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de Groot ER, Wang X, Wojtal K, Janson E, Alderliesten T, Tataranno ML, Benders MJNL, Dudink J. Association between sleep stages and brain microstructure in preterm infants: Insights from DTI analysis. Sleep Med 2024; 121:336-342. [PMID: 39053129 DOI: 10.1016/j.sleep.2024.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/14/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024]
Abstract
STUDY OBJECTIVES The aim of this study was to investigate the relationship between sleep stages and neural microstructure - measured using diffusion tensor imaging - of the posterior limb of the internal capsule and corticospinal tract in preterm infants. METHODS A retrospective cohort of 50 preterm infants born between 24 + 4 and 29 + 3 weeks gestational age was included in the study. Sleep stages were continuously measured for 5-7 consecutive days between 29 + 0 and 31 + 6 weeks postmenstrual age using an in-house-developed, and recently published, automated sleep staging algorithm based on routinely measured heart rate and respiratory rate. Additionally, a diffusion tensor imaging scan was conducted at term equivalent age as part of standard care. Region of interest analysis of the posterior limb of the internal capsule was performed, and tractography was used to analyze the corticospinal tract. The association between sleep and white matter microstructure of the posterior limb of the internal capsule and corticospinal tract was examined using a multiple linear regression model, adjusted for potential confounders. RESULTS The results of the analyses revealed an interaction effect between sleep stage and days of invasive ventilation on the fractional anisotropy of the left and right posterior limb of the internal capsule (β = 0.04, FDR-adjusted p = 0.001 and β = 0.04, FDR-adjusted p = 0.02, respectively). Furthermore, an interaction effect between sleep stage and days of invasive ventilation was observed for the radial diffusivity of the mean of the left and right PLIC (β = -4.1e-05, FDR-adjusted p = 0.04). CONCLUSIONS Previous research has shown that, in very preterm infants, invasive ventilation has a negative effect on white matter tract maturation throughout the brain. A positive association between active sleep and white matter microstructure of the posterior limb of the internal capsule, may indicate a protective role of sleep in this vulnerable population.
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Affiliation(s)
- Eline R de Groot
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Xiaowan Wang
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Klaudia Wojtal
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Els Janson
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Thomas Alderliesten
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Maria Luisa Tataranno
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Manon J N L Benders
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jeroen Dudink
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
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Vanderhasselt T, Naeyaert M, Buls N, Allemeersch GJ, Raeymaeckers S, Raeymaekers H, Smeets N, Cools F, de Mey J, Dudink J. Synthetic magnetic resonance-based relaxometry and brain volume: cutoff values for predicting neurocognitive outcomes in very preterm infants. Pediatr Radiol 2024:10.1007/s00247-024-05981-x. [PMID: 38980354 DOI: 10.1007/s00247-024-05981-x] [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: 03/18/2024] [Revised: 06/20/2024] [Accepted: 06/23/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Early neurorehabilitation can enhance neurocognitive outcomes in very preterm infants (<32 weeks), and conventional magnetic resonance imaging (MRI) is commonly used to assess neonatal brain injury; however, the predictive value for neurodevelopmental delay is limited. Timely predictive quantitative biomarkers are needed to improve early identification and management of infants at risk of neurodevelopmental delay. OBJECTIVE To evaluate the potential of quantitative synthetic MRI measurements at term-equivalent age as predictive biomarkers of neurodevelopmental impairment and establish practical cutoff values to guide clinical decision-making. MATERIALS AND METHODS This retrospective study included 93 very preterm infants who underwent synthetic MRI at term-equivalent age between January 2017 and September 2020. Clinical outcomes were assessed using the Bayley-III scale of infant development (mean age 2.1 years). The predictive value for impaired development was analyzed using receiver operating characteristic curves for synthetic MRI-based volumetry and T1 and T2 relaxation measurements. RESULTS The T1 relaxation time in the posterior limb of the internal capsule was a potent predictor of severe (sensitivity, 92%; specificity, 80%; area under the curve (AUC), 0.91) and mild or severe (AUC, 0.75) developmental impairment. T2 relaxation time in the posterior limb of the internal capsule was a significant predictor of severe impairment (AUC, 0.76), whereas the brain parenchymal volume was a significant predictor of severe (AUC, 0.72) and mild or severe impairment (AUC, 0.71) outperforming the reported qualitative MRI scores (AUC, 0.66). CONCLUSION The proposed cutoff values for T1 relaxation time in the posterior limb of the internal capsule and for total brain volume measurements, derived from synthetic MRI, show promise as predictors of both mild and severe neurodevelopmental impairment in very preterm infants.
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Affiliation(s)
- Tim Vanderhasselt
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Maarten Naeyaert
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Nico Buls
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Gert-Jan Allemeersch
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Steven Raeymaeckers
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Hubert Raeymaekers
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Nathalie Smeets
- Department of Pediatric Neurology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Filip Cools
- Department of Neonatology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Johan de Mey
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
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Vaes JEG, Onstwedder SM, Trayford C, Gubbins E, Maas M, van Rijt SH, Nijboer CH. Modifying the Secretome of Mesenchymal Stem Cells Prolongs the Regenerative Treatment Window for Encephalopathy of Prematurity. Int J Mol Sci 2024; 25:6494. [PMID: 38928201 PMCID: PMC11203777 DOI: 10.3390/ijms25126494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/28/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Clinical treatment options to combat Encephalopathy of Prematurity (EoP) are still lacking. We, and others, have proposed (intranasal) mesenchymal stem cells (MSCs) as a potent therapeutic strategy to boost white matter repair in the injured preterm brain. Using a double-hit mouse model of diffuse white matter injury, we previously showed that the efficacy of MSC treatment was time dependent, with a significant decrease in functional and histological improvements after the postponement of cell administration. In this follow-up study, we aimed to investigate the mechanisms underlying this loss of therapeutic efficacy. Additionally, we optimized the regenerative potential of MSCs by means of genetic engineering with the transient hypersecretion of beneficial factors, in order to prolong the treatment window. Though the cerebral expression of known chemoattractants was stable over time, the migration of MSCs to the injured brain was partially impaired. Moreover, using a primary oligodendrocyte (OL) culture, we showed that the rescue of injured OLs was reduced after delayed MSC coculture. Cocultures of modified MSCs, hypersecreting IGF1, LIF, IL11, or IL10, with primary microglia and OLs, revealed a superior treatment efficacy over naïve MSCs. Additionally, we showed that the delayed intranasal administration of IGF1-, LIF-, or IL11-hypersecreting MSCs, improved myelination and the functional outcome in EoP mice. In conclusion, the impaired migration and regenerative capacity of intranasally applied MSCs likely underlie the observed loss of efficacy after delayed treatment. The intranasal administration of IGF1-, LIF-, or IL11-hypersecreting MSCs, is a promising optimization strategy to prolong the window for effective MSC treatment in preterm infants with EoP.
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Affiliation(s)
- Josine E. G. Vaes
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3508 AB Utrecht, The Netherlands
- Department of Neonatology, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3508 AB Utrecht, The Netherlands
| | - Suzanne M. Onstwedder
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3508 AB Utrecht, The Netherlands
| | - Chloe Trayford
- Department of Instructive Biomaterials Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Eva Gubbins
- Department of Instructive Biomaterials Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Mirjam Maas
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3508 AB Utrecht, The Netherlands
| | - Sabine H. van Rijt
- Department of Instructive Biomaterials Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Cora H. Nijboer
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3508 AB Utrecht, The Netherlands
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4
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Zhao H, Cai H, Liu M. Transformer based multi-modal MRI fusion for prediction of post-menstrual age and neonatal brain development analysis. Med Image Anal 2024; 94:103140. [PMID: 38461655 DOI: 10.1016/j.media.2024.103140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/23/2023] [Accepted: 03/05/2024] [Indexed: 03/12/2024]
Abstract
The brain development during the perinatal period is characterized by rapid changes in both structure and function, which have significant impact on the cognitive and behavioral abilities later in life. Accurate assessment of brain age is a crucial indicator for brain development maturity and can help predict the risk of neonatal pathology. However, evaluating neonatal brains using magnetic resonance imaging (MRI) is challenging due to its complexity, multi-dimension, and noise with subtle alterations. In this paper, we propose a multi-modal deep learning framework based on transformers for precise post-menstrual age (PMA) estimation and brain development analysis using T2-weighted structural MRI (T2-sMRI) and diffusion MRI (dMRI) data. First, we build a two-stream dense network to learn modality-specific features from T2-sMRI and dMRI of brain individually. Then, a transformer module based on self-attention mechanism integrates these features for PMA prediction and preterm/term classification. Finally, saliency maps on brain templates are used to enhance the interpretability of results. Our method is evaluated on the multi-modal MRI dataset of the developing Human Connectome Project (dHCP), which contains 592 neonates, including 478 term-born and 114 preterm-born subjects. The results demonstrate that our method achieves a 0.5-week mean absolute error (MAE) in PMA estimation for term-born subjects. Notably, preterm-born subjects exhibit delayed brain development, worsening with increasing prematurity. Our method also achieves 95% accuracy in classification of term-born and preterm-born subjects, revealing significant group differences.
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Affiliation(s)
- Haiyan Zhao
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Hongjie Cai
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Manhua Liu
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China; MoE Key Lab of Artificial Intelligence, AI Institute, Shanghai, China.
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5
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Jang YH, Ham J, Kasani PH, Kim H, Lee JY, Lee GY, Han TH, Kim BN, Lee HJ. Predicting 2-year neurodevelopmental outcomes in preterm infants using multimodal structural brain magnetic resonance imaging with local connectivity. Sci Rep 2024; 14:9331. [PMID: 38653988 DOI: 10.1038/s41598-024-58682-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
The neurodevelopmental outcomes of preterm infants can be stratified based on the level of prematurity. We explored brain structural networks in extremely preterm (EP; < 28 weeks of gestation) and very-to-late (V-LP; ≥ 28 and < 37 weeks of gestation) preterm infants at term-equivalent age to predict 2-year neurodevelopmental outcomes. Using MRI and diffusion MRI on 62 EP and 131 V-LP infants, we built a multimodal feature set for volumetric and structural network analysis. We employed linear and nonlinear machine learning models to predict the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) scores, assessing predictive accuracy and feature importance. Our findings revealed that models incorporating local connectivity features demonstrated high predictive performance for BSID-III subsets in preterm infants. Specifically, for cognitive scores in preterm (variance explained, 17%) and V-LP infants (variance explained, 17%), and for motor scores in EP infants (variance explained, 15%), models with local connectivity features outperformed others. Additionally, a model using only local connectivity features effectively predicted language scores in preterm infants (variance explained, 15%). This study underscores the value of multimodal feature sets, particularly local connectivity, in predicting neurodevelopmental outcomes, highlighting the utility of machine learning in understanding microstructural changes and their implications for early intervention.
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Affiliation(s)
- Yong Hun Jang
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Jusung Ham
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, 52242, USA
| | - Payam Hosseinzadeh Kasani
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Hyuna Kim
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Joo Young Lee
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Gang Yi Lee
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Tae Hwan Han
- Division of Neurology, Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Division of Children and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea.
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6
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França LGS, Ciarrusta J, Gale-Grant O, Fenn-Moltu S, Fitzgibbon S, Chew A, Falconer S, Dimitrova R, Cordero-Grande L, Price AN, Hughes E, O'Muircheartaigh J, Duff E, Tuulari JJ, Deco G, Counsell SJ, Hajnal JV, Nosarti C, Arichi T, Edwards AD, McAlonan G, Batalle D. Neonatal brain dynamic functional connectivity in term and preterm infants and its association with early childhood neurodevelopment. Nat Commun 2024; 15:16. [PMID: 38331941 PMCID: PMC10853532 DOI: 10.1038/s41467-023-44050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 11/28/2023] [Indexed: 02/10/2024] Open
Abstract
Brain dynamic functional connectivity characterises transient connections between brain regions. Features of brain dynamics have been linked to emotion and cognition in adult individuals, and atypical patterns have been associated with neurodevelopmental conditions such as autism. Although reliable functional brain networks have been consistently identified in neonates, little is known about the early development of dynamic functional connectivity. In this study we characterise dynamic functional connectivity with functional magnetic resonance imaging (fMRI) in the first few weeks of postnatal life in term-born (n = 324) and preterm-born (n = 66) individuals. We show that a dynamic landscape of brain connectivity is already established by the time of birth in the human brain, characterised by six transient states of neonatal functional connectivity with changing dynamics through the neonatal period. The pattern of dynamic connectivity is atypical in preterm-born infants, and associated with atypical social, sensory, and repetitive behaviours measured by the Quantitative Checklist for Autism in Toddlers (Q-CHAT) scores at 18 months of age.
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Affiliation(s)
- Lucas G S França
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Computer and Information Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Judit Ciarrusta
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Oliver Gale-Grant
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Sunniva Fenn-Moltu
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Sean Fitzgibbon
- Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, OX3 9DU, UK
| | - Andrew Chew
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Ralica Dimitrova
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, 28040, Madrid, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Anthony N Price
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Emer Hughes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Jonathan O'Muircheartaigh
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, UK
| | - Eugene Duff
- Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, OX3 9DU, UK
- Department of Brain Sciences, Imperial College London, London, W12 0BZ, UK
- UK Dementia Research Institute at Imperial College London, London, W12 0BZ, UK
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500, Turku, Finland
- Turku Collegium for Science and Medicine and Technology, University of Turku, 20500, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, 20500, Turku, Finland
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Pompeu Fabra University, 08002, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies, 08010, Barcelona, Spain
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany
- School of Psychological Sciences, Monash University, Melbourne, VIC, 3010, Australia
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, UK
- Department of Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, UK
| | - Grainne McAlonan
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Dafnis Batalle
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK.
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.
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Filippa M, Benis D, Adam-Darque A, Grandjean D, Hüppi PS. Preterm infants show an atypical processing of the mother's voice. Brain Cogn 2023; 173:106104. [PMID: 37949001 DOI: 10.1016/j.bandc.2023.106104] [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: 09/13/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
To understand the consequences of prematurity on language perception, it is fundamental to determine how atypical early sensory experience affects brain development. At term equivalent age, ten preterm and ten full-term newborns underwent high-density EEG during mother or stranger speech presentation, in the forward or backward order. A general group effect terms > preterms is evident in the theta frequency band, in the left temporal area, with preterms showing significant activation for strangers' and terms for the mother's voice. A significant group contrast in the low and high theta in the right temporal regions indicates higher activations for the stranger's voice in preterms. Finally, only full terms presented a late gamma band increase for the maternal voice, indicating a more mature brain response. EEG time-frequency analysis demonstrate that preterm infants are selectively responsive to stranger voices in both temporal hemispheres, and that they lack selective brain responses to their mother's forward voice.
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Affiliation(s)
- Manuela Filippa
- Division of Development and Growth, Child and Adolescent Department, Rue Willy-Donzé 1205 Genève, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, Department of Psychology and Educational Sciences, University of Geneva, Boulevard Carl-Vogt 101 Genève, Geneva, Switzerland.
| | - Damien Benis
- Division of Development and Growth, Child and Adolescent Department, Rue Willy-Donzé 1205 Genève, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, Department of Psychology and Educational Sciences, University of Geneva, Boulevard Carl-Vogt 101 Genève, Geneva, Switzerland
| | - Alexandra Adam-Darque
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neuroscience, Division of Neurorehabilitation, University Hospital of Geneva and University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
| | - Didier Grandjean
- Swiss Center for Affective Sciences, Department of Psychology and Educational Sciences, University of Geneva, Boulevard Carl-Vogt 101 Genève, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Child and Adolescent Department, Rue Willy-Donzé 1205 Genève, University of Geneva, Geneva, Switzerland
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8
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Keles E, Bagci U. The past, current, and future of neonatal intensive care units with artificial intelligence: a systematic review. NPJ Digit Med 2023; 6:220. [PMID: 38012349 PMCID: PMC10682088 DOI: 10.1038/s41746-023-00941-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/05/2023] [Indexed: 11/29/2023] Open
Abstract
Machine learning and deep learning are two subsets of artificial intelligence that involve teaching computers to learn and make decisions from any sort of data. Most recent developments in artificial intelligence are coming from deep learning, which has proven revolutionary in almost all fields, from computer vision to health sciences. The effects of deep learning in medicine have changed the conventional ways of clinical application significantly. Although some sub-fields of medicine, such as pediatrics, have been relatively slow in receiving the critical benefits of deep learning, related research in pediatrics has started to accumulate to a significant level, too. Hence, in this paper, we review recently developed machine learning and deep learning-based solutions for neonatology applications. We systematically evaluate the roles of both classical machine learning and deep learning in neonatology applications, define the methodologies, including algorithmic developments, and describe the remaining challenges in the assessment of neonatal diseases by using PRISMA 2020 guidelines. To date, the primary areas of focus in neonatology regarding AI applications have included survival analysis, neuroimaging, analysis of vital parameters and biosignals, and retinopathy of prematurity diagnosis. We have categorically summarized 106 research articles from 1996 to 2022 and discussed their pros and cons, respectively. In this systematic review, we aimed to further enhance the comprehensiveness of the study. We also discuss possible directions for new AI models and the future of neonatology with the rising power of AI, suggesting roadmaps for the integration of AI into neonatal intensive care units.
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Affiliation(s)
- Elif Keles
- Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL, USA.
| | - Ulas Bagci
- Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL, USA
- Northwestern University, Department of Biomedical Engineering, Chicago, IL, USA
- Department of Electrical and Computer Engineering, Chicago, IL, USA
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9
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Crump C, Sundquist J, Sundquist K. Preterm or early term birth and risk of attention-deficit/hyperactivity disorder: a national cohort and co-sibling study. Ann Epidemiol 2023; 86:119-125.e4. [PMID: 37648179 PMCID: PMC10538375 DOI: 10.1016/j.annepidem.2023.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE To examine risks of attention-deficit/hyperactivity disorder (ADHD) in preterm and early term birth survivors, and potential sex-specific differences. METHODS A national cohort study was conducted of all 4061,795 singletons born in Sweden in 1973-2013 who survived infancy, followed up for ADHD identified from nationwide diagnoses and medications through 2018. Poisson regression was used to compute prevalence ratios (PRs), adjusting for sociodemographic and perinatal factors. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic or environmental) factors. RESULTS ADHD prevalences by gestational age at birth were 12.1% for extremely preterm (22-27 weeks), 7.0% for moderately preterm (28-33 weeks), 5.7% for late preterm (34-36 weeks), 6.1% for all preterm (<37 weeks), 5.2% for early term (37-38 weeks), and 4.5% for full-term (39-41 weeks). Adjusted PRs comparing extremely preterm, all preterm, or early term versus full-term, respectively, were 2.35 (95% CI, 2.15-2.57), 1.28 (1.25-1.31), and 1.12 (1.10-1.13) among males, and 2.46 (2.17-2.78), 1.24 (1.20-1.28), and 1.08 (1.06-1.10) among females (P < .001 for each). These associations were virtually unchanged after controlling for shared familial factors. Both spontaneous and medically indicated preterm birth were associated with ADHD (adjusted PRs, 1.21; 95% CI, 1.18-1.24; and 1.39; 1.34-1.43, respectively). CONCLUSIONS In this large cohort, preterm and early term birth were associated with increased risks of ADHD in males and females, independently of covariates and shared familial factors.
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Affiliation(s)
- Casey Crump
- Departments of Family Medicine and Community Health and of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden
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10
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Vanes L, Fenn-Moltu S, Hadaya L, Fitzgibbon S, Cordero-Grande L, Price A, Chew A, Falconer S, Arichi T, Counsell SJ, Hajnal JV, Batalle D, Edwards AD, Nosarti C. Longitudinal neonatal brain development and socio-demographic correlates of infant outcomes following preterm birth. Dev Cogn Neurosci 2023; 61:101250. [PMID: 37150083 PMCID: PMC10195853 DOI: 10.1016/j.dcn.2023.101250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/31/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023] Open
Abstract
Preterm birth results in premature exposure of the brain to the extrauterine environment during a critical period of neurodevelopment. Consequently, infants born preterm are at a heightened risk of adverse behavioural outcomes in later life. We characterise longitudinal development of neonatal regional brain volume and functional connectivity in the first weeks following preterm birth, sociodemographic factors, and their respective relationships to psychomotor outcomes and psychopathology in toddlerhood. We study 121 infants born preterm who underwent magnetic resonance imaging shortly after birth, at term-equivalent age, or both. Longitudinal regional brain volume and functional connectivity were modelled as a function of psychopathology and psychomotor outcomes at 18 months. Better psychomotor functioning in toddlerhood was associated with greater relative right cerebellar volume and a more rapid decrease over time of sensorimotor degree centrality in the neonatal period. In contrast, increased 18-month psychopathology was associated with a more rapid decrease in relative regional subcortical volume. Furthermore, while socio-economic deprivation was related to both psychopathology and psychomotor outcomes, cognitively stimulating parenting predicted psychopathology only. Our study highlights the importance of longitudinal imaging to better predict toddler outcomes following preterm birth, as well as disparate environmental influences on separable facets of behavioural development in this population.
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Affiliation(s)
- Lucy Vanes
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom.
| | - Sunniva Fenn-Moltu
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Sean Fitzgibbon
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Lucilio Cordero-Grande
- Biomedical Image Technologies, TelecomunicacionETSI Telecomunicación, Universidad Politécnica de Madrid & CIBER-BBN, ISCIII, Spain
| | - Anthony Price
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Andrew Chew
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, United Kingdom; Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Dafnis Batalle
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, United Kingdom
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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11
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Conole ELS, Vaher K, Cabez MB, Sullivan G, Stevenson AJ, Hall J, Murphy L, Thrippleton MJ, Quigley AJ, Bastin ME, Miron VE, Whalley HC, Marioni RE, Boardman JP, Cox SR. Immuno-epigenetic signature derived in saliva associates with the encephalopathy of prematurity and perinatal inflammatory disorders. Brain Behav Immun 2023; 110:322-338. [PMID: 36948324 DOI: 10.1016/j.bbi.2023.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/12/2023] [Accepted: 03/16/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Preterm birth is closely associated with a phenotype that includes brain dysmaturation and neurocognitive impairment, commonly termed Encephalopathy of Prematurity (EoP), of which systemic inflammation is considered a key driver. DNA methylation (DNAm) signatures of inflammation from peripheral blood associate with poor brain imaging outcomes in adult cohorts. However, the robustness of DNAm inflammatory scores in infancy, their relation to comorbidities of preterm birth characterised by inflammation, neonatal neuroimaging metrics of EoP, and saliva cross-tissue applicability are unknown. METHODS Using salivary DNAm from 258 neonates (n = 155 preterm, gestational age at birth 23.28 - 34.84 weeks, n = 103 term, gestational age at birth 37.00 - 42.14 weeks), we investigated the impact of a DNAm surrogate for C-reactive protein (DNAm CRP) on brain structure and other clinically defined inflammatory exposures. We assessed i) if DNAm CRP estimates varied between preterm infants at term equivalent age and term infants, ii) how DNAm CRP related to different types of inflammatory exposure (maternal, fetal and postnatal) and iii) whether elevated DNAm CRP associated with poorer measures of neonatal brain volume and white matter connectivity. RESULTS Higher DNAm CRP was linked to preterm status (-0.0107 ± 0.0008, compared with -0.0118 ± 0.0006 among term infants; p < 0.001), as well as perinatal inflammatory diseases, including histologic chorioamnionitis, sepsis, bronchopulmonary dysplasia, and necrotising enterocolitis (OR range |2.00 | to |4.71|, p < 0.01). Preterm infants with higher DNAm CRP scores had lower brain volume in deep grey matter, white matter, and hippocampi and amygdalae (β range |0.185| to |0.218|). No such associations were observed for term infants. Association magnitudes were largest for measures of white matter microstructure among preterms, where elevated epigenetic inflammation associated with poorer global measures of white matter integrity (β range |0.206| to |0.371|), independent of other confounding exposures. CONCLUSIONS Inflammatory-related DNAm captures the allostatic load of inflammatory burden in preterm infants. Such DNAm measures complement biological and clinical metrics when investigating the determinants of neurodevelopmental differences.
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Affiliation(s)
- Eleanor L S Conole
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK; Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK.
| | - Kadi Vaher
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Manuel Blesa Cabez
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Gemma Sullivan
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Anna J Stevenson
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Jill Hall
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Lee Murphy
- Edinburgh Clinical Research Facility, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Michael J Thrippleton
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK; Edinburgh Clinical Research Facility, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Alan J Quigley
- Imaging Department, Royal Hospital for Children and Young People, Edinburgh, EH16 4TJ, UK
| | - Mark E Bastin
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Veronique E Miron
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Heather C Whalley
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - James P Boardman
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK; MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Simon R Cox
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK.
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12
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Adrian J, Sawyer C, Bakeman R, Haist F, Akshoomoff N. Longitudinal Structural and Diffusion-Weighted Neuroimaging of Young Children Born Preterm. Pediatr Neurol 2023; 141:34-41. [PMID: 36773405 DOI: 10.1016/j.pediatrneurol.2022.12.008] [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: 01/17/2022] [Revised: 11/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Children born preterm are at risk for diffuse injury to subcortical gray and white matter. METHODS We used a longitudinal cohort study to examine the development of subcortical gray matter and white matter volumes, and diffusivity measures of white matter tracts following preterm birth. Our participants were 47 children born preterm (24 to 32 weeks gestational age) and 28 children born at term. None of the children born preterm had significant neonatal brain injury. Children received structural and diffusion weighted magnetic resonance imaging scans at ages five, six, and seven years. We examined volumes of amygdala, hippocampus, caudate nucleus, putamen, thalamus, brainstem, cerebellar white matter, intracranial space, and ventricles, and volumes, fractional anisotropy, and mean diffusivity of anterior thalamic radiation, cingulum, corticospinal tract, corpus callosum, inferior frontal occipital fasciculus, inferior longitudinal fasciculus, temporal and parietal superior longitudinal fasciculus, and uncinate fasciculus. RESULTS Children born preterm had smaller volumes of thalamus, brainstem, cerebellar white matter, cingulum, corticospinal tract, inferior frontal occipital fasciculus, uncinate fasciculus, and temporal superior longitudinal fasciculus, whereas their ventricles were larger compared with term-born controls. We found no significant effect of preterm birth on diffusivity measures. Despite developmental changes and growth, group differences were present and similarly strong at all three ages. CONCLUSION Even in the absence of significant neonatal brain injury, preterm birth has a persistent impact on early brain development. The lack of a significant term status by age interaction suggests a delayed developmental trajectory.
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Affiliation(s)
- Julia Adrian
- Department of Cognitive Science, University of California, San Diego, La Jolla, California; Center for Human Development, University of California, San Diego, La Jolla, California.
| | - Carolyn Sawyer
- Center for Human Development, University of California, San Diego, La Jolla, California; Department of Pediatrics, University of California, San Diego, La Jolla, California
| | - Roger Bakeman
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Frank Haist
- Center for Human Development, University of California, San Diego, La Jolla, California; Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Natacha Akshoomoff
- Center for Human Development, University of California, San Diego, La Jolla, California; Department of Psychiatry, University of California, San Diego, La Jolla, California
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13
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Mathewson KJ, Saigal S, Van Lieshout RJ, Schmidt LA. Intellectual functioning in survivors of extremely low birthweight: Cognitive outcomes in childhood and adolescence. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:186-204. [PMID: 36814136 DOI: 10.1111/jir.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/15/2021] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Infants born at extremely low birthweight (ELBW: ≤1000 g) are vulnerable to intellectual disabilities, but the factors that may distinguish between ELBW survivors with and without these impairments are not well understood. In this study, prospective associations between neonatal factors and functional outcomes in childhood and adolescence were compared in ELBW survivors with and without borderline intellectual functioning (BIF). METHODS Borderline intellectual functioning was defined by IQ < 85, assessed at 8 years. Among 146 ELBW survivors, 48 (33%) had IQ scores under 85, and 98 (67%) had scores equal to or over 85. Group differences in demographic and risk factors were assessed via t-test, chi-squared analysis or non-parametric tests. Neonatal factors that differed between ELBW groups were tested for association with adaptive behaviour assessed at age 5 years, and reading and arithmetic skills assessed at ages 8 and 15 years, using hierarchical regression models. RESULTS Extremely low birthweight survivors with BIF had significantly lower birthweights than ELBW survivors without BIF (790 vs. 855 g, P < 0.01) and were more likely to be born to mothers with lower socioeconomic status (SES) (78% vs. 48%, P < 0.01). These ELBW survivors also were more likely to be diagnosed with significant neurosensory impairment (NSI; 35% vs. 19%, P < 0.04), experienced more bronchopulmonary dysplasia (56% vs. 38%, P < 0.04), received more days of respiratory support (median 33 vs. 14 days, P < 0.01) and remained in hospital for longer periods (median 81 vs. 63 days, P < 0.03). Birthweight, familial SES, NSI and duration of respiratory support were significant predictors for one or more outcomes. Across groups, lower familial SES was associated with lower academic scores (Ps < 0.05), and NSI predicted lower adaptive functioning (Ps < 0.001). Other associations were moderated by group: among ELBW survivors with BIF, heavier birthweights predicted better arithmetic skills, the presence of NSI was associated with poorer arithmetic skills and more ventilation days predicted poorer reading skills. CONCLUSIONS At birth, ELBW survivors with BIF faced more physiological and social disadvantages and required more medical intervention than their ELBW peers without BIF. Smaller birth size, NSI burden and prolonged neonatal ventilatory support displayed gradients of risk for childhood and adolescent academic outcomes across groups. Whereas academic performance in ELBW survivors with BIF was sensitive to variation in birth size, NSI or ventilation days, ELBW survivors without BIF attained thresholds of intellectual ability that were sufficient to support higher levels of academic performance at both ages, regardless of their status on these factors. The findings are discussed in relation to Zigler's developmental theory of intellectual disability.
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Affiliation(s)
- K J Mathewson
- Child Emotion Lab, Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - S Saigal
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - R J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - L A Schmidt
- Child Emotion Lab, Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
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14
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The effect of mindfulness-based intervention on neurobehavioural functioning and its association with white-matter microstructural changes in preterm young adolescents. Sci Rep 2023; 13:2010. [PMID: 36737638 PMCID: PMC9898533 DOI: 10.1038/s41598-023-29205-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Very preterm (VPT) young adolescents are at high risk of executive, behavioural and socio-emotional difficulties. Previous research has shown significant evidence of the benefits of mindfulness-based intervention (MBI) on these abilities. This study aims to assess the association between the effects of MBI on neurobehavioral functioning and changes in white-matter microstructure in VPT young adolescents who completed an 8-week MBI program. Neurobehavioural assessments (i.e., neuropsychological testing, parents- and self-reported questionnaires) and multi-shell diffusion MRI were performed before and after MBI in 32 VPT young adolescents. Combined diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) measures were extracted on well-defined white matter tracts (TractSeg). A multivariate data-driven approach (partial least squares correlation) was used to explore associations between MBI-related changes on neurobehavioural measures and microstructural changes. The results showed an enhancement of global executive functioning using parent-reported questionnaire after MBI that was associated with a general pattern of increase in fractional anisotropy (FA) and decrease in axonal dispersion (ODI) in white-matter tracts involved in executive processes. Young VPT adolescents with lower gestational age at birth showed the greatest gain in white-matter microstructural changes after MBI.
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15
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Wang W, Yu Q, Liang W, Xu F, Li Z, Tang Y, Liu S. Altered cortical microstructure in preterm infants at term-equivalent age relative to term-born neonates. Cereb Cortex 2023; 33:651-662. [PMID: 35259759 DOI: 10.1093/cercor/bhac091] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/11/2022] [Accepted: 02/08/2022] [Indexed: 02/03/2023] Open
Abstract
Preterm (PT) birth is a potential factor for abnormal brain development. Although various alterations of cortical structure and functional connectivity in preterm infants have been reported, the underlying microstructural foundation is still undetected thoroughly in PT infants relative to full-term (FT) neonates. To detect the very early cortical microstructural alteration noninvasively with advanced neurite orientation dispersion and density imaging (NODDI) on a whole-brain basis, we used multi-shell diffusion MRI of healthy newborns selected from the Developing Human Connectome Project. 73 PT infants and 69 FT neonates scanned at term-equivalent age were included in this study. By extracting the core voxels of gray matter (GM) using GM-based spatial statistics (GBSS), we found that comparing to FT neonates, infants born preterm showed extensive lower neurite density in both primary and higher-order association cortices (FWE corrected, P < 0.025). Higher orientation dispersion was only found in very preterm subgroup in the orbitofrontal cortex, fronto-insular cortex, entorhinal cortex, a portion of posterior cingular gyrus, and medial parieto-occipital cortex. This study provided new insights into exploring structural MR for functional and behavioral variations in preterm population, and these findings may have marked clinical importance, particularly in the guidance of ameliorating the development of premature brain.
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Affiliation(s)
- Wenjun Wang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Qiaowen Yu
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Wenjia Liang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Feifei Xu
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Zhuoran Li
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Yuchun Tang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Shuwei Liu
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
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16
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Moser JJ, Archer DP, Walker AM, Rice TK, Dewey D, Lodha AK, McAllister DL. Association of sedation and anesthesia on cognitive outcomes in very premature infants: a retrospective observational study. Can J Anaesth 2023; 70:56-68. [PMID: 36536155 DOI: 10.1007/s12630-022-02353-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Cognitive outcomes in preterm infants may be adversely affected by use of sedation and anesthetic agents. We investigated the associations between anesthetics/sedatives and full-scale intelligence quotient (FSIQ) measured at 36 months corrected age (CA) in very preterm infants (born < 29 weeks gestational age). METHODS This retrospective cohort study included preterm infants born at < 29 weeks of gestation between 1 January 2006 and 31 December 2012, whose cognitive outcomes were assessed at 36 months CA. Imputed and complete case univariable and adjusted multivariable linear regressions were used to investigate the associations between FSIQ [standardized to mean (standard deviation) 100 (15)] and exposure to volatile anesthetics, propofol, benzodiazepines, barbiturates, and ketamine. These agents were the subject of a 2016 warning from regulatory authorities in the USA recommending caution for administration to children and pregnant women. RESULTS A total of 731 infants met the inclusion criteria. Unadjusted associations were -7 (95% confidence interval [CI], -10 to -4; P < 0.001) and -6 (95% CI, -10 to -3; P < 0.001) FSIQ points with exposure to warned medications using imputed and complete case analyses, respectively. Imputed and complete case adjusted associations between FSIQ and warned medications were -3 (95% CI, -7 to 0; P = 0.045) and -4 (95% CI, -8 to 0; P = 0.071) FSIQ points, respectively. Adjusted associations between volatile anesthetic exposure only and FSIQ were -3 (95% CI, -6 to 0; P = 0.072) and -5 (95% CI, -9 to -2; P = 0.004) FSIQ points using imputed and complete case data sets, respectively. FSIQ was not associated with opioid exposure. CONCLUSION Exposure of very preterm infants to anesthetics/sedatives on the United States Food and Drug Administration warning list was associated with a decrease in FSIQ points at 36 months CA. There was no association between opioid exposure and FSIQ.
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Affiliation(s)
- Joanna J Moser
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, South Health Campus, 4448 Front Street S.E, Calgary, AB, T3M 1M4, Canada.
| | - David P Archer
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, South Health Campus, 4448 Front Street S.E, Calgary, AB, T3M 1M4, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrew M Walker
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, South Health Campus, 4448 Front Street S.E, Calgary, AB, T3M 1M4, Canada
| | - Tiffany K Rice
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, South Health Campus, 4448 Front Street S.E, Calgary, AB, T3M 1M4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Deborah Dewey
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Owerko Center at the Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Abhay K Lodha
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Debbie L McAllister
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, South Health Campus, 4448 Front Street S.E, Calgary, AB, T3M 1M4, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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17
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Trousson C, Toumazi A, Bourmaud A, Biran V, Baud O. Neurocognitive outcomes at age 5 years after prophylactic hydrocortisone in infants born extremely preterm. Dev Med Child Neurol 2022. [PMID: 36417367 DOI: 10.1111/dmcn.15470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/24/2022]
Abstract
AIM To assess the 5-year neurocognitive outcomes of children born extremely preterm exposed to prophylactic hydrocortisone to improve survival without bronchopulmonary dysplasia. METHOD This was a prespecified secondary analysis of the PREMILOC clinical trial (trial registration: EudraCT no. 2007-002041-20, NCT00623740). The primary outcome was full-scale IQ based on the Wechsler Preschool and Primary Scale of Intelligence. RESULTS Among 109 surviving children recruited at the Robert Debré Children's Hospital, Paris, outcome data were available for 42 out of 56 infants (75%) in the group treated with hydrocortisone and 41 out of 53 (77%) in the placebo group. Mean scores were not significantly different between the two groups on full-scale IQ (hydrocortisone: 91.9 [SD = 13.9], placebo: 86.3 [SD = 15.4]; mean difference = 5.7, 95% confidence interval [CI] = -1.0 to 12.3, p = 0.10); however, working memory and retention ability were significantly better in the group treated with hydrocortisone. In a multivariate logistic regression including potential confounding variables, hydrocortisone treatment was significantly associated with a greater chance to survive at 5 years of age with a full-scale IQ equal to or greater than 90 compared to placebo (adjusted odds ratio = 4.26, 95% CI = 1.47-12.36, p = 0.008). INTERPRETATION This exploratory analysis provides reassuring data regarding the long-term neurodevelopmental safety of prophylactic hydrocortisone in infants born extremely preterm.
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Affiliation(s)
- Clémence Trousson
- Assistance Publique-Hôpitaux de Paris, Neonatal Intensive Care Unit, Robert Debré Children's Hospital, Paris, France
| | - Artemis Toumazi
- Assistance Publique-Hôpitaux de Paris, Unit of Clinical Epidemiology, Robert Debré Children's Hospital, University of Paris, Institut National de la Santé et de la Recherche Médicale U1123 and CIC-EC 1426, Paris, France
| | - Aurélie Bourmaud
- Assistance Publique-Hôpitaux de Paris, Unit of Clinical Epidemiology, Robert Debré Children's Hospital, University of Paris, Institut National de la Santé et de la Recherche Médicale U1123 and CIC-EC 1426, Paris, France
| | - Valérie Biran
- Assistance Publique-Hôpitaux de Paris, Neonatal Intensive Care Unit, Robert Debré Children's Hospital, Paris, France.,Institut National de la Santé et de la Recherche Médicale U1141, University of Paris, Paris, France
| | - Olivier Baud
- Institut National de la Santé et de la Recherche Médicale U1141, University of Paris, Paris, France.,Division of Neonatology and Pediatric Intensive Care, Children's University Hospital of Geneva and University of Geneva, Geneva, Switzerland
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Tsujimura K, Shiohama T, Takahashi E. microRNA Biology on Brain Development and Neuroimaging Approach. Brain Sci 2022; 12:brainsci12101366. [PMID: 36291300 PMCID: PMC9599180 DOI: 10.3390/brainsci12101366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/22/2022] Open
Abstract
Proper brain development requires the precise coordination and orchestration of various molecular and cellular processes and dysregulation of these processes can lead to neurological diseases. In the past decades, post-transcriptional regulation of gene expression has been shown to contribute to various aspects of brain development and function in the central nervous system. MicroRNAs (miRNAs), short non-coding RNAs, are emerging as crucial players in post-transcriptional gene regulation in a variety of tissues, such as the nervous system. In recent years, miRNAs have been implicated in multiple aspects of brain development, including neurogenesis, migration, axon and dendrite formation, and synaptogenesis. Moreover, altered expression and dysregulation of miRNAs have been linked to neurodevelopmental and psychiatric disorders. Magnetic resonance imaging (MRI) is a powerful imaging technology to obtain high-quality, detailed structural and functional information from the brains of human and animal models in a non-invasive manner. Because the spatial expression patterns of miRNAs in the brain, unlike those of DNA and RNA, remain largely unknown, a whole-brain imaging approach using MRI may be useful in revealing biological and pathological information about the brain affected by miRNAs. In this review, we highlight recent advancements in the research of miRNA-mediated modulation of neuronal processes that are important for brain development and their involvement in disease pathogenesis. Also, we overview each MRI technique, and its technological considerations, and discuss the applications of MRI techniques in miRNA research. This review aims to link miRNA biological study with MRI analytical technology and deepen our understanding of how miRNAs impact brain development and pathology of neurological diseases.
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Affiliation(s)
- Keita Tsujimura
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Group of Brain Function and Development, Nagoya University Neuroscience Institute of the Graduate School of Science, Nagoya 4648602, Japan
- Research Unit for Developmental Disorders, Institute for Advanced Research, Nagoya University, Nagoya 4648602, Japan
- Correspondence: (K.T.); (E.T.)
| | - Tadashi Shiohama
- Department of Pediatrics, Chiba University Hospital, Chiba 2608677, Japan
| | - Emi Takahashi
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Correspondence: (K.T.); (E.T.)
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Balance Rehabilitation Approach by Bobath and Vojta Methods in Cerebral Palsy: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101481. [PMID: 36291417 PMCID: PMC9600654 DOI: 10.3390/children9101481] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022]
Abstract
In cerebral palsy (CP) the basis for rehabilitation comes from neuroplasticity. One of the leading therapeutic approaches used in the management of CP is the NDT Bobath therapy and Vojta therapy consists in trying to program the ideal movement patterns for the age. The aim of our research was to analyze, from a functional point of view, the evolution of the biomechanical parameters characterizing the balance, in children with CP. The group of 12 subjects average age of 7 ± 3.28 years. The subject’s evaluation included a functional clinical evaluation by Berg pediatric scale and a biomechanical evaluation performed using the “Stabilometry footboard PoData 2.00” for evaluation the body weight distribution on the foot level. The rehabilitation program was developed based on two methods, NDT Bobath and Vojta. A 90-min physiotherapy session starts with a Vojta therapy activation, for 20 min. Between the two therapies there is a 10-min break, then the session continues with NDT Bobath exercises within the 3 physical exercises proposed for 60 min. 5 days per week, 6 months. The analysis of the data collected before and after the application of the rehabilitation program, regarding the using the Berg scale indicates a progress of 32.35%, (p = 0.0001 < 0.05) and the effect size is large. The evolution of the data that indicate the distribution of body weight at the level of the two lower limbs, at the two moments pre/post, evaluation. For left side a progress of 8.39%, (p = 0.027 < 0.05) but a small effect size of 0.86. For right side a progress of 10.36% (p = 0.027 < 0.05) and also a small effect size of 0.86. Analyzing the results, we find that there is a left-right rebalancing in most patients. The favorable results that were obtained by drawing up a physiotherapy program composed of the combination of the two Vojta and NDT Bobath methods are proof of the fact that both methods are based on the creation of a stimulating peripheral pressure, which, if maintained, generates an extended stereotyped motor response. A pattern of symmetrical muscle contraction is thus created and thus balance and postural control can be achieved. The left-right rebalancing, proven by the percentage distribution analysis of the weight at the lower segmental level, demonstrated that the body alignment approach through the Vojta method on the one hand and the inhibitory facilitating postures/exercises promoted by the NDT Bobath method, allows obtaining a symmetry.
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Sensory-based interventions in the NICU: systematic review of effects on preterm brain development. Pediatr Res 2022; 92:47-60. [PMID: 34508227 DOI: 10.1038/s41390-021-01718-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear. METHODS A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth. RESULTS Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions. CONCLUSIONS Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU. IMPACT This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development. Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice. This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.
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Youn J, Kim M, Park S, Kim JS, Park H, Cho JW. Pallidal Structural Changes Related to Levodopa-induced Dyskinesia in Parkinson's Disease. Front Aging Neurosci 2022; 14:781883. [PMID: 35601615 PMCID: PMC9120819 DOI: 10.3389/fnagi.2022.781883] [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: 09/23/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDespite the clinical impact of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD), the mechanism, especially the role of basal ganglia (BG), is not fully elucidated yet. We investigated the BG structural changes related to LID in PD using a surface-based shape analysis technique.MethodsWe recruited patients with PD who developed LID within 3 years (LID group, 28 patients) and who did not develop it after 7 years (non-LID group, 35 patients) from levodopa treatment for the extreme case-control study. BG structure volumes were measured using volumetry analysis and the surface-based morphometry feature (i.e., Jacobian) from the subcortical surface vertices. We compared the volume and Jacobian of meshes in the regions between the two groups. We also performed a correlation analysis between local atrophy and the severity of LID. Additionally, we evaluated structural connectivity profiles from globus pallidus interna and externa (GPi and GPe) to other brain structures based on the group comparison.ResultsThe demographic and clinical data showed no significant difference except for disease duration, treatment duration, parkinsonism severity, and levodopa equivalent dose. The LID group had more local atrophies of vertices in the right GPi than the non-LID group, despite no difference in volumes. Furthermore, the LID group demonstrated significantly reduced structural connectivity between left GPi and thalamus.ConclusionThis is the first demonstration of distinct shape alterations of basal ganglia structures, especially GPi, related to LID in PD. Considering both direct and indirect BG pathways share the connection between GPi and thalamus, the BG pathway plays a crucial role in the development of LID.
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Ana K, Iris ŽI, Nina P, Marina R, Tomislav Ć, Snježana S, Andrea B, Milan R, Ivica K. Linking integrity of visual pathways trajectories to visual behavior deficit in very preterm infants. Infant Behav Dev 2022; 67:101697. [DOI: 10.1016/j.infbeh.2022.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/05/2022]
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Beer RJ, Cnattingius S, Susser ES, Villamor E. Associations of preterm birth, small-for-gestational age, preeclampsia and placental abruption with attention-deficit/hyperactivity disorder in the offspring: Nationwide cohort and sibling-controlled studies. Acta Paediatr 2022; 111:1546-1555. [PMID: 35485179 PMCID: PMC9544732 DOI: 10.1111/apa.16375] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
Aim The aim of this study was to investigate preterm birth, small‐for‐gestational age (SGA), preeclampsia and placental abruption in relation to attention‐deficit/hyperactivity disorder (ADHD) in offspring. Methods We conducted a population‐based cohort study among non‐malformed live‐born singleton children in Sweden born during 2002–2014. Using national registries with recorded information, we followed 1,212,201 children for an ADHD diagnosis from 3 to 15 years. We compared ADHD rates between exposure categories using adjusted hazard ratios (HR) with 95% confidence intervals (CI) from Cox proportional hazards models. We also conducted sibling‐controlled analyses among 751,464 full siblings. Results There were 27,665 ADHD diagnoses in the cohort. Compared with term birth (≥37 weeks), adjusted HR (95% CI) for ADHD increased with decreasing gestational age: 1.18 (1.11, 1.25), 1.61 (1.37, 1.89) and 2.79 (2.23, 3.49) for 32–36 weeks, 28–31 weeks and 22–27 weeks. Both spontaneous and medically indicated preterm birth were associated with ADHD. SGA was related to 1.62 (1.49, 1.77) times higher ADHD incidence. Preeclampsia, but not placental abruption, was associated with ADHD. Sibling‐controlled analyses showed similar results. Preterm birth did not fully explain the associations of SGA or preeclampsia with ADHD. Conclusion Preterm birth, SGA and preeclampsia are related to ADHD incidence in offspring.
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Affiliation(s)
- Rachael J. Beer
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor Michigan USA
| | - Sven Cnattingius
- Division of Clinical Epidemiology Department of Medicine (Solna) Karolinska Institutet Stockholm Sweden
| | - Ezra S. Susser
- Department of Epidemiology Mailman School of Public Health Columbia University, and New York State Psychiatric Institute New York New York USA
| | - Eduardo Villamor
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor Michigan USA
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Kim HG, Choi JW, Lee JH, Jung DE, Gho SM. Association of Cerebral Blood Flow and Brain Tissue Relaxation Time With Neurodevelopmental Outcomes of Preterm Neonates: Multidelay Arterial Spin Labeling and Synthetic MRI Study. Invest Radiol 2022; 57:254-262. [PMID: 34743135 DOI: 10.1097/rli.0000000000000833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Both cerebral blood flow (CBF) and brain tissue relaxation times are known to reflect maturation in the neonatal brain. However, we do not yet know if these factors are associated with neurodevelopmental outcomes. The objective of this study was to acquire CBF and relaxation time in preterm neonates, using multidelay arterial spin labeling and synthetic magnetic resonance imaging (MRI), and show their association with later neurodevelopmental outcomes. MATERIALS AND METHODS In this prospective study, preterm neonates were recruited, and multidelay arterial spin labeling and synthetic MRI were performed between September 2017 and December 2018. These neonates underwent the Bayley Scales of Infant Development test at 18 months of age, and both cognitive and motor outcome scores were measured. Transit time-corrected CBF and T1 and T2 relaxation time values were measured for different brain regions. The measured values were correlated with gestational age (GA) at birth and corrected GA at the MRI scan. Simple and multiple linear regression analyses were performed for the measured values and neurodevelopmental outcome scores. RESULTS Forty-nine neonates (median [interquartile range] GA, 30 [2] weeks, 209 [17] days; 28 boys) underwent MRI scans at or near term-equivalent age (median [interquartile range] corrected GA, 37 [2] weeks, 258 [14] days). Transit time-corrected CBF (coefficient, 0.31-0.59) and relaxation time (coefficient, -0.39 to -0.86) values showed significant correlation with corrected GA but not with GA. After controlling for GA, the frontal white matter CBF in preterm neonates showed a negative relationship with cognitive outcome scores (β = -0.97; P = 0.029). Frontal white matter T1 relaxation times showed a positive relationship with cognitive outcome scores (β = 0.03; P = 0.025) after controlling for GA. CONCLUSIONS Higher CBF values and lower T1 relaxation times in frontal white matter were associated with poorer cognitive outcomes. As quantitative neuroimaging markers, CBF and relaxation times may help predict neurodevelopmental outcomes in preterm neonates.
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Affiliation(s)
| | | | - Jang Hoon Lee
- Pediatrics, Ajou University School of Medicine, Ajou University Medical Center, Suwon
| | - Da Eun Jung
- Pediatrics, Ajou University School of Medicine, Ajou University Medical Center, Suwon
| | - Sung-Min Gho
- MR Clinical Research and Development, GE Healthcare, Seoul, South Korea
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Perrone S, Lembo C, Gironi F, Petrolini C, Catalucci T, Corbo G, Buonocore G, Gitto E, Esposito SMR. Erythropoietin as a Neuroprotective Drug for Newborn Infants: Ten Years after the First Use. Antioxidants (Basel) 2022; 11:antiox11040652. [PMID: 35453337 PMCID: PMC9031072 DOI: 10.3390/antiox11040652] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 01/27/2023] Open
Abstract
Protective strategies against perinatal brain injury represent a major challenge for modern neonatology. Erythropoietin (Epo) enhances endogenous mechanisms of repair and angiogenesis. In order to analyse the newest evidence on the role of Epo in prematurity, hypoxic ischemic encephalopathy (HIE) and perinatal stroke, a critical review using 2020 PRISMA statement guidelines was conducted. This review uncovered 26 clinical trials examining the use of Epo for prematurity and brain injury-related outcomes. The effects of Epo on prematurity were analysed in 16 clinical trials. Erythropoietin was provided until 32–35 weeks of corrected postnatal age with a dosage between 500–3000 UI/kg/dose. Eight trials reported the Epo effects on HIE term newborn infants: Erythropoietin was administered in the first weeks of life, at different multiple doses between 250–2500 UI/kg/dose, as either an adjuvant therapy with hypothermia or a substitute for hypothermia. Two trials investigated Epo effects in perinatal stroke. Erythropoietin was administered at a dose of 1000 IU/kg for three days. No beneficial effect in improving morbidity was observed after Epo administration in perinatal stroke. A positive effect on neurodevelopmental outcome seems to occur when Epo is used as an adjuvant therapy with hypothermia in the HIE newborns. Administration of Epo in preterm infants still presents inconsistencies with regard to neurodevelopmental outcome. Clinical trials show significant differences mainly in target population and intervention scheme. The identification of specific markers and their temporal expression at different time of recovery after hypoxia-ischemia in neonates might be implemented to optimize the therapeutic scheme after hypoxic-ischemic injury in the developing brain. Additional studies on tailored regimes, accounting for the risk stratification of brain damage in newborns, are required.
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Affiliation(s)
- Serafina Perrone
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (C.P.); (S.M.R.E.)
- Correspondence:
| | - Chiara Lembo
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.L.); (F.G.); (T.C.); (G.C.); (G.B.)
| | - Federica Gironi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.L.); (F.G.); (T.C.); (G.C.); (G.B.)
| | - Chiara Petrolini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (C.P.); (S.M.R.E.)
| | - Tiziana Catalucci
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.L.); (F.G.); (T.C.); (G.C.); (G.B.)
| | - Giulia Corbo
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.L.); (F.G.); (T.C.); (G.C.); (G.B.)
| | - Giuseppe Buonocore
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.L.); (F.G.); (T.C.); (G.C.); (G.B.)
| | - Eloisa Gitto
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy;
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Nosko D, Strindberg M, Svoboda J, Kvanta H, Broström L, Padilla N, Mårtensson G, Örtqvist M, Moreira NC, Ådén U. Discrete white matter abnormalities at age 8-11 years in children born extremely preterm are not associated with adverse cognitive or motor outcomes. Acta Paediatr 2022; 111:566-575. [PMID: 34665877 DOI: 10.1111/apa.16158] [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: 05/03/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/27/2022]
Abstract
AIM Little is known about the prevalence of discrete white matter abnormalities (WMA) beyond the first years in children born extremely preterm (EPT) and the relation to neurodevelopmental outcomes. Our aim was to investigate the prevalence of discrete WMA in children born EPT and the relationship to neonatal white matter injuries (WMI), white matter (WM) volume, WM diffusivity and neurodevelopment. METHODS The study was a part of a longitudinal follow-up study of EPT neonates. All children were scanned at Karolinska University hospital 2004-2007 (neonates) and 2014-2015 (children at 8-11 years). WMA was qualitatively assessed by visual inspection. Developmental assessment was conducted at 12 years. RESULTS In total, 112 children (median age 10.3 years, 56 girls) underwent MRI of the brain (68 EPT, 45 controls). In the EPT group, a subset had MRI around term equivalent age (n = 61). In the EPT group, the prevalence of discrete WMA at 8-11 years was 52%. There was a positive association between WMI at TEA and 8-11 years. There was no association between WMI and WM volumes or diffusivity at 8-11 years. Discrete WMA was not related to neurodevelopmental outcomes. CONCLUSION Discrete WMA was prevalent in children born EPT at 8-11 years but were not related to neurodevelopmental outcomes.
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Affiliation(s)
- Daniela Nosko
- Department of Paediatrics Örebro University Hospital Örebro Sweden
| | - Marika Strindberg
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Jan Svoboda
- Department of Neuroradiology Karolinska University Hospital Stockholm Sweden
| | - Hedvig Kvanta
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Lina Broström
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Nelly Padilla
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Gustaf Mårtensson
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Maria Örtqvist
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Nuno Canto Moreira
- Department of Neuroradiology Karolinska University Hospital Stockholm Sweden
| | - Ulrika Ådén
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Department of Neonatal Medicine Karolinska University Hospital Stockholm Sweden
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Clinical experience with an in-NICU magnetic resonance imaging system. J Perinatol 2022; 42:873-879. [PMID: 35459908 PMCID: PMC9026005 DOI: 10.1038/s41372-022-01387-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/07/2022] [Accepted: 03/31/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the utility of the 1 Tesla (1 T) Embrace (Aspect Imaging) neonatal magnetic resonance imaging (MRI) scanner in a level III NICU. STUDY DESIGN Embrace brain MRI findings for 207 infants were reviewed, including 32 scans directly compared within 5 days with imaging on a 3 T Siemens Trio. Clinical MRI scan abnormalities were also compared to cranial ultrasound findings. RESULT Of the 207 Embrace brain MRIs, 146 (70.5%) were obtained for clinical indications and 61 (29.5%) were research cases. Abnormal findings were found in 80 scans, most commonly hemorrhage and white matter injury. Notable findings included a stroke, medullary brainstem tumor, and polymicrogyria. In the 1 T versus 3 T comparison cohort, results were discordant in only one infant with punctate foci of susceptibility noted only on the 3 T scan. CONCLUSION The Embrace MRI scans detected clinically relevant brain abnormalities and in a subset were clinically comparable to 3 T scans.
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Physical and Neurological Development of a Girl Born to a Mother with Methylmalonic Acidemia and Kidney Transplantation and Review of the Literature. CHILDREN 2021; 8:children8111013. [PMID: 34828726 PMCID: PMC8619094 DOI: 10.3390/children8111013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/08/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
Background: actual literature suggests that children of methylmalonic acidemia patients are mostly healthy, but data are only partial, especially regarding long-term outcome. Therefore, our aim was to evaluate the possible long-term neurological effects of fetal exposure to high levels of methylmalonic acid in a child of a renal transplant recipient. Methods: we retrospectively evaluated the clinical and neurological records of a girl whose mother is a kidney transplant recipient affected by methylmalonic acidemia. Subsequently, we compared our results with the ones already published. Results: the girl’s weight and stature were within the normal range in the first years of life but, starting from 4 years of age, she became progressively overweight. Regarding the neurodevelopment aspects, for the first time we performed a complete and seriated neuropsychological evaluation, highlighting a mild but significant weakness in the verbal domain, with a worsening trend at three-year revaluation. Conclusions: since children of MMA patients are exposed to methylmalonic acid, the efforts of the physicians caring for these children should be directed on careful evaluation of growth, prevention of obesity and regular neurological examination together with structured neuropsychological tests to achieve a better insight in possible complications of pregnancy in patients suffering from this condition.
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Maeda T, Kidokoro H, Tachibana T, Shiraki A, Yamamoto H, Nakata T, Fukasawa T, Kubota T, Sato Y, Kato T, Natsume J, Okumura A, Hayakawa M. Trajectory of the incidence of brushes on preterm electroencephalogram and its association with neurodevelopment in extremely low birth weight infants. Brain Dev 2021; 43:979-987. [PMID: 34334244 DOI: 10.1016/j.braindev.2021.07.003] [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: 03/16/2021] [Revised: 06/16/2021] [Accepted: 07/11/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Brush or delta brush is a well-known characteristic waveform in preterm electroencephalograms. However, the longitudinal trajectory of brushes and its association with neurodevelopment remain uncertain. METHODS We analyzed the longitudinal incidence of brushes in 36 extremely low birth weight infants without severe brain lesions and its association with neurodevelopment and white matter abnormality. Conventional eight-channel electroencephalograms were recorded at 30, 32, 36, and 40 postmenstrual weeks (PMW). Incidence of brushes was calculated as the sum of brushes from each channel separated by active sleep and quiet sleep. A developmental delay was defined as a developmental quotient of <85 assessed at corrected age of 18 months. White matter abnormalities were evaluated with term-equivalent magnetic resonance imaging. RESULTS The median incidence of brushes (per minute) in 36 infants at PMW 30, 32, 36, and 40 was 16.4, 20.4, 22.5, and 1.8 during active sleep and 7.5, 10.3, 11.5, and 1.7 during quiet sleep, respectively. Among the 36 infants, 14 infants were diagnosed with developmental delay. Longitudinal trajectories of the incidence of brushes were different between the normal and the delayed development groups. Brushes were observed most frequently at 36 PMW in the delayed development group. The incidence of brushes at 36 PMW was significantly correlated with the severity of white matter abnormalities and negatively correlated with the developmental quotient. CONCLUSION The incidence of brushes at 36 PMW can be a unique predictor of early neurodevelopment in extremely low birth weight infants without severe brain lesions.
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Affiliation(s)
- Takashi Maeda
- Department of Pediatric Cardiology and Neonatology, Ogaki Municipal Hospital, Gifu, Japan
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan.
| | - Takashi Tachibana
- Department of Pediatric Cardiology and Neonatology, Ogaki Municipal Hospital, Gifu, Japan
| | - Anna Shiraki
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hiroyuki Yamamoto
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tomohiko Nakata
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | | | - Tetsuo Kubota
- Department of Pediatrics, Anjo Kosei Hospital, Aichi, Japan
| | - Yoshiaki Sato
- Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Aichi, Japan
| | - Toru Kato
- Department of Pediatrics, Okazaki City Hospital, Aichi, Japan
| | - Jun Natsume
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan; Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Aichi, Japan
| | - Masahiro Hayakawa
- Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Aichi, Japan
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Mossad SI, Young JM, Wong SM, Dunkley BT, Hunt BAE, Pang EW, Taylor MJ. The Very Preterm Brain at Rest: Longitudinal Social-Cognitive Network Connectivity During Childhood. Soc Cogn Affect Neurosci 2021; 17:377-386. [PMID: 34654932 PMCID: PMC8972272 DOI: 10.1093/scan/nsab110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/22/2021] [Accepted: 10/15/2021] [Indexed: 11/20/2022] Open
Abstract
Very preterm (VPT: ≤32 weeks of gestational age) birth poses an increased risk for social and cognitive morbidities that persist throughout life. Resting-state functional network connectivity studies provide information about the intrinsic capacity for cognitive processing. We studied the following four social–cognitive resting-state networks: the default mode, salience, frontal-parietal and language networks. We examined functional connectivity using magnetoencephalography with individual head localization using each participant’s MRI at 6 (n = 40) and 8 (n = 40) years of age compared to age- and sex-matched full-term (FT) born children (n = 38 at 6 years and n = 43 at 8 years). VPT children showed increased connectivity compared to FT children in the gamma band (30–80 Hz) at 6 years within the default mode network (DMN), and between the DMN and the salience, frontal-parietal and language networks, pointing to more diffuse, less segregated processing across networks at this age. At 8 years, VPT children had more social and academic difficulties. Increased DMN connectivity at 6 years was associated with social and working memory difficulties at 8 years. Therefore, we suggest that increased DMN connectivity contributes to the observed emerging social and cognitive morbidities in school age.
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Affiliation(s)
- Sarah I Mossad
- Department of Psychology, Hospital for Sick Children, Canada
| | - Julia M Young
- Department of Psychology, Hospital for Sick Children, Canada
| | - Simeon M Wong
- Neurosciences & Mental Health, SickKids Research Institute, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Canada
| | - Benjamin T Dunkley
- Neurosciences & Mental Health, SickKids Research Institute, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Canada
| | - Benjamin A E Hunt
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Elizabeth W Pang
- Neurosciences & Mental Health, SickKids Research Institute, Canada.,Division of Neurology, Hospital for Sick Children, Toronto, Canada
| | - Margot J Taylor
- Neurosciences & Mental Health, SickKids Research Institute, Canada.,Department of Psychology, University of Toronto, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
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Diffusion Tensor Imaging Changes Do Not Affect Long-Term Neurodevelopment following Early Erythropoietin among Extremely Preterm Infants in the Preterm Erythropoietin Neuroprotection Trial. Brain Sci 2021; 11:brainsci11101360. [PMID: 34679424 PMCID: PMC8533828 DOI: 10.3390/brainsci11101360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to evaluate diffusion tensor imaging (DTI) in infants born extremely preterm, to determine the effect of erythropoietin (Epo) on DTI, and to correlate DTI with neurodevelopmental outcomes at 2 years of age for infants in the Preterm Erythropoietin Neuroprotection (PENUT) Trial. Infants who underwent MRI with DTI at 36 weeks postmenstrual age were included. Neurodevelopmental outcomes were evaluated by Bayley Scales of Infant and Toddler Development (BSID-III). Generalized linear models were used to assess the association between DTI parameters and treatment group, and then with neurodevelopmental outcomes. A total of 101 placebo- and 93 Epo-treated infants underwent MRI. DTI white matter mean diffusivity (MD) was lower in placebo- compared to Epo-treated infants in the cingulate and occipital regions, and occipital white matter fractional isotropy (FA) was lower in infants born at 24-25 weeks vs. 26-27 weeks. These values were not associated with lower BSID-III scores. Certain decreases in clustering coefficients tended to have lower BSID-III scores. Consistent with the PENUT Trial findings, there was no effect on long-term neurodevelopment in Epo-treated infants even in the presence of microstructural changes identified by DTI.
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Ha SY, Sung YH. Changes of Neural Pathways after Vojta Approach in a Child with Developmental Delay. CHILDREN-BASEL 2021; 8:children8100918. [PMID: 34682183 PMCID: PMC8534406 DOI: 10.3390/children8100918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022]
Abstract
The development of motor function is related to the development of neural pathways in the white matter. Children with developmental delay (DD) and hypotonia have reduced motor function, and their neural pathways are observed differently from those of typically developed children. We investigated changes in neural pathways through diffusion tensor imaging (DTI) after utilizing the Vojta approach. The participant was a child with DD and hypotonia, and had delayed motor function. Although he had no brain damage on magnetic resonance imaging findings, damage to the neural pathway was confirmed through DTI due to cytomegalovirus infection in the mother's womb. From 11 months of age, the Vojta approach was performed for a total of 8 months. In this study, we found that in CST, the left FA and right TV increased in follow-up DTI more than in the initial DTI. In CRP, Wallerian degeneration was observed in the left FA, MD, and TV in follow-up DTI. GMFM-88 improved after intervention. The structural change of neural pathways through the Vojta approach influenced the improvement of gross motor function. Therefore, it is thought that the Vojta approach can be suggested as a meaningful intervention for children with DD and hypotonia.
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Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon 51767, Korea;
| | - Yun-Hee Sung
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon 51767, Korea;
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon 51767, Korea
- Correspondence: ; Tel.: +82-55-249-6334
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Miranda-Herrero MC, Vázquez-López M, Barredo-Valderrama E, de Castro de Castro P, Chacón-Pascual A, Pascual-Pascual SI. Visuospatial functions in preterm schoolchildren without cognitive delay: Using Pascual's Graphomotor test as a screening method. Early Hum Dev 2021; 161:105454. [PMID: 34496347 DOI: 10.1016/j.earlhumdev.2021.105454] [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: 09/13/2020] [Revised: 08/16/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Preterm children obtain worse scores in tests that evaluate visuospatial functions. Pascual's graphomotor test (PGMt) assesses maturity in copying drawings in childhood, quickly evaluating the graphomotor aptitude that is a partial aspect of non-verbal intelligence. AIMS To evaluate visuospatial functions in preterm children compared to full-term children. To assess the capacity of the Pascual graphomotor test (PGMt) to detect visuospatial disorders more specifically than non-verbal intelligence quotient (IQ). STUDY DESIGN AND SUBJECTS case and control study. CASES preterm children between 5 and 11 years of age without cognitive delay; controls: full-term children with the same characteristics. For each child clinical history, neurological examination, language-free intelligence test Toni 2 (IQ) and Pascual's graphomotor test (PGMt) were carried out. RESULTS 135 children were enrolled (59 cases vs. 79 controls). The mean age was 7.4 years. 55% were male. The mean gestational age of cases was 30.5 weeks with 34% extremely preterm. Cases obtained worse mean scores in both tests. The mean IQ scores were: cases 117.4, controls 125.0 (p = 0.004). The mean graphomotor quotient (GQ) scores were statistically and clinically significant (cases 76.8; controls 98.3, p = 0.001). Although we have found a positive correlation between IQ and GQ scores (cc = 0.31 p = 0.01), the differences found in the GQ between groups have been maintained regardless of the IQ in the multivariate analysis (GQ: cases 78.3 (SD 14.8), controls 98.3 (SD 12.5), p = 0.04). CONCLUSIONS GQ is a useful tool for screening for visuospatial anomalies. GQ more specifically measures the visuoperceptive disorder regardless of non-verbal cognitive level.
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Affiliation(s)
| | - María Vázquez-López
- Department of Neuropediatrics, Hospital Materno Infantil Gregorio Marañón, Calle O'Donnell 48-50, 28009 Madrid, Spain
| | - Estibaliz Barredo-Valderrama
- Department of Neuropediatrics, Hospital Materno Infantil Gregorio Marañón, Calle O'Donnell 48-50, 28009 Madrid, Spain
| | - Pedro de Castro de Castro
- Department of Neuropediatrics, Hospital Materno Infantil Gregorio Marañón, Calle O'Donnell 48-50, 28009 Madrid, Spain
| | - Almudena Chacón-Pascual
- Department of Neuropediatrics, Hospital Materno Infantil Gregorio Marañón, Calle O'Donnell 48-50, 28009 Madrid, Spain
| | - Samuel Ignacio Pascual-Pascual
- Department of Neuropediatrics, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain; Department of Pediatrics, School of Medicine, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo, 4, 28029 Madrid, Spain
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Upadhyaya S, Sourander A, Luntamo T, Matinolli HM, Chudal R, Hinkka-Yli-Salomäki S, Filatova S, Cheslack-Postava K, Sucksdorff M, Gissler M, Brown AS, Lehtonen L. Preterm Birth Is Associated With Depression From Childhood to Early Adulthood. J Am Acad Child Adolesc Psychiatry 2021; 60:1127-1136. [PMID: 33068750 DOI: 10.1016/j.jaac.2020.09.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 09/14/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE There have been inconsistent findings on the associations among prematurity, poor fetal growth, and depression. We examined the associations among gestational age, poor fetal growth, and depression in individuals aged 5 to 25 years. METHOD We identified 37,682 case subjects based on International Classification of Diseases, Ninth Revision code 2961 and International Classification of Diseases, Tenth Revision codes F32.0-F32.9 and F33.0-F33.9 from the Care Register for Health Care, and 148,795 matched controls from the Finnish Central Population Register. Conditional logistic regression examined the associations between gestational age by each gestational week, poor fetal growth, and depression. The associations were adjusted for parental age and psychopathology, paternal immigrant status, maternal substance abuse, depression, number of previous births, marital status, socio-economic status, smoking during pregnancy, and the infant's birthplace. RESULTS In the adjusted models, increased risk of depression was found in children born ≤25 weeks (adjusted odds ratio [aOR] 1.89, 95% CI 1.08-3.31), at 26 weeks (aOR 2.62, 95% CI 1.49-4.61), at 27 weeks (aOR 1.93, 95% CI 1.05-3.53), and ≥42 weeks (aOR 1.11, 95% CI 1.05-1.19). In girls, extremely preterm birth was associated with depression diagnosed at 5 to 12 years (aOR 2.70, 95% CI 1.83-3.98) and 13 to 18 years (aOR 2.97, 95% CI 1.84-4.78). In boys, postterm birth (≥42 weeks) was associated with depression diagnosed at 19 to 25 years (aOR 1.28, 95% CI 1.07-1.54). Poor fetal growth was associated with an increased risk of depression in full-term infants (aOR 1.06, 95% CI 1.03-1.10) and postterm infants (aOR 1.24, 95% CI 1.08-1.43). CONCLUSION Preterm birth before 28 weeks of gestation appeared to play a role in the development of childhood depression. Smaller effects were also seen in postterm births, especially in boys.
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Affiliation(s)
| | - Andre Sourander
- University of Turku, Finland; Turku University Hospital, Finland; Columbia University, New York.
| | | | - Hanna-Maria Matinolli
- University of Turku, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | | | | | | | - Mika Gissler
- University of Turku, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland; Karolinska Institute, Stockholm, Sweden
| | | | - Liisa Lehtonen
- University of Turku, Finland; Turku University Hospital, Finland
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Menegaux A, Meng C, Bäuml JG, Berndt MT, Hedderich DM, Schmitz-Koep B, Schneider S, Nuttall R, Zimmermann J, Daamen M, Zimmer C, Boecker H, Bartmann P, Wolke D, Sorg C. Aberrant cortico-thalamic structural connectivity in premature-born adults. Cortex 2021; 141:347-362. [PMID: 34126289 DOI: 10.1016/j.cortex.2021.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/15/2021] [Accepted: 04/26/2021] [Indexed: 12/29/2022]
Abstract
Premature birth is associated with alterations in brain structure, particularly in white matter. Among white matter, alterations in cortico-thalamic connections are present in premature-born infants, and they have been suggested both to last until adulthood and to contribute to impaired cognitive functions. To test these hypotheses, 70 very premature-born adults and 67 full-term controls underwent cognitive testing and diffusion-weighted imaging. Each cortical hemisphere was parcellated into six lobes, from which probabilistic tractography was performed to the thalamus. Connection probability was chosen as metric of structural connectivity. We found increased cortico-thalamic connection probability between left prefrontal cortices and left medio-dorsal thalamus and reduced connection probability between bilateral temporal cortices and bilateral anterior thalami in very premature-born adults. Aberrant prefronto- and temporo-thalamic connection probabilities were correlated with birth weight and days on ventilation, respectively, supporting the suggestion that these connectivity changes relate with the degree of prematurity. Moreover, an increase in left prefronto-thalamic connection probability also correlated with lower verbal comprehension index indicating its relevance for verbal cognition. Together, our results demonstrate that cortico-thalamic structural connectivity is aberrant in premature-born adults, with these changes being linked with impairments in verbal cognitive abilities. Due to corresponding findings in infants, data suggest aberrant development of cortico-thalamic connectivity after premature birth with lasting effects into adulthood.
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Affiliation(s)
- Aurore Menegaux
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Chun Meng
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Josef G Bäuml
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Maria T Berndt
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dennis M Hedderich
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Benita Schmitz-Koep
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sebastian Schneider
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Rachel Nuttall
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Juliana Zimmermann
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marcel Daamen
- Functional Neuroimaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany; Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Claus Zimmer
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Henning Boecker
- Functional Neuroimaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - Christian Sorg
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany; TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany; Department of Psychiatry, School of Medicine, Technical University of Munich, Munich, Germany
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Chiarelli AM, Sestieri C, Navarra R, Wise RG, Caulo M. Distinct effects of prematurity on MRI metrics of brain functional connectivity, activity, and structure: Univariate and multivariate analyses. Hum Brain Mapp 2021; 42:3593-3607. [PMID: 33955622 PMCID: PMC8249887 DOI: 10.1002/hbm.25456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 12/27/2022] Open
Abstract
Premature birth affects the developmental trajectory of the brain during a period of intense maturation with possible lifelong consequences. To better understand the effect of prematurity on brain structure and function, we performed blood‐oxygen‐level dependent (BOLD) and anatomical magnetic resonance imaging (MRI) at 40 weeks of postmenstrual age on 88 newborns with variable gestational age (GA) at birth and no evident radiological alterations. We extracted measures of resting‐state functional connectivity and activity in a set of 90 cortical and subcortical brain regions through the evaluation of BOLD correlations between regions and of fractional amplitude of low‐frequency fluctuation (fALFF) within regions, respectively. Anatomical information was acquired through the assessment of regional volumes. We performed univariate analyses on each metric to examine the association with GA at birth, the spatial distribution of the effects, and the consistency across metrics. Moreover, a data‐driven multivariate analysis (i.e., Machine Learning) framework exploited the high dimensionality of the data to assess the sensitivity of each metric to the effect of premature birth. Prematurity was associated with bidirectional alterations of functional connectivity and regional volume and, to a lesser extent, of fALFF. Notably, the effects of prematurity on functional connectivity were spatially diffuse, mainly within cortical regions, whereas effects on regional volume and fALFF were more focal, involving subcortical structures. While the two analytical approaches delivered consistent results, the multivariate analysis was more sensitive in capturing the complex pattern of prematurity effects. Future studies might apply multivariate frameworks to identify premature infants at risk of a negative neurodevelopmental outcome.
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Affiliation(s)
- Antonio M Chiarelli
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara; Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Carlo Sestieri
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara; Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Riccardo Navarra
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara; Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Richard G Wise
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara; Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Massimo Caulo
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara; Institute for Advanced Biomedical Technologies, Chieti, Italy
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Structural Changes in the Cortico-Ponto-Cerebellar Axis at Birth are Associated with Abnormal Neurological Outcomes in Childhood. Clin Neuroradiol 2021; 31:1005-1020. [PMID: 33944956 DOI: 10.1007/s00062-021-01017-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/04/2021] [Indexed: 10/21/2022]
Abstract
White matter lesions in hypoxic-ischemic encephalopathy (HIE) are considered to be the important substrate of frequent neurological consequences in preterm infants. The aim of the study was to analyze volumes and tractographic parameters of the cortico-ponto-cerebellar axis to assess alterations in the periventricular fiber system and crossroads, corticopontine and corticospinal pathways and prospective transsynaptic changes of the cerebellum.Term infants (control), premature infants without (normotypic) and with perinatal HIE (HIE) underwent brain magnetic resonance imaging at term-equivalent age (TEA) and at 2 years. Cerebrum, cerebellum, brainstem divisions and ventrodorsal compartments volumetric analysis were performed, as well as fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of corticopontine, corticospinal pathways and middle cerebellar peduncles. Amiel-Tison scale at TEA and the Hempel test at 2 years were assessed.Cerebellum, brainstem and its compartments volumes were decreased in normotypic and HIE groups at TEA, while at 2 years volumes were significantly reduced in the HIE group, accompanied by decreased volume and FA and increased ADC of corticopontine and corticospinal pathways. Negative association of the brainstem, cerebellum, mesencephalon, pons, corticopontine volumes and corticospinal pathway FA at TEA with the neurological score at 2 years. Cerebellum and pons volumes presented as potential prognostic indicators of neurological outcomes.Our findings agree that these pathways, as a part of the periventricular fiber system and crossroads, exhibit lesion-induced reaction and vulnerability in HIE. Structural differences between normotypic and HIE group at the 2 years suggest a different developmental structural plasticity.
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Prasad JD, van de Looij Y, Gunn KC, Ranchhod SM, White PB, Berry MJ, Bennet L, Sizonenko SV, Gunn AJ, Dean JM. Long-term coordinated microstructural disruptions of the developing neocortex and subcortical white matter after early postnatal systemic inflammation. Brain Behav Immun 2021; 94:338-356. [PMID: 33307171 DOI: 10.1016/j.bbi.2020.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/16/2020] [Accepted: 12/06/2020] [Indexed: 12/21/2022] Open
Abstract
Severe postnatal systemic infection is highly associated with persistent disturbances in brain development and neurobehavioral outcomes in survivors of preterm birth. However, the contribution of less severe but prolonged postnatal infection and inflammation to such disturbances is unclear. Further, the ability of modern imaging techniques to detect the underlying changes in cellular microstructure of the brain in these infants remains to be validated. We used high-field ex-vivo MRI, neurohistopathology, and behavioral tests in newborn rats to demonstrate that prolonged postnatal systemic inflammation causes subtle, persisting disturbances in brain development, with neurodevelopmental delays and mild motor impairments. Diffusion-tensor MRI and neurite orientation dispersion and density imaging (NODDI) revealed delayed maturation of neocortical and subcortical white matter microstructure. Analysis of pyramidal neurons showed that the cortical deficits involved impaired dendritic arborization and spine formation. Analysis of oligodendrocytes showed that the white matter deficits involved impaired oligodendrocyte maturation and axonal myelination. These findings indicate that prolonged postnatal inflammation, without severe infection, may critically contribute to the diffuse spectrum of brain pathology and subtle long-term disability in preterm infants, with a cellular mechanism involving oligodendrocyte and neuronal dysmaturation. NODDI may be useful for clinical detection of these microstructural deficits.
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Affiliation(s)
- Jaya D Prasad
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Yohan van de Looij
- Division of Child Development and Growth, Department of Pediatrics and Gynecology Obstetrics, University of Geneva, Geneva, Switzerland; Center for Biomedical Imaging - Animal Imaging and Technology, Lausanne Federal Polytechnic School, Lausanne, Switzerland
| | - Katherine C Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Sonya M Ranchhod
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Petra B White
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Mary J Berry
- The Department of Pediatrics and Health Care, University of Otago, New Zealand
| | - Laura Bennet
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Stéphane V Sizonenko
- Division of Child Development and Growth, Department of Pediatrics and Gynecology Obstetrics, University of Geneva, Geneva, Switzerland
| | - Alistair J Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Justin M Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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Lautarescu A, Hadaya L, Craig MC, Makropoulos A, Batalle D, Nosarti C, Edwards AD, Counsell SJ, Victor S. Exploring the relationship between maternal prenatal stress and brain structure in premature neonates. PLoS One 2021; 16:e0250413. [PMID: 33882071 PMCID: PMC8059832 DOI: 10.1371/journal.pone.0250413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Exposure to maternal stress in utero is associated with a range of adverse outcomes. We previously observed an association between maternal stress and white matter microstructure in a sample of infants born prematurely. In this study, we aimed to investigate the relationship between maternal trait anxiety, stressful life events and brain volumes. METHODS 221 infants (114 males, 107 females) born prematurely (median gestational age = 30.43 weeks [range 23.57-32.86]) underwent magnetic resonance imaging around term-equivalent age (mean = 42.20 weeks, SD = 1.60). Brain volumes were extracted for the following regions of interest: frontal lobe, temporal lobe, amygdala, hippocampus, thalamus and normalized to total brain volume. Multiple linear regressions were conducted to investigate the relationship between maternal anxiety/stress and brain volumes, controlling for gestational age at birth, postmenstrual age at scan, socioeconomic status, sex, days on total parenteral nutrition. Additional exploratory Tensor Based Morphometry analyses were performed to obtain voxel-wise brain volume changes from Jacobian determinant maps. RESULTS AND CONCLUSION In this large prospective study, we did not find evidence of a relationship between maternal prenatal stress or trait anxiety and brain volumes. This was the case for both the main analysis using a region-of-interest approach, and for the exploratory analysis using Jacobian determinant maps. We discuss these results in the context of conflicting evidence from previous studies and highlight the need for further research on premature infants, particularly including term-born controls.
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Affiliation(s)
- Alexandra Lautarescu
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Laila Hadaya
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Michael C. Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- National Female Hormone Clinic, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Antonis Makropoulos
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Dafnis Batalle
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Chiara Nosarti
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - A. David Edwards
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Serena J. Counsell
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Suresh Victor
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
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Morrison JL, Ayonrinde OT, Care AS, Clarke GD, Darby JRT, David AL, Dean JM, Hooper SB, Kitchen MJ, Macgowan CK, Melbourne A, McGillick EV, McKenzie CA, Michael N, Mohammed N, Sadananthan SA, Schrauben E, Regnault TRH, Velan SS. Seeing the fetus from a DOHaD perspective: discussion paper from the advanced imaging techniques of DOHaD applications workshop held at the 2019 DOHaD World Congress. J Dev Orig Health Dis 2021; 12:153-167. [PMID: 32955011 DOI: 10.1017/s2040174420000884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Advanced imaging techniques are enhancing research capacity focussed on the developmental origins of adult health and disease (DOHaD) hypothesis, and consequently increasing awareness of future health risks across various subareas of DOHaD research themes. Understanding how these advanced imaging techniques in animal models and human population studies can be both additively and synergistically used alongside traditional techniques in DOHaD-focussed laboratories is therefore of great interest. Global experts in advanced imaging techniques congregated at the advanced imaging workshop at the 2019 DOHaD World Congress in Melbourne, Australia. This review summarizes the presentations of new imaging modalities and novel applications to DOHaD research and discussions had by DOHaD researchers that are currently utilizing advanced imaging techniques including MRI, hyperpolarized MRI, ultrasound, and synchrotron-based techniques to aid their DOHaD research focus.
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Affiliation(s)
- Janna L Morrison
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Oyekoya T Ayonrinde
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Alison S Care
- The Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Geoffrey D Clarke
- Department of Radiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Jack R T Darby
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Justin M Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Stuart B Hooper
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- The Department of Obstetrics and Gynecology, Monash University, Melbourne, Victoria, Australia
| | - Marcus J Kitchen
- School of Physics and Astronomy, Monash University, Melbourne, Victoria, Australia
| | | | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, Kings College London, London, UK
| | - Erin V McGillick
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- The Department of Obstetrics and Gynecology, Monash University, Melbourne, Victoria, Australia
| | - Charles A McKenzie
- Department of Medical Biophysics, Western University, London, ON, Canada
- Lawson Health Research Institute and Children's Health Research Institute, London, ON, Canada
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Nuruddin Mohammed
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Aga Khan University Hospital, Karachi, Pakistan
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Eric Schrauben
- Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Timothy R H Regnault
- Lawson Health Research Institute and Children's Health Research Institute, London, ON, Canada
- Department of Obstetrics and Gynecology, Western University, London, ON, Canada
- Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - S Sendhil Velan
- Singapore Bioimaging Consortium, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
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Ke X, Xing B, Dahl MJ, Alvord J, McKnight RA, Lane RH, Albertine KH. Hippocampal epigenetic and insulin-like growth factor alterations in noninvasive versus invasive mechanical ventilation in preterm lambs. Pediatr Res 2021; 90:998-1008. [PMID: 33603215 PMCID: PMC7891485 DOI: 10.1038/s41390-020-01305-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND The brain of chronically ventilated preterm human infants is vulnerable to collateral damage during invasive mechanical ventilation (IMV). Damage is manifest, in part, by learning and memory impairments, which are hippocampal functions. A molecular regulator of hippocampal development is insulin-like growth factor 1 (IGF1). A gentler ventilation strategy is noninvasive respiratory support (NRS). We tested the hypotheses that NRS leads to greater levels of IGF1 messenger RNA (mRNA) variants and distinct epigenetic profile along the IGF1 gene locus in the hippocampus compared to IMV. METHODS Preterm lambs were managed by NRS or IMV for 3 or 21 days. Isolated hippocampi were analyzed for IGF1 mRNA levels and splice variants for promoter 1 (P1), P2, and IGF1A and 1B, DNA methylation in P1 region, and histone covalent modifications along the gene locus. RESULTS NRS had significantly greater levels of IGF1 P1 (predominant transcript), and 1A and 1B mRNA variants compared to IMV at 3 or 21 days. NRS also led to more DNA methylation and greater occupancy of activating mark H3K4 trimethylation (H3K4me3), repressive mark H3K27me3, and elongation mark H3K36me3 compared to IMV. CONCLUSIONS NRS leads to distinct IGF1 mRNA variant levels and epigenetic profile in the hippocampus compared to IMV. IMPACT Our study shows that 3 or 21 days of NRS of preterm lambs leads to distinct IGF1 mRNA variant levels and epigenetic profile in the hippocampus compared to IMV. Preterm infant studies suggest that NRS leads to better neurodevelopmental outcomes later in life versus IMV. Also, duration of IMV is directly related to hippocampal damage; however, molecular players remain unknown. NRS, as a gentler mode of respiratory management of preterm neonates, may reduce damage to the immature hippocampus through an epigenetic mechanism.
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Affiliation(s)
- Xingrao Ke
- grid.223827.e0000 0001 2193 0096Department of Pediatrics, Division of Neonatology, School of Medicine, University of Utah, Salt Lake City, UT 84132-2202 USA
| | - Bohan Xing
- grid.223827.e0000 0001 2193 0096Department of Pediatrics, Division of Neonatology, School of Medicine, University of Utah, Salt Lake City, UT 84132-2202 USA
| | - Mar Janna Dahl
- grid.223827.e0000 0001 2193 0096Department of Pediatrics, Division of Neonatology, School of Medicine, University of Utah, Salt Lake City, UT 84132-2202 USA
| | - Jeremy Alvord
- grid.223827.e0000 0001 2193 0096Department of Pediatrics, Division of Neonatology, School of Medicine, University of Utah, Salt Lake City, UT 84132-2202 USA
| | - Robert A. McKnight
- grid.223827.e0000 0001 2193 0096Department of Pediatrics, Division of Neonatology, School of Medicine, University of Utah, Salt Lake City, UT 84132-2202 USA
| | - Robert H. Lane
- grid.239559.10000 0004 0415 5050Children Mercy Research Institute, Children’s Mercy, Kansas City, MO 64108 USA
| | - Kurt H. Albertine
- grid.223827.e0000 0001 2193 0096Department of Pediatrics, Division of Neonatology, School of Medicine, University of Utah, Salt Lake City, UT 84132-2202 USA
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Jinnou H. Regeneration using endogenous neural stem cells following neonatal brain injury. Pediatr Int 2021; 63:13-21. [PMID: 32609915 DOI: 10.1111/ped.14368] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 05/29/2020] [Accepted: 06/25/2020] [Indexed: 01/25/2023]
Abstract
Despite recent advancements in perinatal care, the incidence of neonatal brain injury has not decreased. No therapies are currently available to repair injured brain tissues. In the postnatal brain, neural stem cells reside in the ventricular-subventricular zone (V-SVZ) and continuously generate new immature neurons (neuroblasts). After brain injury in rodents, V-SVZ-derived neuroblasts migrate toward the injured area using blood vessels as a scaffold. Notably, the neonatal V-SVZ has a remarkable neurogenic capacity. Furthermore, compared with the adult brain, after neonatal brain injury, larger numbers of neuroblasts migrate toward the lesion, raising the possibility that the V-SVZ could be a source for endogenous neuronal regeneration after neonatal brain injury. We recently demonstrated that efficient migration of V-SVZ-derived neuroblasts toward a lesion is supported by neonatal radial glia via neural cadherin (N-cadherin)-mediated neuron-fiber contact, which promotes RhoA activity. Moreover, providing blood vessel- and radial glia-mimetic scaffolds for migrating neuroblasts promotes neuronal migration and improves functional gait behaviors after neonatal brain injury. In the V-SVZ, oligodendrocyte progenitor cells (OPCs) are also generated and migrate toward the surrounding white matter, where they differentiate and form myelin. After white matter injury in rodents, the production and subsequent migration of V-SVZ-derived OPCs are enhanced. In the neonatal period, administration of growth factors at a specific time promotes oligodendrocyte regeneration and functional recovery after brain injury. These findings suggest that activating the high regenerative capacity that is specific to the neonatal period could lead to the development of new therapeutic strategies for neonatal brain injury.
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Affiliation(s)
- Hideo Jinnou
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Developmental and Regenerative Neurobiology, Institute of Brain Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Scher MS. "The First Thousand Days" Define a Fetal/Neonatal Neurology Program. Front Pediatr 2021; 9:683138. [PMID: 34408995 PMCID: PMC8365757 DOI: 10.3389/fped.2021.683138] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/27/2021] [Indexed: 01/11/2023] Open
Abstract
Gene-environment interactions begin at conception to influence maternal/placental/fetal triads, neonates, and children with short- and long-term effects on brain development. Life-long developmental neuroplasticity more likely results during critical/sensitive periods of brain maturation over these first 1,000 days. A fetal/neonatal program (FNNP) applying this perspective better identifies trimester-specific mechanisms affecting the maternal/placental/fetal (MPF) triad, expressed as brain malformations and destructive lesions. Maladaptive MPF triad interactions impair progenitor neuronal/glial populations within transient embryonic/fetal brain structures by processes such as maternal immune activation. Destructive fetal brain lesions later in pregnancy result from ischemic placental syndromes associated with the great obstetrical syndromes. Trimester-specific MPF triad diseases may negatively impact labor and delivery outcomes. Neonatal neurocritical care addresses the symptomatic minority who express the great neonatal neurological syndromes: encephalopathy, seizures, stroke, and encephalopathy of prematurity. The asymptomatic majority present with neurologic disorders before 2 years of age without prior detection. The developmental principle of ontogenetic adaptation helps guide the diagnostic process during the first 1,000 days to identify more phenotypes using systems-biology analyses. This strategy will foster innovative interdisciplinary diagnostic/therapeutic pathways, educational curricula, and research agenda among multiple FNNP. Effective early-life diagnostic/therapeutic programs will help reduce neurologic disease burden across the lifespan and successive generations.
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Affiliation(s)
- Mark S Scher
- Division of Pediatric Neurology, Department of Pediatrics, Fetal/Neonatal Neurology Program, Emeritus Scholar Tenured Full Professor in Pediatrics and Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, United States
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Vaes JEG, Kosmeijer CM, Kaal M, van Vliet R, Brandt MJV, Benders MJNL, Nijboer CH. Regenerative Therapies to Restore Interneuron Disturbances in Experimental Models of Encephalopathy of Prematurity. Int J Mol Sci 2020; 22:ijms22010211. [PMID: 33379239 PMCID: PMC7795049 DOI: 10.3390/ijms22010211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/22/2022] Open
Abstract
Encephalopathy of Prematurity (EoP) is a major cause of morbidity in (extreme) preterm neonates. Though the majority of EoP research has focused on failure of oligodendrocyte maturation as an underlying pathophysiological mechanism, recent pioneer work has identified developmental disturbances in inhibitory interneurons to contribute to EoP. Here we investigated interneuron abnormalities in two experimental models of EoP and explored the potential of two promising treatment strategies, namely intranasal mesenchymal stem cells (MSCs) or insulin-like growth factor I (IGF1), to restore interneuron development. In rats, fetal inflammation and postnatal hypoxia led to a transient increase in total cortical interneuron numbers, with a layer-specific deficit in parvalbumin (PV)+ interneurons. Additionally, a transient excess of total cortical cell density was observed, including excitatory neuron numbers. In the hippocampal cornu ammonis (CA) 1 region, long-term deficits in total interneuron numbers and PV+ subtype were observed. In mice subjected to postnatal hypoxia/ischemia and systemic inflammation, total numbers of cortical interneurons remained unaffected; however, subtype analysis revealed a global, transient reduction in PV+ cells and a long-lasting layer-specific increase in vasoactive intestinal polypeptide (VIP)+ cells. In the dentate gyrus, a long-lasting deficit of somatostatin (SST)+ cells was observed. Both intranasal MSC and IGF1 therapy restored the majority of interneuron abnormalities in EoP mice. In line with the histological findings, EoP mice displayed impaired social behavior, which was partly restored by the therapies. In conclusion, induction of experimental EoP is associated with model-specific disturbances in interneuron development. In addition, intranasal MSCs and IGF1 are promising therapeutic strategies to aid interneuron development after EoP.
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Affiliation(s)
- Josine E. G. Vaes
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands; (J.E.G.V.); (C.M.K.); (M.K.); (R.v.V.); (M.J.V.B.)
- Department of Neonatology, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands;
| | - Chantal M. Kosmeijer
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands; (J.E.G.V.); (C.M.K.); (M.K.); (R.v.V.); (M.J.V.B.)
| | - Marthe Kaal
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands; (J.E.G.V.); (C.M.K.); (M.K.); (R.v.V.); (M.J.V.B.)
| | - Rik van Vliet
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands; (J.E.G.V.); (C.M.K.); (M.K.); (R.v.V.); (M.J.V.B.)
| | - Myrna J. V. Brandt
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands; (J.E.G.V.); (C.M.K.); (M.K.); (R.v.V.); (M.J.V.B.)
| | - Manon J. N. L. Benders
- Department of Neonatology, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands;
| | - Cora H. Nijboer
- Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children’s Hospital, Utrecht University, 3584 Utrecht, The Netherlands; (J.E.G.V.); (C.M.K.); (M.K.); (R.v.V.); (M.J.V.B.)
- Correspondence: ; Tel.: +31-88-755-4360
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Vanderhasselt T, Zolfaghari R, Naeyaert M, Dudink J, Buls N, Allemeersch GJ, Raeymaekers H, Cools F, de Mey J. Synthetic MRI demonstrates prolonged regional relaxation times in the brain of preterm born neonates with severe postnatal morbidity. NEUROIMAGE-CLINICAL 2020; 29:102544. [PMID: 33385883 PMCID: PMC7786121 DOI: 10.1016/j.nicl.2020.102544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/13/2020] [Accepted: 12/20/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND To identify preterm infants at risk for neurodevelopment impairment that might benefit from early neurorehabilitation, early prognostic biomarkers of future outcomes are needed. OBJECTIVE To determine whether synthetic MRI is sensitive to age-related changes in regional tissue relaxation times in the brain of preterm born neonates when scanned at term equivalent age (TEA, 37-42 weeks), and to investigate whether severe postnatal morbidity results in prolonged regional tissue relaxation times. MATERIALS AND METHODS This retrospective study included 70 very preterm born infants scanned with conventional and synthetic MRI between January 2017 and June 2019 at TEA. Infants with severe postnatal morbidity were allocated to a high-risk group (n = 22). All other neonates were allocated to a low-risk group (n = 48). Linear regression analysis was performed to determine the relationship between relaxation times and postmenstrual age (PMA) at scan. Analysis of covariance was used to evaluate the impact of severe postnatal morbidity in the high-risk group on T1 and T2 relaxation times. Receiver operating characteristic (ROC) curves were plotted and analysed with area under the ROC curve (AUC) to evaluate the accuracy of classifying high-risk patients based on regional relaxation times. RESULTS A linear age-related decrease of T1 and T2 relaxation times correlating with PMA at scan (between 37 and 42 weeks) was found in the deep gray matter, the cerebellum, the cortex, and the posterior limb of the internal capsule (PLIC) (p < .005 each), but not in the global, frontal, parietal, or central white matter. Analysis of covariance for both risk groups, adjusted for PMA, revealed significantly prolonged regional tissue relaxation times in neonates with severe postnatal morbidity, which was best illustrated in the central white matter of the centrum semiovale (T1 Δ = 11.5%, T2 Δ = 13.4%, p < .001) and in the PLIC (T1 Δ = 9.2%, T2 Δ = 6.9%, p < .001). The relaxation times in the PLIC and the central white matter predicted high-risk status with excellent accuracy (AUC range 0.82-0.86). CONCLUSION Synthetic MRI-based relaxometry in the brain of preterm born neonates is sensitive to age-related maturational changes close to TEA. Severe postnatal morbidity correlated with a significant delay in tissue relaxation. Synthetic MRI may provide early prognostic biomarkers for neurodevelopment impairment.
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Affiliation(s)
- Tim Vanderhasselt
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium.
| | - Roya Zolfaghari
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Maarten Naeyaert
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nico Buls
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Gert-Jan Allemeersch
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Hubert Raeymaekers
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Filip Cools
- Department of Neonatology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Johan de Mey
- Department of Radiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Menegaux A, Hedderich DM, Bäuml JG, Manoliu A, Daamen M, Berg RC, Preibisch C, Zimmer C, Boecker H, Bartmann P, Wolke D, Sorg C, Stämpfli P. Reduced apparent fiber density in the white matter of premature-born adults. Sci Rep 2020; 10:17214. [PMID: 33057208 PMCID: PMC7560721 DOI: 10.1038/s41598-020-73717-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/21/2020] [Indexed: 12/13/2022] Open
Abstract
Premature-born adults exhibit lasting white matter alterations as demonstrated by widespread reduction in fractional anisotropy (FA) based on diffusion-weighted imaging (DWI). FA reduction, however, is non-specific for microscopic underpinnings such as aberrant myelination or fiber density (FD). Using recent advances in DWI, we tested the hypothesis of reduced FD in premature-born adults and investigated its link with the degree of prematurity and cognition. 73 premature- and 89 mature-born adults aged 25-27 years underwent single-shell DWI, from which a FD measure was derived using convex optimization modeling for microstructure informed tractography (COMMIT). Premature-born adults exhibited lower FD in numerous tracts including the corpus callosum and corona radiata compared to mature-born adults. These FD alterations were associated with both the degree of prematurity, as assessed via gestational age and birth weight, as well as with reduced cognition as measured by full-scale IQ. Finally, lower FD overlapped with lower FA, suggesting lower FD underlie unspecific FA reductions. Results provide evidence that premature birth leads to lower FD in adulthood which links with lower full-scale IQ. Data suggest that lower FD partly underpins FA reductions of premature birth but that other processes such as hypomyelination might also take place.
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Affiliation(s)
- Aurore Menegaux
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany. .,TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Dennis M Hedderich
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Josef G Bäuml
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Wellcome Centre for Human Neuroimaging, University College London, London, UK.,Centre for Computational Psychiatry and Ageing Research, Max Planck University College London, London, UK
| | - Marcel Daamen
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany.,Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Ronja C Berg
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christine Preibisch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Henning Boecker
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Christian Sorg
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,TUM Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Psychiatry, School of Medicine, Technical University of Munich, Munich, Germany
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,MR-Center of the Department of Psychiatry, Psychotherapy, and Psychosomatics and the Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Zurich, University of Zurich, Zurich, Switzerland
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Sa de Almeida J, Meskaldji DE, Loukas S, Lordier L, Gui L, Lazeyras F, Hüppi PS. Preterm birth leads to impaired rich-club organization and fronto-paralimbic/limbic structural connectivity in newborns. Neuroimage 2020; 225:117440. [PMID: 33039621 DOI: 10.1016/j.neuroimage.2020.117440] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
Prematurity disrupts brain development during a critical period of brain growth and organization and is known to be associated with an increased risk of neurodevelopmental impairments. Investigating whole-brain structural connectivity alterations accompanying preterm birth may provide a better comprehension of the neurobiological mechanisms related to the later neurocognitive deficits observed in this population. Using a connectome approach, we aimed to study the impact of prematurity on neonatal whole-brain structural network organization at term-equivalent age. In this cohort study, twenty-four very preterm infants at term-equivalent age (VPT-TEA) and fourteen full-term (FT) newborns underwent a brain MRI exam at term age, comprising T2-weighted imaging and diffusion MRI, used to reconstruct brain connectomes by applying probabilistic constrained spherical deconvolution whole-brain tractography. The topological properties of brain networks were quantified through a graph-theoretical approach. Furthermore, edge-wise connectivity strength was compared between groups. Overall, VPT-TEA infants' brain networks evidenced increased segregation and decreased integration capacity, revealed by an increased clustering coefficient, increased modularity, increased characteristic path length, decreased global efficiency and diminished rich-club coefficient. Furthermore, in comparison to FT, VPT-TEA infants had decreased connectivity strength in various cortico-cortical, cortico-subcortical and intra-subcortical networks, the majority of them being intra-hemispheric fronto-paralimbic and fronto-limbic. Inter-hemispheric connectivity was also decreased in VPT-TEA infants, namely through connections linking to the left precuneus or left dorsal cingulate gyrus - two regions that were found to be hubs in FT but not in VPT-TEA infants. Moreover, posterior regions from Default-Mode-Network (DMN), namely precuneus and posterior cingulate gyrus, had decreased structural connectivity in VPT-TEA group. Our finding that VPT-TEA infants' brain networks displayed increased modularity, weakened rich-club connectivity and diminished global efficiency compared to FT infants suggests a delayed transition from a local architecture, focused on short-range connections, to a more distributed architecture with efficient long-range connections in those infants. The disruption of connectivity in fronto-paralimbic/limbic and posterior DMN regions might underlie the behavioral and social cognition difficulties previously reported in the preterm population.
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Affiliation(s)
- Joana Sa de Almeida
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Djalel-Eddine Meskaldji
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland; Institute of Mathematics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Serafeim Loukas
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland; Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Lara Lordier
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Laura Gui
- Department of Radiology and Medical Informatics, Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - François Lazeyras
- Department of Radiology and Medical Informatics, Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
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48
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de Silva A, Neel ML, Maitre N, Busch T, Taylor HG. Resilience and vulnerability in very preterm 4-year-olds. Clin Neuropsychol 2020; 35:904-924. [DOI: 10.1080/13854046.2020.1817565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Aryanne de Silva
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Mary Lauren Neel
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Nathalie Maitre
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Tyler Busch
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - H. Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
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49
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Hedderich DM, Avram M, Menegaux A, Nuttall R, Zimmermann J, Schneider SC, Schmitz-Koep B, Daamen M, Scheef L, Boecker H, Zimmer C, Baumann N, Bartmann P, Wolke D, Bäuml JG, Sorg C. Hippocampal subfield volumes are nonspecifically reduced in premature-born adults. Hum Brain Mapp 2020; 41:5215-5227. [PMID: 32845045 PMCID: PMC7670635 DOI: 10.1002/hbm.25187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/07/2020] [Accepted: 08/11/2020] [Indexed: 01/06/2023] Open
Abstract
Reduced global hippocampus volumes have been demonstrated in premature‐born individuals, from newborns to adults; however, it is unknown whether hippocampus subfield (HCSF) volumes are differentially affected by premature birth and how relevant they are for cognitive performance. To address these questions, we investigated magnetic resonance imaging (MRI)‐derived HCSF volumes in very premature‐born adults, and related them with general cognitive performance in adulthood. We assessed 103 very premature‐born (gestational age [GA] <32 weeks and/or birth weight <1,500 g) and 109 term‐born individuals with cognitive testing and structural MRI at 26 years of age. HCSFs were automatically segmented based on three‐dimensional T1‐ and T2‐weighted sequences and studied both individually and grouped into three functional units, namely hippocampus proper (HP), subicular complex (SC), and dentate gyrus (DG). Cognitive performance was measured using the Wechsler‐Adult‐Intelligence‐Scale (full‐scale intelligence quotient [FS‐IQ]) at 26 years. We observed bilateral volume reductions for almost all HCSF volumes in premature‐born adults and associations with GA and neonatal treatment intensity but not birth weight. Left‐sided HP, SC, and DG volumes were associated with adult FS‐IQ. Furthermore, left DG volume was a mediator of the association between GA and adult FS‐IQ in premature‐born individuals. Results demonstrate nonspecifically reduced HCSF volumes in premature‐born adults; but specific associations with cognitive outcome highlight the importance of the left DG. Data suggest that specific interventions toward hippocampus function might be promising to lower adverse cognitive effects of prematurity.
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Affiliation(s)
- Dennis M Hedderich
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Mihai Avram
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Aurore Menegaux
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Rachel Nuttall
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Juliana Zimmermann
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Sebastian C Schneider
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Benita Schmitz-Koep
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Marcel Daamen
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany.,Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Lukas Scheef
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Henning Boecker
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Josef G Bäuml
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany
| | - Christian Sorg
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Technical University of Munich-NIC Neuroimaging Center, Munich, Germany.,Department of Psychiatry, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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50
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Katušić A, Raguž M, Žunić Išasegi I. Brain tissue volumes at term-equivalent age are associated with early motor behavior in very preterm infants. Int J Dev Neurosci 2020; 80:409-417. [PMID: 32433785 DOI: 10.1002/jdn.10039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 11/10/2022] Open
Abstract
Preterm birth is associated with a wide range of adverse developmental outcomes, including sensory, motor, cognitive and language impairments, and behavioral or attention problems. Subtle motor deficits that might emerge in premature infants with no evident or with mild brain injury encompass qualitative and quantitative aspects of motor behavior. This prospective cohort study provided an evaluation of the relationship between brain tissue volumes revealed by magnetic resonance imaging (MRI) at term-equivalent age and motor behavior in infancy in very preterm infants (total number = 40; mean gestational age = 28 weeks + 4 days; mean birth weight = 1190 g) without evident or with mild brain injury. Infants were recruited at birth and assessed at 12 months corrected age using the tool for qualitative and quantitative assessment of motor behavior, infant motor profile. The brain tissue was segmented first using advanced segmentation techniques and the volumes were measured by summing the volumes of all voxels belonging to a particular tissue class. The associations between volumetric brain MRI measures with motor behavior were explored using linear regression analyses. Results showed that larger total brain volumes were associated with higher motor score. Similar relationships were documented for parietal lobe, deep gray matter, and cerebellum volumes. Volumetric quantitative data of brain structures may serve as biomarkers for subtle motor deficits described in very preterm born infants without or with mild brain lesions apparent on MRI.
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Affiliation(s)
- Ana Katušić
- Croatian Institute for Brain Research, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marina Raguž
- Department of Neurosurgery, School of Medicine, University Hospital Dubrava, University of Zagreb, Zagreb, Croatia
| | - Iris Žunić Išasegi
- Croatian Institute for Brain Research, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, University of Zagreb, Zagreb, Croatia
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