University of Toronto, Ontario, Canada.,6 Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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17
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Chau CMY, Ranger M, Bichin M, Park MTM, Amaral RSC, Chakravarty M, Poskitt K, Synnes AR, Miller SP, Grunau RE. Hippocampus, Amygdala, and Thalamus Volumes in Very Preterm Children at 8 Years: Neonatal Pain and Genetic Variation. Front Behav Neurosci 2019; 13:51. [PMID: 30941021 PMCID: PMC6433974 DOI: 10.3389/fnbeh.2019.00051] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/01/2019] [Indexed: 01/09/2023] Open
Abstract
Altered hippocampal morphology and reduced volumes have been found in children born preterm compared to full-term. Stress inhibits neurogenesis in the hippocampus, and neonatal stress/noxious stimulation in rodent pups are associated with long-term alterations in hippocampal volumes. We have previously shown reduced cortical thickness and cerebellar volumes in relation to more exposure to pain-related stress of neonatal invasive procedures in children born very preterm. We have reported targeted gene-by-pain environment interactions that contribute to long-term brain development and outcomes in this population. We now aim to determine whether exposure to pain-related stress (adjusted for clinical factors and genotype) differentially impacts regional structures within the limbic system and thalamus, and investigate relationships with outcomes in very preterm children. Our study included 57 children born very preterm (<32 weeks GA) followed longitudinally from birth who underwent 3-D T1 MRI neuroimaging at ∼8 years. Hippocampal subfields and white matter tracts, thalamus and amygdala were automatically segmented using the MAGeT Brain algorithm. The relationship between those subcortical brain volumes (adjusted for total brain volume) and neonatal invasive procedures, gestational age (GA), illness severity, postnatal infection, days of mechanical ventilation, number of surgeries, morphine exposure, and genotype (COMT, SLC6A4, and BDNF) was examined using constrained principal component analysis. We found that neonatal clinical factors and genotypes accounted for 46% of the overall variance in volumes of hippocampal subregions, tracts, basal ganglia, thalamus and amygdala. After controlling for clinical risk factors and total brain volume, greater neonatal invasive procedures was associated with lower volumes in the amygdala and thalamus (p = 0.0001) and an interaction with COMT genotype predicted smaller hippocampal subregional volume (p = 0.0001). More surgeries, days of ventilation, and lower GA were also related to smaller volumes in various subcortical regions (p < 0.002). These reduced volumes were in turn differentially related to poorer cognitive, visual-motor and behavioral outcomes. Our findings highlight the complexity that interplays when examining how exposure to early-life stress may impact brain development both at the structural and functional level, and provide new insight on possible novel avenues of research to discover brain-protective treatments to improve the care of children born preterm.
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Affiliation(s)
- Cecil M Y Chau
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Manon Ranger
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.,School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Mark Bichin
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
| | - Min Tae M Park
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada.,Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Robert S C Amaral
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Kenneth Poskitt
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Anne R Synnes
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Steven P Miller
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Ruth E Grunau
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
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Schlichting ML, Mack ML, Guarino KF, Preston AR. Performance of semi-automated hippocampal subfield segmentation methods across ages in a pediatric sample. Neuroimage 2019; 191:49-67. [PMID: 30731245 DOI: 10.1016/j.neuroimage.2019.01.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/20/2018] [Accepted: 01/19/2019] [Indexed: 10/27/2022] Open
Abstract
Episodic memory function has been shown to depend critically on the hippocampus. This region is made up of a number of subfields, which differ in both cytoarchitectural features and functional roles in the mature brain. Recent neuroimaging work in children and adolescents has suggested that these regions may undergo different developmental trajectories-a fact that has important implications for how we think about learning and memory processes in these populations. Despite the growing research interest in hippocampal structure and function at the subfield level in healthy young adults, comparatively fewer studies have been carried out looking at subfield development. One barrier to studying these questions has been that manual segmentation of hippocampal subfields-considered by many to be the best available approach for defining these regions-is laborious and can be infeasible for large cross-sectional or longitudinal studies of cognitive development. Moreover, manual segmentation requires some subjectivity and is not impervious to bias or error. In a developmental sample of individuals spanning 6-30 years, we assessed the degree to which two semi-automated segmentation approaches-one approach based on Automated Segmentation of Hippocampal Subfields (ASHS) and another utilizing Advanced Normalization Tools (ANTs)-approximated manual subfield delineation on each individual by a single expert rater. Our main question was whether performance varied as a function of age group. Across several quantitative metrics, we found negligible differences in subfield validity across the child, adolescent, and adult age groups, suggesting that these methods can be reliably applied to developmental studies. We conclude that ASHS outperforms ANTs overall and is thus preferable for analyses carried out in individual subject space. However, we underscore that ANTs is also acceptable and may be well-suited for analyses requiring normalization to a single group template (e.g., voxelwise analyses across a wide age range). Previous work has supported the use of such methods in healthy young adults, as well as several special populations such as older adults and those suffering from mild cognitive impairment. Our results extend these previous findings to show that ASHS and ANTs can also be used in pediatric populations as young as six.
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Affiliation(s)
- Margaret L Schlichting
- Center for Learning and Memory, The University of Texas at Austin, USA; Department of Psychology, University of Toronto, Canada.
| | - Michael L Mack
- Center for Learning and Memory, The University of Texas at Austin, USA; Department of Psychology, University of Toronto, Canada
| | | | - Alison R Preston
- Center for Learning and Memory, The University of Texas at Austin, USA; Department of Psychology, The University of Texas at Austin, USA; Department of Neuroscience, The University of Texas at Austin, USA
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19
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Annink KV, de Vries LS, Groenendaal F, van den Heuvel MP, van Haren NEM, Swaab H, van Handel M, Jongmans MJ, Benders MJ, van der Aa NE. The long-term effect of perinatal asphyxia on hippocampal volumes. Pediatr Res 2019; 85:43-49. [PMID: 30254237 DOI: 10.1038/s41390-018-0115-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/20/2018] [Accepted: 06/22/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Hypoxic-ischemic encephalopathy (HIE) in term-born infants can lead to memory problems. The hippocampus is important for long-term episodic memory. The primary aim was to investigate the effect of HIE on hippocampal volumes in 9- to 10-year-old children. The secondary aim was to investigate the association between hippocampal volumes and previously found impaired memory and cognitive functions in the current cohort. METHODS In total 26 children with mild HIE, 26 with moderate HIE, and 37 controls were included. The intelligence quotient (IQ) and memory were tested. A 3D-volumetric MRI was obtained. Brain segmentation was performed for hippocampal volumes and intracranial volume. The differences in hippocampal volumes, memory, and IQ between the groups were determined. Multivariable linear regression analyses were performed, including hippocampal volume as a percentage of intracranial volume as a dependent variable. RESULTS Smaller hippocampal volumes were found in moderate HIE (p < 0.001), with a trend toward smaller volumes in mild HIE, compared to controls. In multivariable linear regression analysis, hippocampal volume as a percentage of intracranial volume was significantly associated with long-term visuospatial memory. CONCLUSION Children with moderate HIE had smaller hippocampal volumes than controls, with a trend toward smaller volumes following mild HIE. Reduced hippocampal volumes were associated with poorer long-term visuospatial memory.
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Affiliation(s)
- Kim V Annink
- Department of Neonatology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Linda S de Vries
- Department of Neonatology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Floris Groenendaal
- Department of Neonatology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Martijn P van den Heuvel
- Connectome Lab, Department of Complex Traits Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Genetics, VU Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent studies, University Leiden, Leiden, The Netherlands
| | - Mariëlle van Handel
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marian J Jongmans
- Department of Neonatology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Education & Pedagogy, Utrecht University, Utrecht, The Netherlands
| | - Manon J Benders
- Department of Neonatology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Niek E van der Aa
- Department of Neonatology, Brain Center Rudolf Magnus, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
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20
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Caravaggio F, Plavén-Sigray P, Matheson GJ, Plitman E, Chakravarty MM, Borg J, Graff-Guerrero A, Cervenka S. Trait impulsivity is not related to post-commissural putamen volumes: A replication study in healthy men. PLoS One 2018; 13:e0209584. [PMID: 30571791 PMCID: PMC6301704 DOI: 10.1371/journal.pone.0209584] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 12/07/2018] [Indexed: 01/18/2023] Open
Abstract
High levels of trait impulsivity are considered a risk factor for substance abuse and drug addiction. We recently found that non-planning trait impulsivity was negatively correlated with post-commissural putamen volumes in men, but not women, using the Karolinska Scales of Personality (KSP). Here, we attempted to replicate this finding in an independent sample using an updated version of the KSP: the Swedish Universities Scales of Personality (SSP). Data from 88 healthy male participants (Mean Age: 28.16±3.34), who provided structural T1-weighted magnetic resonance images (MRIs) and self-reported SSP impulsivity scores, were analyzed. Striatal sub-region volumes were acquired using the Multiple Automatically Generated Templates (MAGeT-Brain) algorithm. Contrary to our previous findings trait impulsivity measured using SSP was not a significant predictor of post-commissural putamen volumes (β = .14, df = 84, p = .94). A replication Bayes Factors analysis strongly supported this null result. Consistent with our previous findings, secondary exploratory analyses found no relationship between ventral striatum volumes and SSP trait impulsivity (β = -.05, df = 84, p = .28). An exploratory analysis of the other striatal compartments showed that there were no significant associations with trait impulsivity. While we could not replicate our previous findings in the current sample, we believe this work will aide future studies aimed at establishing meaningful brain biomarkers for addiction vulnerability in healthy humans.
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Affiliation(s)
- Fernando Caravaggio
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Pontus Plavén-Sigray
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE, Stockholm, Sweden
| | - Granville James Matheson
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE, Stockholm, Sweden
| | - Eric Plitman
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - M. Mallar Chakravarty
- Department of Biological & Biomedical Engineering, McGill University, Montreal, Quebec, Canada
- Cerebral Imaging Centre, Douglas Mental Health Institute, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Jacqueline Borg
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE, Stockholm, Sweden
| | - Ariel Graff-Guerrero
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Simon Cervenka
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE, Stockholm, Sweden
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21
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Herten A, Konrad K, Krinzinger H, Seitz J, von Polier GG. Accuracy and bias of automatic hippocampal segmentation in children and adolescents. Brain Struct Funct 2018; 224:795-810. [DOI: 10.1007/s00429-018-1802-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 11/24/2018] [Indexed: 11/30/2022]
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White matter injury predicts disrupted functional connectivity and microstructure in very preterm born neonates. NEUROIMAGE-CLINICAL 2018; 21:101596. [PMID: 30458986 PMCID: PMC6411591 DOI: 10.1016/j.nicl.2018.11.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 10/26/2018] [Accepted: 11/12/2018] [Indexed: 11/28/2022]
Abstract
Objective To determine whether the spatial extent and location of early-identified punctate white matter injury (WMI) is associated with regionally-specific disruptions in thalamocortical-connectivity in very-preterm born neonates. Methods 37 very-preterm born neonates (median gestational age: 28.1 weeks; interquartile range [IQR]: 27–30) underwent early MRI (median age 32.9 weeks; IQR: 32–35), and WMI was identified in 13 (35%) neonates. Structural T1-weighted, resting-state functional Magnetic Resonance Imaging (rs-fMRI, n = 34) and Diffusion Tensor Imaging (DTI, n = 31) sequences were acquired using 3 T-MRI. A probabilistic map of WMI was developed for the 13 neonates demonstrating brain injury. A neonatal atlas was applied to the WMI maps, rs-fMRI and DTI analyses to extract volumetric, functional and microstructural data from regionally-specific brain areas. Associations of thalamocortical-network strength and alterations in fractional anisotropy (FA, a measure of white-matter microstructure) with WMI volume were assessed in general linear models, adjusting for age at scan and cerebral volumes. Results WMI volume in the superior (β = −0.007; p = .02) and posterior corona radiata (β = −0.01; p = .01), posterior thalamic radiations (β = −0.01; p = .005) and superior longitudinal fasciculus (β = −0.02; p = .001) was associated with reduced connectivity strength between thalamus and parietal resting-state networks. WMI volume in the left (β = −0.02; p = .02) and right superior corona radiata (β = −0.03; p = .008), left posterior corona radiata (β = −0.03; p = .01), corpus callosum (β = −0.11; p < .0001) and right superior longitudinal fasciculus (β = −0.02; p = .02) was associated with functional connectivity strength between thalamic and sensorimotor networks. Increased WMI volume was also associated with decreased FA values in the corpus callosum (β = −0.004, p = .015). Conclusions Regionally-specific alterations in early functional and structural network complexity resulting from WMI may underlie impaired outcomes. Lesions in white matter pathways predicted altered functional connectivity. White matter lesions predicted alterations in white matter microstructure. Findings of lesion location and size were regionally-specific. White matter lesion size and location may underlie later delays in development.
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23
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Schneider J, Fischer Fumeaux CJ, Duerden EG, Guo T, Foong J, Graz MB, Hagmann P, Chakravarty MM, Hüppi PS, Beauport L, Truttmann AC, Miller SP. Nutrient Intake in the First Two Weeks of Life and Brain Growth in Preterm Neonates. Pediatrics 2018; 141:peds.2017-2169. [PMID: 29440285 DOI: 10.1542/peds.2017-2169] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Optimizing early nutritional intake in preterm neonates may promote brain health and neurodevelopment through enhanced brain maturation. Our objectives were (1) to determine the association of energy and macronutrient intake in the first 2 weeks of life with regional and total brain growth and white matter (WM) maturation, assessed by 3 serial MRI scans in preterm neonates; (2) to examine how critical illness modifies this association; and (3) to investigate the relationship with neurodevelopmental outcomes. METHODS Forty-nine preterm neonates (21 boys, median [interquartile range] gestational age: 27.6 [2.3] weeks) were scanned serially at the following median postmenstrual weeks: 29.4, 31.7, and 41. The total brain, basal nuclei, and cerebellum were semiautomatically segmented. Fractional anisotropy was extracted from diffusion tensor imaging data. Nutritional intake from day of life 1 to 14 was monitored and clinical factors were collected. RESULTS Greater energy and lipid intake predicted increased total brain and basal nuclei volumes over the course of neonatal care to term-equivalent age. Similarly, energy and lipid intake were significantly associated with fractional anisotropy values in selected WM tracts. The association of ventilation duration with smaller brain volumes was attenuated by higher energy intake. Brain growth predicted psychomotor outcome at 18 months' corrected age. CONCLUSIONS In preterm neonates, greater energy and enteral feeding during the first 2 weeks of life predicted more robust brain growth and accelerated WM maturation. The long-lasting effect of early nutrition on neurodevelopment may be mediated by enhanced brain growth. Optimizing nutrition in preterm neonates may represent a potential avenue to mitigate the adverse brain health consequences of critical illness.
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Affiliation(s)
- Juliane Schneider
- Department of Paediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Canada.,Department of Woman-Mother-Child, Clinic of Neonatology and
| | | | - Emma G Duerden
- Department of Paediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | - Ting Guo
- Department of Paediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | - Justin Foong
- Department of Paediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | | | - Patric Hagmann
- Department of Radiology, Clinic of Neuroradiology, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - M Mallar Chakravarty
- Douglas Mental Health University Institute, Montreal, Canada.,Departments of Psychiatry and Biological and Biomedical Engineering, McGill University, Montreal, Canada; and
| | - Petra S Hüppi
- Division of Development and Growth, Department of Paediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Lydie Beauport
- Department of Woman-Mother-Child, Clinic of Neonatology and
| | | | - Steven P Miller
- Department of Paediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Canada;
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24
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Early Procedural Pain Is Associated with Regionally-Specific Alterations in Thalamic Development in Preterm Neonates. J Neurosci 2017; 38:878-886. [PMID: 29255007 DOI: 10.1523/jneurosci.0867-17.2017] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 11/17/2017] [Accepted: 11/22/2017] [Indexed: 02/01/2023] Open
Abstract
Very preterm human neonates are exposed to numerous invasive procedures as part of life-saving care. Evidence suggests that repetitive neonatal procedural pain precedes long-term alterations in brain development. However, to date the link between pain and brain development has limited temporal and anatomic specificity. We hypothesized that early exposure to painful stimuli during a period of rapid brain development, before pain modulatory systems reach maturity, will predict pronounced changes in thalamic development, and thereby cognitive and motor function. In a prospective cohort study, 155 very preterm neonates (82 males, 73 females) born 24-32 weeks' gestation underwent two MRIs at median postmenstrual ages 32 and 40 weeks that included structural, metabolic, and diffusion imaging. Detailed day-by-day clinical data were collected. Cognitive and motor abilities were assessed at 3 years, corrected age. The association of early (skin breaks, birth-Scan 1) and late pain (skin breaks, Scans 1-2) with thalamic volumes and N-acetylaspartate (NAA)/choline (Cho), and fractional anisotropy of white-matter pathways was assessed. Early pain was associated with slower thalamic macrostructural growth, most pronounced in extremely premature neonates. Deformation-based morphometry analyses confirmed early pain-related volume losses were localized to somatosensory regions. In extremely preterm neonates early pain was associated with decreased thalamic NAA/Cho and microstructural alterations in thalamocortical pathways. Thalamic growth was in turn related to cognitive and motor outcomes. We observed regionally-specific alterations in the lateral thalamus and thalamocortical pathways in extremely preterm neonates exposed to more procedural pain. Findings suggest a sensitive period leading to lasting alterations in somatosensory-system development.SIGNIFICANCE STATEMENT Early exposure to repetitive procedural pain in very preterm neonates may disrupt the development of regions involved in somatosensory processing, leading to poor functional outcomes. We demonstrate that early pain is associated with thalamic volume loss in the territory of the somatosensory thalamus and is accompanied by disruptions thalamic metabolic growth and thalamocortical pathway maturation, particularly in extremely preterm neonates. Thalamic growth was associated with cognitive and motor outcome at 3 years corrected age. Findings provide evidence for a developmentally sensitive period whereby subcortical structures in young neonates may be most vulnerable to procedural pain. Furthermore, results suggest that the thalamus may play a key role underlying the association between neonatal pain and poor neurodevelopmental outcomes in these high-risk neonates.
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25
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Procedural pain and oral glucose in preterm neonates: brain development and sex-specific effects. Pain 2017; 159:515-525. [DOI: 10.1097/j.pain.0000000000001123] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Guo T, Duerden EG, Adams E, Chau V, Branson HM, Chakravarty MM, Poskitt KJ, Synnes A, Grunau RE, Miller SP. Quantitative assessment of white matter injury in preterm neonates: Association with outcomes. Neurology 2017; 88:614-622. [PMID: 28100727 DOI: 10.1212/wnl.0000000000003606] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 09/29/2016] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To quantitatively assess white matter injury (WMI) volume and location in very preterm neonates, and to examine the association of lesion volume and location with 18-month neurodevelopmental outcomes. METHODS Volume and location of WMI was quantified on MRI in 216 neonates (median gestational age 27.9 weeks) who had motor, cognitive, and language assessments at 18 months corrected age (CA). Neonates were scanned at 32.1 postmenstrual weeks (median) and 68 (31.5%) had WMI; of 66 survivors, 58 (87.9%) had MRI and 18-month outcomes. WMI was manually segmented and transformed into a common image space, accounting for intersubject anatomical variability. Probability maps describing the likelihood of a lesion predicting adverse 18-month outcomes were developed. RESULTS WMI occurs in a characteristic topology, with most lesions occurring in the periventricular central region, followed by posterior and frontal regions. Irrespective of lesion location, greater WMI volumes predicted poor motor outcomes (p = 0.001). Lobar regional analysis revealed that greater WMI volumes in frontal, parietal, and temporal lobes have adverse motor outcomes (all, p < 0.05), but only frontal WMI volumes predicted adverse cognitive outcomes (p = 0.002). To account for lesion location and volume, voxel-wise odds ratio (OR) maps demonstrate that frontal lobe lesions predict adverse cognitive and language development, with maximum odds ratios (ORs) of 78.9 and 17.5, respectively, while adverse motor outcomes are predicted by widespread injury, with maximum OR of 63.8. CONCLUSIONS The predictive value of frontal lobe WMI volume highlights the importance of lesion location when considering the neurodevelopmental significance of WMI. Frontal lobe lesions are of particular concern.
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Affiliation(s)
- Ting Guo
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Emma G Duerden
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Elysia Adams
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Vann Chau
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Helen M Branson
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - M Mallar Chakravarty
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Kenneth J Poskitt
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Anne Synnes
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Ruth E Grunau
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Steven P Miller
- From Neurosciences and Mental Health (T.G., E.G.D., V.C., S.P.M.), The Hospital for Sick Children Research Institute; Departments of Paediatrics (T.G., E.G.D., E.A., V.C., S.P.M.) and Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and the University of Toronto; Cerebral Imaging Centre (M.M.C.), Douglas Mental Health Research Institute, Verdun; Department of Psychiatry (M.M.C.) and Biological and Biomedical Engineering (M.M.C.), McGill University, Montreal; and Department of Pediatrics (K.J.P., A.S., R.E.G.), University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada.
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Bhagwat N, Pipitone J, Winterburn JL, Guo T, Duerden EG, Voineskos AN, Lepage M, Miller SP, Pruessner JC, Chakravarty MM. Manual-Protocol Inspired Technique for Improving Automated MR Image Segmentation during Label Fusion. Front Neurosci 2016; 10:325. [PMID: 27486386 PMCID: PMC4949270 DOI: 10.3389/fnins.2016.00325] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 06/28/2016] [Indexed: 01/08/2023] Open
Abstract
Recent advances in multi-atlas based algorithms address many of the previous limitations in model-based and probabilistic segmentation methods. However, at the label fusion stage, a majority of algorithms focus primarily on optimizing weight-maps associated with the atlas library based on a theoretical objective function that approximates the segmentation error. In contrast, we propose a novel method—Autocorrecting Walks over Localized Markov Random Fields (AWoL-MRF)—that aims at mimicking the sequential process of manual segmentation, which is the gold-standard for virtually all the segmentation methods. AWoL-MRF begins with a set of candidate labels generated by a multi-atlas segmentation pipeline as an initial label distribution and refines low confidence regions based on a localized Markov random field (L-MRF) model using a novel sequential inference process (walks). We show that AWoL-MRF produces state-of-the-art results with superior accuracy and robustness with a small atlas library compared to existing methods. We validate the proposed approach by performing hippocampal segmentations on three independent datasets: (1) Alzheimer's Disease Neuroimaging Database (ADNI); (2) First Episode Psychosis patient cohort; and (3) A cohort of preterm neonates scanned early in life and at term-equivalent age. We assess the improvement in the performance qualitatively as well as quantitatively by comparing AWoL-MRF with majority vote, STAPLE, and Joint Label Fusion methods. AWoL-MRF reaches a maximum accuracy of 0.881 (dataset 1), 0.897 (dataset 2), and 0.807 (dataset 3) based on Dice similarity coefficient metric, offering significant performance improvements with a smaller atlas library (< 10) over compared methods. We also evaluate the diagnostic utility of AWoL-MRF by analyzing the volume differences per disease category in the ADNI1: Complete Screening dataset. We have made the source code for AWoL-MRF public at: https://github.com/CobraLab/AWoL-MRF.
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Affiliation(s)
- Nikhil Bhagwat
- Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada; Cerebral Imaging Centre, Douglas Mental Health University InstituteVerdun, QC, Canada; Kimel Family Translational Imaging-Genetics Research Lab, Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthToronto, ON, Canada
| | - Jon Pipitone
- Kimel Family Translational Imaging-Genetics Research Lab, Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health Toronto, ON, Canada
| | - Julie L Winterburn
- Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada; Cerebral Imaging Centre, Douglas Mental Health University InstituteVerdun, QC, Canada; Kimel Family Translational Imaging-Genetics Research Lab, Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthToronto, ON, Canada
| | - Ting Guo
- Neurosciences and Mental Health, The Hospital for Sick Children Research InstituteToronto, ON, Canada; Department of Paediatrics, The Hospital for Sick Children and the University of TorontoToronto, ON, Canada
| | - Emma G Duerden
- Neurosciences and Mental Health, The Hospital for Sick Children Research InstituteToronto, ON, Canada; Department of Paediatrics, The Hospital for Sick Children and the University of TorontoToronto, ON, Canada
| | - Aristotle N Voineskos
- Kimel Family Translational Imaging-Genetics Research Lab, Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthToronto, ON, Canada; Department of Psychiatry, University of TorontoToronto, ON, Canada
| | - Martin Lepage
- Cerebral Imaging Centre, Douglas Mental Health University InstituteVerdun, QC, Canada; Department of Psychiatry, McGill UniversityMontreal, QC, Canada
| | - Steven P Miller
- Neurosciences and Mental Health, The Hospital for Sick Children Research InstituteToronto, ON, Canada; Department of Paediatrics, The Hospital for Sick Children and the University of TorontoToronto, ON, Canada
| | - Jens C Pruessner
- Cerebral Imaging Centre, Douglas Mental Health University InstituteVerdun, QC, Canada; McGill Centre for Studies in AgingMontreal, QC, Canada
| | - M Mallar Chakravarty
- Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada; Cerebral Imaging Centre, Douglas Mental Health University InstituteVerdun, QC, Canada; Department of Psychiatry, McGill UniversityMontreal, QC, Canada; Biological and Biomedical Engineering, McGill UniversityMontreal, QC, Canada
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Duerden EG, Guo T, Dodbiba L, Chakravarty MM, Chau V, Poskitt KJ, Synnes A, Grunau RE, Miller SP. Midazolam dose correlates with abnormal hippocampal growth and neurodevelopmental outcome in preterm infants. Ann Neurol 2016; 79:548-59. [DOI: 10.1002/ana.24601] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 12/22/2015] [Accepted: 01/02/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Emma G. Duerden
- Department of Paediatrics; Hospital for Sick Children and University of Toronto; Toronto Ontario
| | - Ting Guo
- Department of Paediatrics; Hospital for Sick Children and University of Toronto; Toronto Ontario
| | - Lorin Dodbiba
- Department of Paediatrics; Hospital for Sick Children and University of Toronto; Toronto Ontario
| | - M. Mallar Chakravarty
- Cerebral Imaging Centre; Douglas Mental Health University Institute; Montreal Quebec
- Departments of Psychiatry and Biomedical Engineering; McGill University; Montreal Quebec
| | - Vann Chau
- Department of Paediatrics; Hospital for Sick Children and University of Toronto; Toronto Ontario
- University of Toronto; Toronto Ontario
| | - Kenneth J. Poskitt
- Department of Pediatrics; University of British Columbia and Children's & Women's Health Centre of British Columbia, and Child & Family Research Institute; Vancouver British Columbia Canada
| | - Anne Synnes
- Department of Pediatrics; University of British Columbia and Children's & Women's Health Centre of British Columbia, and Child & Family Research Institute; Vancouver British Columbia Canada
| | - Ruth E. Grunau
- Department of Pediatrics; University of British Columbia and Children's & Women's Health Centre of British Columbia, and Child & Family Research Institute; Vancouver British Columbia Canada
| | - Steven P. Miller
- Department of Paediatrics; Hospital for Sick Children and University of Toronto; Toronto Ontario
- University of Toronto; Toronto Ontario
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