1
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Solis-Urra P, Rodriguez-Ayllon M, Verdejo-Román J, Erickson KI, Verdejo-García A, Catena A, Ortega FB, Esteban-Cornejo I. Early life factors and structural brain network in children with overweight/obesity: The ActiveBrains project. Pediatr Res 2024; 95:1812-1817. [PMID: 38066249 DOI: 10.1038/s41390-023-02923-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 10/24/2023] [Accepted: 11/07/2023] [Indexed: 07/14/2024]
Abstract
BACKGROUND The aims of this study were to investigate the association of early life factors, including birth weight, birth length, and breastfeeding practices, with structural brain networks; and to test whether structural brain networks associated with early life factors were also associated with academic performance in children with overweight/obesity (OW/OB). METHOD 96 children with OW/OB aged 8-11 years (10.03 ± 1.16) from the ActiveBrains project were included. Early life factors were collected from birth records and reported by parents as weight, height, and months of breastfeeding. T1-weighted images were used to identify structural networks using a non-negative matrix factorization (NNMF) approach. Academic performance was evaluated by the Woodcock-Muñoz standardized test battery. RESULTS Birth weight and birth length were associated with seven networks involving the cerebellum, cingulate gyrus, occipital pole, and subcortical structures including hippocampus, caudate nucleus, putamen, pallidum, nucleus accumbens, and amygdala. No associations were found for breastfeeding practices. None of the networks linked to birth weight and birth length were linked to academic performance. CONCLUSIONS Birth weight and birth length, but not breastfeeding, were associated with brain structural networks in children with OW/OB. Thus, early life factors are related to brain networks, yet a link with academic performance was not observed. IMPACT Birth weight and birth length, but not breastfeeding, were associated with several structural brain networks involving the cerebellum, cingulate gyrus, occipital pole, and subcortical structures including hippocampus, caudate, putamen, pallidum, accumbens and amygdala in children with overweight/obesity, playing a role for a normal brain development. Despite no academic consequences, other behavioral consequences should be investigated. Interventions aimed at improving optimal intrauterine growth and development may be of importance to achieve a healthy brain later in life.
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Affiliation(s)
- Patricio Solis-Urra
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, 18014, Granada, España.
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar, 2531015, Chile.
| | - Maria Rodriguez-Ayllon
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Juan Verdejo-Román
- Department of Personality, Assessment & Psychological Treatment, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- AdventHealth Research Institute, Neuroscience, Orlando, FL, USA
| | - Antonio Verdejo-García
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Andrés Catena
- School of Psychology, University of Granada, Campus de Cartuja s/n, 18071, Granada, Spain
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Irene Esteban-Cornejo
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
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2
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Shah DK, Pereira S, Lodygensky GA. Long-Term Neurologic Consequences following Fetal Growth Restriction: The Impact on Brain Reserve. Dev Neurosci 2024:1-8. [PMID: 38740013 DOI: 10.1159/000539266] [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: 10/09/2023] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Fetal growth restriction (FGR) corresponds to the fetus's inability to achieve an adequate weight gain based on genetic potential and gestational age. It is an important cause of morbidity and mortality. SUMMARY In this review, we address the challenges of diagnosis and classification of FGR. We review how chronic fetal hypoxia impacts brain development. We describe recent advances on placental and fetal brain imaging using magnetic resonance imaging and how they offer new noninvasive means to study growth restriction in humans. We go on to review the impact of FGR on brain integrity in the neonatal period, later childhood, and adulthood and review available therapies. KEY MESSAGES FGR consequences are not limited to the perinatal period. We hypothesize that impaired brain reserve, as defined by structure and size, may predict some concerning epidemiological data of impaired cognitive outcomes and dementia with aging in this group of patients.
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Affiliation(s)
- Divyen K Shah
- Centre for Neuroscience and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Neonatal Intensive Care, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Susana Pereira
- Obstetrics and Maternity Care, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Gregory A Lodygensky
- Department of Pediatrics, University of Montréal, Montréal, Québec, Canada
- Department of Pharmacology and Physiology, Université de Montréal, Montréal, Québec, Canada
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3
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Chincarini G, Walker DW, Wong F, Richardson SJ, Cumberland A, Tolcos M. Thyroid hormone analogues: Promising therapeutic avenues to improve the neurodevelopmental outcomes of intrauterine growth restriction. J Neurochem 2024. [PMID: 38742992 DOI: 10.1111/jnc.16124] [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: 12/14/2023] [Revised: 04/14/2024] [Accepted: 04/19/2024] [Indexed: 05/16/2024]
Abstract
Intrauterine growth restriction (IUGR) is a pregnancy complication impairing fetal growth and development. The compromised development is often attributed to disruptions of oxygen and nutrient supply from the placenta, resulting in a number of unfavourable physiological outcomes with impaired brain and organ growth. IUGR is associated with compromised development of both grey and white matter, predisposing the infant to adverse neurodevelopmental outcomes, including long-lasting cognitive and motor difficulties. Cerebral thyroid hormone (TH) signalling, which plays a crucial role in regulating white and grey matter development, is dysregulated in IUGR, potentially contributing to the neurodevelopmental delays associated with this condition. Notably, one of the major TH transporters, monocarboxylate transporter-8 (MCT8), is deficient in the fetal IUGR brain. Currently, no effective treatment to prevent or reverse IUGR exists. Management strategies involve close antenatal monitoring, management of maternal risk factors if present and early delivery if IUGR is found to be severe or worsening in utero. The overall goal is to determine the most appropriate time for delivery, balancing the risks of preterm birth with further fetal compromise due to IUGR. Drug candidates have shown either adverse effects or little to no benefits in this vulnerable population, urging further preclinical and clinical investigation to establish effective therapies. In this review, we discuss the major neuropathology of IUGR driven by uteroplacental insufficiency and the concomitant long-term neurobehavioural impairments in individuals born IUGR. Importantly, we review the existing clinical and preclinical literature on cerebral TH signalling deficits, particularly the impaired expression of MCT8 and their correlation with IUGR. Lastly, we discuss the current evidence on MCT8-independent TH analogues which mimic the brain actions of THs by being metabolised in a similar manner as promising, albeit underappreciated approaches to promote grey and white matter development and improve the neurobehavioural outcomes following IUGR.
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Affiliation(s)
- Ginevra Chincarini
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - David W Walker
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
- Monash Newborn Health, Monash Medical Centre, Clayton, Melbourne, Victoria, Australia
| | - Flora Wong
- Monash Newborn Health, Monash Medical Centre, Clayton, Melbourne, Victoria, Australia
| | | | - Angela Cumberland
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Mary Tolcos
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
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4
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Xie Y, Yang Y, Yuan T. Brain Damage in the Preterm Infant: Clinical Aspects and Recent Progress in the Prevention and Treatment. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:27-40. [PMID: 35209835 DOI: 10.2174/1871527321666220223092905] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/16/2022] [Accepted: 01/16/2022] [Indexed: 12/16/2022]
Abstract
Although the prevalence of brain injury and related neurodevelopmental disabilities resulting from preterm birth are major public health concerns, there are no definite neuroprotective strategies to prevent or reduce brain injury. The pattern of brain injury seen in preterm infants has evolved into more subtle lesions that are still essential to diagnose regarding neurodevelopmental outcomes. There is no specific effective method for the treatment of premature infant brain injury, and the focus of clinical treatment is still on prevention. Prevention of this injury requires insight into the pathogenesis, but many gaps exist in our understanding of how neonatal treatment procedures and medications impact cerebral hemodynamics and preterm brain injury. Many studies provide evidence about the prevention of premature infant brain injury, which is related to some drugs (such as erythropoietin, melatonin, mesenchymal stem cells, etc.). However, there are still some controversies about the quality of research and the effectiveness of therapy. This review aims to recapitulate the results of preclinical studies and provide an update on the latest developments around etiological pathways, prevention, and treatment.
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Affiliation(s)
- Yixuan Xie
- Department of Neonatology, Children\'s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, P.R. China
| | - Yue Yang
- Department of Neonatology, Children\'s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, P.R. China
| | - Tianming Yuan
- Department of Neonatology, Children\'s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, P.R. China
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5
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Korkalainen N, Ilvesmäki T, Parkkola R, Perhomaa M, Mäkikallio K. Brain volumes and white matter microstructure in 8- to 10-year-old children born with fetal growth restriction. Pediatr Radiol 2022; 52:2388-2400. [PMID: 35460034 PMCID: PMC9616762 DOI: 10.1007/s00247-022-05372-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/05/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fetal growth restriction caused by placental insufficiency is associated with increased risk of poor neurodevelopment, even in the absence of specific perinatal brain injury. Placental insufficiency leads to chronic hypoxaemia that may alter cerebral tissue organisation and maturation. OBJECTIVE The aim of this study was to assess the effects fetal growth restriction and fetal haemodynamic abnormalities have on brain volumes and white matter microstructure at early school age. MATERIALS AND METHODS This study examined 32 children born with fetal growth restriction at 24 to 40 gestational weeks, and 27 gestational age-matched children, who were appropriate for gestational age. All children underwent magnetic resonance imaging (MRI) at the age of 8-10 years. Cerebral volumes were analysed, and tract-based spatial statistics and atlas-based analysis of white matter were performed on 17 children born with fetal growth restriction and 14 children with birth weight appropriate for gestational age. RESULTS Children born with fetal growth restriction demonstrated smaller total intracranial volumes compared to children with normal fetal growth, whereas no significant differences in grey or white matter volumes were detected. On atlas-based analysis of white matter, children born with fetal growth restriction demonstrated higher mean and radial diffusivity values in large white matter tracts when compared to children with normal fetal growth. CONCLUSION Children ages 8-10 years old born with fetal growth restriction demonstrated significant changes in white matter microstructure compared to children who were appropriate for gestational age, even though no differences in grey and white matter volumes were detected. Poor fetal growth may impact white matter maturation and lead to neurodevelopmental impairment later in life.
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Affiliation(s)
- Noora Korkalainen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital, Aapistie 5 A, 5000, FI-90014, Oulu, PL, Finland.
- University of Oulu, Oulu, Finland.
| | - Tero Ilvesmäki
- Department of Radiology, Turku University Hospital, Turku, Finland
- Department of Radiology, University of Turku, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Turku University Hospital, Turku, Finland
- Department of Radiology, University of Turku, Turku, Finland
| | - Marja Perhomaa
- Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Kaarin Mäkikallio
- Department of Radiology, University of Turku, Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
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6
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Combination of human endothelial colony-forming cells and mesenchymal stromal cells exert neuroprotective effects in the growth-restricted newborn. NPJ Regen Med 2021; 6:75. [PMID: 34795316 PMCID: PMC8602245 DOI: 10.1038/s41536-021-00185-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/19/2021] [Indexed: 11/09/2022] Open
Abstract
The foetal brain is particularly vulnerable to the detrimental effects of foetal growth restriction (FGR) with subsequent abnormal neurodevelopment being common. There are no current treatments to protect the FGR newborn from lifelong neurological disorders. This study examines whether pure foetal mesenchymal stromal cells (MSC) and endothelial colony-forming cells (ECFC) from the human term placenta are neuroprotective through modulating neuroinflammation and supporting the brain vasculature. We determined that one dose of combined MSC-ECFCs (cECFC; 106 ECFC 106 MSC) on the first day of life to the newborn FGR piglet improved damaged vasculature, restored the neurovascular unit, reduced brain inflammation and improved adverse neuronal and white matter changes present in the FGR newborn piglet brain. These findings could not be reproduced using MSCs alone. These results demonstrate cECFC treatment exerts beneficial effects on multiple cellular components in the FGR brain and may act as a neuroprotectant.
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7
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Pagnin M, Kondos-Devcic D, Chincarini G, Cumberland A, Richardson SJ, Tolcos M. Role of thyroid hormones in normal and abnormal central nervous system myelination in humans and rodents. Front Neuroendocrinol 2021; 61:100901. [PMID: 33493504 DOI: 10.1016/j.yfrne.2021.100901] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/07/2021] [Accepted: 01/16/2021] [Indexed: 12/13/2022]
Abstract
Thyroid hormones (THs) are instrumental in promoting the molecular mechanisms which underlie the complex nature of neural development and function within the central nervous system (CNS) in vertebrates. The key neurodevelopmental process of myelination is conserved between humans and rodents, of which both experience peak fetal TH concentrations concomitant with onset of myelination. The importance of supplying adequate levels of THs to the myelin producing cells, the oligodendrocytes, for promoting their maturation is crucial for proper neural function. In this review we examine the key TH distributor and transport proteins, including transthyretin (TTR) and monocarboxylate transporter 8 (MCT8), essential for supporting proper oligodendrocyte and myelin health; and discuss disorders with impaired TH signalling in relation to abnormal CNS myelination in humans and rodents. Furthermore, we explore the importance of using novel TH analogues in the treatment of myelination disorders associated with abnormal TH signalling.
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Affiliation(s)
- Maurice Pagnin
- School of Health and Biomedical Sciences, RMIT University, Bundoora 3083, Australia
| | - Delphi Kondos-Devcic
- School of Health and Biomedical Sciences, RMIT University, Bundoora 3083, Australia
| | - Ginevra Chincarini
- School of Health and Biomedical Sciences, RMIT University, Bundoora 3083, Australia
| | - Angela Cumberland
- School of Health and Biomedical Sciences, RMIT University, Bundoora 3083, Australia
| | | | - Mary Tolcos
- School of Health and Biomedical Sciences, RMIT University, Bundoora 3083, Australia.
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8
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Fanous M, Caputo MP, Lee YJ, Rund LA, Best-Popescu C, Kandel ME, Johnson RW, Das T, Kuchan MJ, Popescu G. Quantifying myelin content in brain tissue using color Spatial Light Interference Microscopy (cSLIM). PLoS One 2020; 15:e0241084. [PMID: 33211727 PMCID: PMC7676665 DOI: 10.1371/journal.pone.0241084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/08/2020] [Indexed: 12/18/2022] Open
Abstract
Deficient myelination of the brain is associated with neurodevelopmental delays, particularly in high-risk infants, such as those born small in relation to their gestational age (SGA). New methods are needed to further study this condition. Here, we employ Color Spatial Light Interference Microscopy (cSLIM), which uses a brightfield objective and RGB camera to generate pathlength-maps with nanoscale sensitivity in conjunction with a regular brightfield image. Using tissue sections stained with Luxol Fast Blue, the myelin structures were segmented from a brightfield image. Using a binary mask, those portions were quantitatively analyzed in the corresponding phase maps. We first used the CLARITY method to remove tissue lipids and validate the sensitivity of cSLIM to lipid content. We then applied cSLIM to brain histology slices. These specimens are from a previous MRI study, which demonstrated that appropriate for gestational age (AGA) piglets have increased internal capsule myelination (ICM) compared to small for gestational age (SGA) piglets and that a hydrolyzed fat diet improved ICM in both. The identity of samples was blinded until after statistical analyses.
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Affiliation(s)
- Michael Fanous
- Quantitative Light Imaging Laboratory, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | - Megan P. Caputo
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Young Jae Lee
- Quantitative Light Imaging Laboratory, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Laurie A. Rund
- Laboratory of Integrative Immunology & Behavior, Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Catherine Best-Popescu
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Mikhail E. Kandel
- Quantitative Light Imaging Laboratory, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | - Rodney W. Johnson
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Laboratory of Integrative Immunology & Behavior, Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Tapas Das
- Abbott Nutrition, Discovery Research, Columbus, OH, United States of America
| | - Matthew J. Kuchan
- Abbott Nutrition, Strategic Research, Columbus, OH, United States of America
| | - Gabriel Popescu
- Quantitative Light Imaging Laboratory, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
- * E-mail:
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9
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Franke K, Van den Bergh BRH, de Rooij SR, Kroegel N, Nathanielsz PW, Rakers F, Roseboom TJ, Witte OW, Schwab M. Effects of maternal stress and nutrient restriction during gestation on offspring neuroanatomy in humans. Neurosci Biobehav Rev 2020; 117:5-25. [PMID: 32001273 PMCID: PMC8207653 DOI: 10.1016/j.neubiorev.2020.01.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 01/06/2023]
Abstract
Cognitive and mental health are major determinants of quality of life, allowing integration into society at all ages. Human epidemiological and animal studies indicate that in addition to genetic factors and lifestyle, prenatal environmental influences may program neuropsychiatric disorders in later life. While several human studies have examined the effects of prenatal stress and nutrient restriction on brain function and mental health in later life, potentially mediating effects of prenatal stress and nutrient restriction on offspring neuroanatomy in humans have been studied only in recent years. Based on neuroimaging and anatomical data, we comprehensively review the studies in this emerging field. We relate prenatal environmental influences to neuroanatomical abnormalities in the offspring, measured in utero and throughout life. We also assess the relationship between neuroanatomical abnormalities and cognitive and mental disorders. Timing- and gender-specific effects are considered, if reported. Our review provides evidence for adverse effects of an unfavorable prenatal environment on structural brain development that may contribute to the risk for cognitive, behavioral and mental health problems throughout life.
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Affiliation(s)
- Katja Franke
- Department of Neurology, Jena University Hospital, Jena, Germany.
| | - Bea R H Van den Bergh
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Department for Welfare, Public Health and Family, Flemish Government, Brussels, Belgium
| | - Susanne R de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
| | - Nasim Kroegel
- Department of Neurology, Jena University Hospital, Jena, Germany; acatech - National Academy of Science and Engineering, Berlin, Germany
| | - Peter W Nathanielsz
- Texas Pregnancy & Life Course Health Research Center, Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, United States; Dept. of Animal Science, University of Wyoming, Laramie, WY, United States
| | - Florian Rakers
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Tessa J Roseboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Matthias Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
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10
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Powell CD, Wilson WM, Olesaningo G, Manyama M, Jamniczky H, Spritz R, Cross JC, Lukowiak K, Hallgrimsson B, Gonzalez PN. Lack of head sparing following third-trimester caloric restriction among Tanzanian Maasai. PLoS One 2020; 15:e0237700. [PMID: 32966295 PMCID: PMC7510984 DOI: 10.1371/journal.pone.0237700] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 08/02/2020] [Indexed: 12/31/2022] Open
Abstract
The reduction of food intake during pregnancy is part of many cultural and religious traditions around the world. The impact of such practices on fetal growth and development are poorly understood. Here, we examined the patterns of diet intake among Maasai pregnant women and assessed their effect on newborn morphometrics. We recruited 141 mother-infant pairs from Ngorongoro Conservation Area (NCA) in Northern Tanzania and quantified dietary intake and changes in maternal diet during pregnancy. We obtained measurements of body weight (BW) and head circumference (HC) at birth. We found that Maasai women significantly reduced their dietary intake during the third trimester, going from an average of 1601 kcal/day during the first two trimesters to 799 kcal/day in the final trimester. The greatest proportion of nutrient reduction was in carbohydrates. Overall, 40% of HC Z-scores of the NCA sample were more than 2 standard deviations below the WHO standard. Nearly a third of neonates classify as low birth weight (< 2500g). HC was smaller relative to BW in this cohort than predicted using the WHO standard. This contrasts markedly to a Tanzanian birth cohort obtained at the same time in an urban context in which only 12% of infants exhibited low weight, only two individuals had HC Z-scores < 2 and HC's relative to birth weight were larger than predicted using the WHO standards. The surprising lack of head sparing in the NCA cohort suggests that the impact of third trimester malnutrition bears further investigation in both animal models and human populations, especially as low HC is negatively associated with long term health outcomes.
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Affiliation(s)
- Christopher D. Powell
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Warren M. Wilson
- Department of Anthropology and Archaeology, University of Calgary, Calgary, Alberta, Canada
| | | | - Mange Manyama
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Division of Medical Education, Weill Cornell Medicine, Qatar
| | - Heather Jamniczky
- Department of Anthropology and Archaeology, University of Calgary, Calgary, Alberta, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, Alberta, Canada
| | - Richard Spritz
- Department of Pediatrics and Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Denver, Colorado
| | - James C. Cross
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, and the Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department Biochemistry & Molecular Biology, University of Calgary, Calgary, Alberta, Canada
| | - Kenneth Lukowiak
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Canada
| | - Benedikt Hallgrimsson
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paula N. Gonzalez
- Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos (CONICET-Hospital El Cruce Dr. Nestor Kirchner-Uiversidad Nacional Arturo Jauretche), Buenos Aires, Argentina
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11
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Caputo MP, Williams JN, Drnevich J, Radlowski EC, Larsen RJ, Sutton BP, Leyshon BJ, Hussain J, Nakamura MT, Kuchan MJ, Das T, Johnson RW. Hydrolyzed Fat Formula Increases Brain White Matter in Small for Gestational Age and Appropriate for Gestational Age Neonatal Piglets. Front Pediatr 2020; 8:32. [PMID: 32117837 PMCID: PMC7029735 DOI: 10.3389/fped.2020.00032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/22/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Intrauterine growth restriction is a common cause of small for gestational age (SGA) infants worldwide. SGA infants are deficient in digestive enzymes required for fat digestion and absorption compared to appropriate for gestational age (AGA) infants, putting them at risk for impaired neurocognitive development. Objective: The objective was to determine if a hydrolyzed fat (HF) infant formula containing soy free fatty acids, 2-monoacylglycerolpalmitate, cholesterol, and soy lecithin could increase brain tissue incorporation of essential fatty acids or white matter to enhance brain development in SGA and AGA neonatal piglet models. Methods: Sex-matched, littermate pairs of SGA (0.5-0.9 kg) and AGA (1.2-1.8 kg) 2 days old piglets (N = 60) were randomly assigned to control (CON) or HF formula diets in a 2 × 2 factorial design. On day 14, 24 piglets were used for hippocampal RNA-sequencing; the rest began a spatial learning task. On days 26-29, brain structure was assessed by magnetic resonance imaging (MRI). Cerebellum and hippocampus were analyzed for fatty acid content. Results: SGA piglets grew more slowly than AGA piglets, with no effect of diet on daily weight gain or weight at MRI. HF diet did not affect brain weight. HF diet increased relative volumes of 7 brain regions and white matter (WM) volume in both SGA and AGA piglets. However, HF did not ameliorate SGA total WM integrity deficits. RNA sequencing revealed SGA piglets had increased gene expression of synapse and cell signaling pathways and decreased expression of ribosome pathways in the hippocampus compared to AGA. HF decreased expression of immune response related genes in the hippocampus of AGA and SGA piglets, but did not correct gene expression patterns in SGA piglets. Piglets learned the T-maze task at the same rate, but SGA HF, SGA CON, and AGA HF piglets had more accurate performance than AGA CON piglets on reversal day 2. HF increased arachidonic acid (ARA) percentage in the cerebellum and total ARA in the hippocampus. Conclusions: HF enhanced brain development in the neonatal piglet measured by brain volume and WM volume in specific brain regions; however, more studies are needed to assess long-term outcomes.
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Affiliation(s)
- Megan P Caputo
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States.,Department of Animal Sciences, University of Illinois, Urbana, IL, United States
| | - Jennifer N Williams
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States.,Department of Animal Sciences, University of Illinois, Urbana, IL, United States
| | - Jenny Drnevich
- High Performance Biological Computing Group and the Carver Biotechnology Center, University of Illinois, Urbana, IL, United States
| | - Emily C Radlowski
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States.,Department of Animal Sciences, University of Illinois, Urbana, IL, United States
| | - Ryan J Larsen
- Beckman Institute, University of Illinois, Urbana, IL, United States
| | - Bradley P Sutton
- Beckman Institute, University of Illinois, Urbana, IL, United States.,Department of Bioengineering, University of Illinois, Urbana, IL, United States
| | - Brian J Leyshon
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States.,Department of Animal Sciences, University of Illinois, Urbana, IL, United States
| | - Jamal Hussain
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States
| | - Manabu T Nakamura
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States.,Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States
| | - Matthew J Kuchan
- Abbott Nutrition, Discovery Research, Columbus, OH, United States
| | - Tapas Das
- Abbott Nutrition, Discovery Research, Columbus, OH, United States
| | - Rodney W Johnson
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States.,Department of Animal Sciences, University of Illinois, Urbana, IL, United States.,Neuroscience Program, University of Illinois, Urbana, IL, United States
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12
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Volpe JJ. Dysmaturation of Premature Brain: Importance, Cellular Mechanisms, and Potential Interventions. Pediatr Neurol 2019; 95:42-66. [PMID: 30975474 DOI: 10.1016/j.pediatrneurol.2019.02.016] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 02/07/2023]
Abstract
Prematurity, especially preterm birth (less than 32 weeks' gestation), is common and associated with high rates of both survival and neurodevelopmental disability, especially apparent in cognitive spheres. The neuropathological substrate of this disability is now recognized to be related to a variety of dysmaturational disturbances of the brain. These disturbances follow initial brain injury, particularly cerebral white matter injury, and involve many of the extraordinary array of developmental events active in cerebral white and gray matter structures during the premature period. This review delineates these developmental events and the dysmaturational disturbances that occur in premature infants. The cellular mechanisms involved in the genesis of the dysmaturation are emphasized, with particular focus on the preoligodendrocyte. A central role for the diffusely distributed activated microglia and reactive astrocytes in the dysmaturation is now apparent. As these dysmaturational cellular mechanisms appear to occur over a relatively long time window, interventions to prevent or ameliorate the dysmaturation, that is, neurorestorative interventions, seem possible. Such interventions include pharmacologic agents, especially erythropoietin, and particular attention has also been paid to such nutritional factors as quality and source of milk, breastfeeding, polyunsaturated fatty acids, iron, and zinc. Recent studies also suggest a potent role for interventions directed at various experiential factors in the neonatal period and infancy, i.e., provision of optimal auditory and visual exposures, minimization of pain and stress, and a variety of other means of environmental behavioral enrichment, in enhancing brain development.
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Affiliation(s)
- Joseph J Volpe
- Department of Neurology, Harvard Medical School, Boston, Massachusetts; Department of Pediatric Newborn Medicine, Harvard Medical School, Boston, Massachusetts.
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13
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Wixey JA, Lee KM, Miller SM, Goasdoue K, Colditz PB, Tracey Bjorkman S, Chand KK. Neuropathology in intrauterine growth restricted newborn piglets is associated with glial activation and proinflammatory status in the brain. J Neuroinflammation 2019; 16:5. [PMID: 30621715 PMCID: PMC6323795 DOI: 10.1186/s12974-018-1392-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/17/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The fetal brain is particularly vulnerable to intrauterine growth restriction (IUGR) conditions evidenced by neuronal and white matter abnormalities and altered neurodevelopment in the IUGR infant. To further our understanding of neurodevelopment in the newborn IUGR brain, clinically relevant models of IUGR are required. This information is critical for the design and implementation of successful therapeutic interventions to reduce aberrant brain development in the IUGR newborn. We utilise the piglet as a model of IUGR as growth restriction occurs spontaneously in the pig as a result of placental insufficiency, making it a highly relevant model of human IUGR. The purpose of this study was to characterise neuropathology and neuroinflammation in the neonatal IUGR piglet brain. METHODS Newborn IUGR (< 5th centile) and normally grown (NG) piglets were euthanased on postnatal day 1 (P1; < 18 h) or P4. Immunohistochemistry was utilised to examine neuronal, white matter and inflammatory responses, and PCR for cytokine analysis in parietal cortex of IUGR and NG piglets. RESULTS The IUGR piglet brain displayed less NeuN-positive cells and reduced myelination at both P1 and P4 in the parietal cortex, indicating neuronal and white matter disruption. A concurrent decrease in Ki67-positive proliferative cells and increase in cell death (caspase-3) in the IUGR piglet brain was also apparent on P4. We observed significant increases in the number of both Iba-1-positive microglia and GFAP-positive astrocytes in the white matter in IUGR piglet brain on both P1 and P4 compared with NG piglets. These increases were associated with a change in activation state, as noted by altered glial morphology. This inflammatory state was further evident with increased expression levels of proinflammatory cytokines (interleukin-1β, tumour necrosis factor-α) and decreased levels of anti-inflammatory cytokines (interleukin-4 and -10) observed in the IUGR piglet brains. CONCLUSIONS These findings suggest that the piglet model of IUGR displays the characteristic neuropathological outcomes of neuronal and white matter impairment similar to those reported in the IUGR human brain. The activated glial morphology and elevated proinflammatory cytokines is indicative of an inflammatory response that may be associated with neuronal damage and white matter disruption. These findings support the use of the piglet as a pre-clinical model for studying mechanisms of altered neurodevelopment in the IUGR newborn.
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Affiliation(s)
- Julie A Wixey
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia.
| | - Kah Meng Lee
- Institute of Health Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
| | - Stephanie M Miller
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
| | - Kate Goasdoue
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
| | - Paul B Colditz
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia.,Perinatal Research Centre, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia
| | - S Tracey Bjorkman
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
| | - Kirat K Chand
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia
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14
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Pulli EP, Kumpulainen V, Kasurinen JH, Korja R, Merisaari H, Karlsson L, Parkkola R, Saunavaara J, Lähdesmäki T, Scheinin NM, Karlsson H, Tuulari JJ. Prenatal exposures and infant brain: Review of magnetic resonance imaging studies and a population description analysis. Hum Brain Mapp 2018; 40:1987-2000. [PMID: 30451332 DOI: 10.1002/hbm.24480] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 12/11/2022] Open
Abstract
Brain development is most rapid during the fetal period and the first years of life. This process can be affected by many in utero factors, such as chemical exposures and maternal health characteristics. The goal of this review is twofold: to review the most recent findings on the effects of these prenatal factors on the developing brain and to qualitatively assess how those factors were generally reported in studies on infants up to 2 years of age. To capture the latest findings in the field, we searched articles from PubMed 2012 onward with search terms referring to magnetic resonance imaging (MRI), brain development, and infancy. We identified 19 MRI studies focusing on the effects of prenatal environment and summarized them to highlight the recent advances in the field. We assessed population descriptions in a representative sample of 67 studies and conclude that prenatal factors that have been shown to affect brain metrics are not generally reported comprehensively. Based on our findings, we propose some improvements for population descriptions to account for plausible confounders and in time enable reliable meta-analyses to be performed. This could help the pediatric neuroimaging field move toward more reliable identification of biomarkers for developmental outcomes and to better decipher the nuances of normal and abnormal brain development.
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Affiliation(s)
- Elmo P Pulli
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Venla Kumpulainen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Jussi H Kasurinen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Future Technologies, University of Turku, Turku, Finland.,Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Tuire Lähdesmäki
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Pediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Turku Collegium for Science and Medicine, University of Turku, Turku, Finland
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15
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Tolcos M, Petratos S, Hirst JJ, Wong F, Spencer SJ, Azhan A, Emery B, Walker DW. Blocked, delayed, or obstructed: What causes poor white matter development in intrauterine growth restricted infants? Prog Neurobiol 2017; 154:62-77. [PMID: 28392287 DOI: 10.1016/j.pneurobio.2017.03.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 03/17/2017] [Accepted: 03/29/2017] [Indexed: 12/22/2022]
Abstract
Poor white matter development in intrauterine growth restricted (IUGR) babies remains a major, untreated problem in neonatology. New therapies, guided by an understanding of the mechanisms that underlie normal and abnormal oligodendrocyte development and myelin formation, are required. Much of our knowledge of the mechanisms that underlie impaired myelination come from studies in adult demyelinating disease, preterm brain injury, or experimental models of hypoxia-ischemia. However, relatively less is known for IUGR which is surprising because IUGR is a leading cause of perinatal mortality and morbidity, second only to premature birth. IUGR is also a significant risk factor for the later development of cerebral palsy, and is a greater risk compared to some of the more traditionally researched antecedents - asphyxia and inflammation. Recent evidence suggests that the white matter injury and reduced myelination in the brains of some preterm babies is due to impaired maturation of oligodendrocytes thereby resulting in the reduced capacity to synthesize myelin. Therefore, it is not surprising that the hypomyelination observable in the central nervous system of IUGR infants has similarly lead to investigations identifying a delay or blockade in the progress of maturation of oligodendrocytes in these infants. This review will discuss current ideas thought to account for the poor myelination often present in the neonate's brain following IUGR, and discuss novel interventions that are promising as treatments that promote oligodendrocyte maturation, and thereby repair the myelination deficits that otherwise persist into infancy and childhood and lead to neurodevelopmental abnormalities.
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Affiliation(s)
- Mary Tolcos
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia.
| | - Steven Petratos
- Department of Medicine, Central Clinical School, Monash University, Prahran, Victoria, 3004, Australia
| | - Jonathan J Hirst
- School of Biomedical Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Flora Wong
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, 3168, Australia; Monash Newborn and Monash University, Clayton, Victoria, 3168, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Aminath Azhan
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, 3168, Australia
| | - Ben Emery
- Oregon Health and Science University, Portland, OR, 97239-3098, USA
| | - David W Walker
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia
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16
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Muñoz-Moreno E, Fischi-Gomez E, Batalle D, Borradori-Tolsa C, Eixarch E, Thiran JP, Gratacós E, Hüppi PS. Structural Brain Network Reorganization and Social Cognition Related to Adverse Perinatal Condition from Infancy to Early Adolescence. Front Neurosci 2016; 10:560. [PMID: 28008304 PMCID: PMC5143343 DOI: 10.3389/fnins.2016.00560] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/21/2016] [Indexed: 11/13/2022] Open
Abstract
Adverse conditions during fetal life have been associated to both structural and functional changes in neurodevelopment from the neonatal period to adolescence. In this study, connectomics was used to assess the evolution of brain networks from infancy to early adolescence. Brain network reorganization over time in subjects who had suffered adverse perinatal conditions is characterized and related to neurodevelopment and cognition. Three cohorts of prematurely born infants and children (between 28 and 35 weeks of gestational age), including individuals with a birth weight appropriated for gestational age and with intrauterine growth restriction (IUGR), were evaluated at 1, 6, and 10 years of age, respectively. A common developmental trajectory of brain networks was identified in both control and IUGR groups: network efficiencies of the fractional anisotropy (FA)-weighted and normalized connectomes increase with age, which can be related to maturation and myelination of fiber connections while the number of connections decreases, which can be associated to an axonal pruning process and reorganization. Comparing subjects with or without IUGR, a similar pattern of network differences between groups was observed in the three developmental stages, mainly characterized by IUGR group having reduced brain network efficiencies in binary and FA-weighted connectomes and increased efficiencies in the connectome normalized by its total connection strength (FA). Associations between brain networks and neurobehavioral impairments were also evaluated showing a relationship between different network metrics and specific social cognition-related scores, as well as a higher risk of inattention/hyperactivity and/or executive functional disorders in IUGR children.
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Affiliation(s)
- Emma Muñoz-Moreno
- Fetal i+D, Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of BarcelonaBarcelona, Spain; Experimental 7T MRI Unit, Institut d'Investigacions Biomèdiques August Pi I SunyerBarcelona, Spain
| | - Elda Fischi-Gomez
- Signal Processing Laboratory 5, École Polytechnique Fédérale de LausanneLausanne, Switzerland; Division of Development and Growth. Department of Pediatrics, University Hospital of GenevaGeneva, Switzerland
| | - Dafnis Batalle
- Fetal i+D, Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of BarcelonaBarcelona, Spain; Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College LondonLondon, UK
| | - Cristina Borradori-Tolsa
- Division of Development and Growth. Department of Pediatrics, University Hospital of Geneva Geneva, Switzerland
| | - Elisenda Eixarch
- Fetal i+D, Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of BarcelonaBarcelona, Spain; Centre for Biomedical Research on Rare DiseasesBarcelona, Spain
| | - Jean-Philippe Thiran
- Signal Processing Laboratory 5, École Polytechnique Fédérale de LausanneLausanne, Switzerland; Department of Radiology, University Hospital Center and University of LausanneLausanne, Switzerland
| | - Eduard Gratacós
- Fetal i+D, Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of BarcelonaBarcelona, Spain; Centre for Biomedical Research on Rare DiseasesBarcelona, Spain
| | - Petra S Hüppi
- Division of Development and Growth. Department of Pediatrics, University Hospital of Geneva Geneva, Switzerland
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17
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Hunter DS, Hazel SJ, Kind KL, Liu H, Marini D, Giles LC, De Blasio MJ, Owens JA, Pitcher JB, Gatford KL. Effects of induced placental and fetal growth restriction, size at birth and early neonatal growth on behavioural and brain structural lateralization in sheep. Laterality 2016; 22:560-589. [PMID: 27759494 DOI: 10.1080/1357650x.2016.1243552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Poor perinatal growth in humans results in asymmetrical grey matter loss in fetuses and infants and increased functional and behavioural asymmetry, but specific contributions of pre- and postnatal growth are unclear. We therefore compared strength and direction of lateralization in obstacle avoidance and maze exit preference tasks in offspring of placentally restricted (PR: 10M, 13F) and control (CON: 23M, 17F) sheep pregnancies at 18 and 40 weeks of age, and examined gross brain structure of the prefrontal cortex at 52 weeks of age (PR: 14M, 18F; CON: 23M, 25F). PR did not affect lateralization direction, but 40-week-old PR females had greater lateralization strength than CON (P = .021). Behavioural lateralization measures were not correlated with perinatal growth. PR did not alter brain morphology. In males, cross-sectional areas of the prefrontal cortex and left hemisphere correlated positively with skull width at birth, and white matter area correlated positively with neonatal growth rate of the skull (all P < .05). These studies reinforce the need to include progeny of both sexes in future studies of neurodevelopmental programming, and suggest that restricting in utero growth has relatively mild effects on gross brain structural or behavioural lateralization in sheep.
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Affiliation(s)
- Damien Seth Hunter
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia.,c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Susan J Hazel
- c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Karen L Kind
- a Robinson Research Institute , North Adelaide , Australia.,c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Hong Liu
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Danila Marini
- c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Lynne C Giles
- a Robinson Research Institute , North Adelaide , Australia.,d School of Population Health , University of Adelaide , Adelaide , South Australia , Australia
| | - Miles J De Blasio
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Julie A Owens
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Julia B Pitcher
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Kathryn L Gatford
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
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18
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Hunter DS, Hazel SJ, Kind KL, Owens JA, Pitcher JB, Gatford KL. Programming the brain: Common outcomes and gaps in knowledge from animal studies of IUGR. Physiol Behav 2016; 164:233-48. [DOI: 10.1016/j.physbeh.2016.06.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 12/18/2022]
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19
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Håberg AK, Hammer TA, Kvistad KA, Rydland J, Müller TB, Eikenes L, Gårseth M, Stovner LJ. Incidental Intracranial Findings and Their Clinical Impact; The HUNT MRI Study in a General Population of 1006 Participants between 50-66 Years. PLoS One 2016; 11:e0151080. [PMID: 26950220 PMCID: PMC4780781 DOI: 10.1371/journal.pone.0151080] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/23/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Evaluate types and prevalence of all, incidental, and clinically relevant incidental intracranial findings, i.e. those referred to primary physician or clinical specialist, in a cohort between 50 and 66 years from the Nord-Trøndelag Health (HUNT) study. Types of follow-up, outcome of repeated neuroimaging and neurosurgical treatment were assessed. MATERIAL AND METHODS 1006 participants (530 women) underwent MRI of the head at 1.5T consisting of T1 weighted sagittal IR-FSPGR volume, axial T2 weighted, gradient echo T2* weighted and FLAIR sequences plus time of flight cerebral angiography covering the circle of Willis. The nature of a finding and if it was incidental were determined from previous radiological examinations, patient records, phone interview, and/or additional neuroimaging. Handling and outcome of the clinically relevant incidental findings were prospectively recorded. True and false positives were estimated from the repeated neuroimaging. RESULTS Prevalence of any intracranial finding was 32.7%. Incidental intracranial findings were present in 27.1% and clinically relevant findings in 15.1% of the participants in the HUNT MRI cohort. 185 individuals (18.4%) were contacted by phone about their findings. 40 participants (6.2%) underwent ≥ 1 additional neuroimaging session to establish etiology. Most false positives were linked to an initial diagnosis of suspected glioma, and overall positive predictive value of initial MRI was 0.90 across different diagnoses. 90.8% of the clinically relevant incidental findings were developmental and acquired cerebrovascular pathologies, the remaining 9.2% were intracranial tumors, of which extra-axial tumors predominated. In total, 3.9% of the participants were referred to a clinical specialist, and 11.7% to their primary physician. 1.4% underwent neurosurgery/radiotherapy, and 1 (0.1%) experienced a procedure related postoperative deficit. CONCLUSIONS In a general population between 50 and 66 years most intracranial findings on MRI were incidental, and >15% of the cohort was referred to clinical-follow up. Hence good routines for handling of findings need to be in place to ensure timely and appropriate handling.
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Affiliation(s)
- Asta Kristine Håberg
- Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Radiology, St. Olav University Hospital, Trondheim, Norway
| | - Tommy Arild Hammer
- Department of Radiology, St. Olav University Hospital, Trondheim, Norway
| | - Kjell Arne Kvistad
- Department of Radiology, St. Olav University Hospital, Trondheim, Norway
| | - Jana Rydland
- Department of Radiology, St. Olav University Hospital, Trondheim, Norway
| | - Tomm B. Müller
- Department of Neurosurgery, St. Olav University Hospital, Trondheim, Norway
| | - Live Eikenes
- Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway
| | - Mari Gårseth
- Department of Radiology, Levanger Hospital, Levanger, Trondheim, Norway
| | - Lars Jacob Stovner
- Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway
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20
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Malhotra A, Yahya Z, Sasi A, Jenkin G, Ditchfield M, Polglase GR, Miller SL. Does fetal growth restriction lead to increased brain injury as detected by neonatal cranial ultrasound in premature infants? J Paediatr Child Health 2015; 51:1103-8. [PMID: 25939374 DOI: 10.1111/jpc.12910] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2015] [Indexed: 01/21/2023]
Abstract
AIM Intra-uterine growth restriction (IUGR) is an important cause for prematurity as well as a significant risk factor for neurodevelopmental deficits. In this study, we aimed to examine the association between IUGR and early brain injury on neonatal cranial ultrasound in preterm infants. METHODS This retrospective cohort study examined the relationship between IUGR and neonatal cranial ultrasound findings in preterm infants <32 weeks gestation with IUGR, compared with gestation and year of birth-matched appropriately grown infants, in a tertiary level neonatal unit. Primary outcome was incidence and severity of intraventricular haemorrhage (IVH), periventricular leucomalacia (PVL) and hydrocephalus detected by cranial ultrasound in the neonatal period. RESULTS A total of 153 IUGR and 306 non-IUGR preterm infants <32 weeks were included. The rates of IVH (21.6% vs. 23.9%), severe IVH (3.9% vs. 4.6%), PVL (8.4% vs. 9.4%), cystic PVL (2.6% vs. 0%) and hydrocephalus (0.7% vs. 0.3%) were similar in the two groups. Composite outcome of death and severe brain injury (severe IVH, cystic PVL and hydrocephalus) was greater (20.2% vs. 9.1%, P = 0.001) in IUGR infants. CONCLUSION IUGR did not lead to increased neonatal brain injury on cranial ultrasound but was associated with increased mortality. Advanced neonatal neuroimaging techniques may be necessary to estimate risk and to provide prognostic information of adverse neurological outcomes in this vulnerable population.
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Affiliation(s)
- Atul Malhotra
- Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.,The Ritchie Centre, MIMR-PHI Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Zamir Yahya
- Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Arun Sasi
- Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Graham Jenkin
- The Ritchie Centre, MIMR-PHI Institute, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Michael Ditchfield
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.,Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia
| | - Graeme R Polglase
- The Ritchie Centre, MIMR-PHI Institute, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Suzanne L Miller
- The Ritchie Centre, MIMR-PHI Institute, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
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21
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Griesmaier E, Burger C, Ralser E, Neubauer V, Kiechl-Kohlendorfer U. Amplitude-integrated electroencephalography shows mild delays in electrocortical activity in preterm infants born small for gestational age. Acta Paediatr 2015; 104:e283-8. [PMID: 25656306 DOI: 10.1111/apa.12967] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/22/2014] [Accepted: 02/02/2015] [Indexed: 11/26/2022]
Abstract
AIM Being born small for gestational age (SGA) seems to be a relevant risk factor for long-term neurologic deficits. We compared the differences between amplitude-integrated electroencephalography (aEEG) signals in very preterm infants born small for gestational age (SGA) and those in age-matched infants born appropriate size for gestational age (AGA). METHODS We performed serial aEEG recording on 305 infants: 255 (83.6%) were AGA, and 50 (16.3%) were SGA. RESULTS The number of bursts per hour decreased over time in both groups, but was higher in the SGA group at every time point. On day one, it was significantly higher in the SGA group (17.4) than in the AGA group (10.1) (p = 0.016). The total Burdjalov score increased with post-natal age and tended to be lower in SGA infants, but did not reach statistical significance at any time point. The percentage of continuous background patterns increased with post-natal age in both groups, with no significant difference between the groups. CONCLUSION Very preterm infants born SGA showed normal maturation of aEEG signals during post-natal life, but they also showed mild delays in electrocortical activity compared to age-matched AGA infants. The predictive value of these findings on neurodevelopmental outcome needs to be further evaluated.
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Affiliation(s)
- E Griesmaier
- Department of Pediatrics II; Neonatology; Innsbruck Medical University; Innsbruck Austria
| | - C Burger
- Department of Pediatrics II; Neonatology; Innsbruck Medical University; Innsbruck Austria
| | - E Ralser
- Department of Pediatrics II; Neonatology; Innsbruck Medical University; Innsbruck Austria
| | - V Neubauer
- Department of Pediatrics II; Neonatology; Innsbruck Medical University; Innsbruck Austria
| | - U Kiechl-Kohlendorfer
- Department of Pediatrics II; Neonatology; Innsbruck Medical University; Innsbruck Austria
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22
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Does Maternal Country of Birth Matter for Understanding Offspring's Birthweight? A Multilevel Analysis of Individual Heterogeneity in Sweden. PLoS One 2015; 10:e0129362. [PMID: 26020535 PMCID: PMC4447418 DOI: 10.1371/journal.pone.0129362] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/07/2015] [Indexed: 01/30/2023] Open
Abstract
Background Many public health and epidemiological studies have found differences between populations (e.g. maternal countries of birth) in average values of a health indicator (e.g. mean offspring birthweight). However, the approach based solely on population-level averages compromises our understanding of variability in individuals’ health around the averages. If this variability is high, the exclusive study of averages may give misleading information. This idea is relevant when investigating country of birth differences in health. Methods and Results To exemplify this concept, we use information from the Swedish Medical Birth Register (2002–2010) and apply multilevel regression analysis of birthweight, with babies (n = 811,329) at the first, mothers (n = 571,876) at the second, and maternal countries of birth (n = 109) at the third level. We disentangle offspring, maternal and maternal country of birth components of the total offspring heterogeneity in birthweight for babies born within the normal timespan (37–42 weeks). We found that of such birthweight variation about 50% was at the baby level, 47% at the maternal level and only 3% at the maternal countries of birth level. Conclusion In spite of seemingly large differences in average birthweight among maternal countries of birth (range 3290–3677g), knowledge of the maternal country of birth does not provide accurate information for ascertaining individual offspring birthweight because of the high inter-offspring heterogeneity around country averages. Our study exemplifies the need for a better understanding of individual health diversity for which group averages may provide insufficient and even misleading information. The analytical approach we outline is therefore relevant to investigations of country of birth (and ethnic) differences in health in general.
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23
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Håberg AK, Olsen A, Moen KG, Schirmer-Mikalsen K, Visser E, Finnanger TG, Evensen KAI, Skandsen T, Vik A, Eikenes L. White matter microstructure in chronic moderate-to-severe traumatic brain injury: Impact of acute-phase injury-related variables and associations with outcome measures. J Neurosci Res 2014; 93:1109-26. [PMID: 25641684 DOI: 10.1002/jnr.23534] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/29/2014] [Accepted: 11/20/2014] [Indexed: 12/20/2022]
Abstract
This study examines how injury mechanisms and early neuroimaging and clinical measures impact white matter (WM) fractional anisotropy (FA), mean diffusivity (MD), and tract volumes in the chronic phase of traumatic brain injury (TBI) and how WM integrity in the chronic phase is associated with different outcome measures obtained at the same time. Diffusion tensor imaging (DTI) at 3 T was acquired more than 1 year after TBI in 49 moderate-to-severe-TBI survivors and 50 matched controls. DTI data were analyzed with tract-based spatial statistics and automated tractography. Moderate-to-severe TBI led to widespread FA decreases, MD increases, and tract volume reductions. In severe TBI and in acceleration/deceleration injuries, a specific FA loss was detected. A particular loss of FA was also present in the thalamus and the brainstem in all grades of diffuse axonal injury. Acute-phase Glasgow Coma Scale scores, number of microhemorrhages on T2*, lesion volume on fluid-attenuated inversion recovery, and duration of posttraumatic amnesia were associated with more widespread FA loss and MD increases in chronic TBI. Episodes of cerebral perfusion pressure <70 mmHg were specifically associated with reduced MD. Neither episodes of intracranial pressure >20 mmHg nor acute-phase Rotterdam CT scores were associated with WM changes. Glasgow Outcome Scale Extended scores and performance-based cognitive control functioning were associated with FA and MD changes, but self-reported cognitive control functioning was not. In conclusion, FA loss specifically reflects the primary injury severity and mechanism, whereas FA and MD changes are associated with objective measures of general and cognitive control functioning.
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Affiliation(s)
- A K Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Medical Imaging, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Olsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K G Moen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurosurgery, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K Schirmer-Mikalsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Anaesthesia and Intensive Care, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - E Visser
- FMRIB Centre, University of Oxford, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom
| | - T G Finnanger
- Regional Centre for Child and Youth Mental Health and Child Welfare-Central Norway, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Mental Healthcare, Department of Child and Adolescent Psychiatry, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K A I Evensen
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Physiotherapy, Trondheim Municipality, Trondheim, Norway
| | - T Skandsen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Vik
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurosurgery, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - L Eikenes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
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24
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Østgård HF, Løhaugen GCC, Bjuland KJ, Rimol LM, Brubakk AM, Martinussen M, Vik T, Håberg AK, Skranes J. Brain morphometry and cognition in young adults born small for gestational age at term. J Pediatr 2014; 165:921-7.e1. [PMID: 25217202 DOI: 10.1016/j.jpeds.2014.07.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/27/2014] [Accepted: 07/24/2014] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To examine brain volumes and cortical surface area and thickness and to relate these brain measures to cognitive function in young adults born small for gestational age (SGA) at term compared with non-SGA control patients. STUDY DESIGN This population-based follow-up study at age 20 years included 58 term-born SGA (birth weight <10th percentile, mean: 2915 g) and 81 non-SGA controls (birth weight ≥ 10th percentile, mean: 3707 g). Brain volumes and cortical surface area and thickness were investigated with magnetic resonance imaging, which was successfully obtained in 47 SGA patients and 61 control patients. Cognitive function was assessed using the Wechsler Adult Intelligence Scale, 3rd edition. A subgroup analysis was performed in the SGA group among subjects diagnosed with fetal growth restriction (FGR) based on repeated fetal ultrasound measurements. RESULTS The SGA group showed regional reductions in cortical surface area, particularly in the frontal, parietal, and temporal lobes. Total brain volume, cortical gray matter, cerebral white matter, and putamen volumes were reduced in the SGA group compared with control patients, but there were no differences in specific subcortical brain structure volumes when correcting for intracranial volume. Reductions were most pronounced among SGA subjects with FGR. No associations were found between brain measures and IQ measures in either group. CONCLUSION Young adults born SGA at term show a global reduction in brain volume as well as regional reductions in cortical surface area. We speculate whether these reductions may be confined to those exposed to FGR. None of the brain measures correlated with cognition.
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Affiliation(s)
- Heidi Furre Østgård
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gro C C Løhaugen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Knut J Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars M Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olav University Hospital, Trondheim, Norway
| | - Marit Martinussen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics, St. Olav University Hospital, Trondheim, Norway
| | - Torstein Vik
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asta K Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Imaging, St. Olav University Hospital, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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25
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Egaña-Ugrinovic G, Sanz-Cortes M, Figueras F, Couve-Perez C, Gratacós E. Fetal MRI insular cortical morphometry and its association with neurobehavior in late-onset small-for-gestational-age fetuses. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 44:322-329. [PMID: 24616027 DOI: 10.1002/uog.13360] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 02/06/2014] [Accepted: 02/26/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate insular cortical morphometry assessed by magnetic resonance imaging (MRI) in late-onset small-for-gestational-age (SGA) fetuses compared with controls, and its association with neurobehavioral outcomes. METHODS MRI was performed in 65 late-onset SGA and 59 normally-grown fetuses at 37 weeks' gestation. T2-weighted half Fourier acquisition single-shot turbo spin echo (HASTE) anatomical and diffusion-weighted images were acquired. Insular cortical thickness, volume and fractional anisotropy values were assessed, and asymmetry indices were constructed. At 42 weeks of age, a Neonatal Behavioral Assessment Scale (NBAS) test was performed on the SGA neonates. RESULTS Late-onset SGA fetuses had significantly thinner insular cortical thickness and smaller insular cortical volume than did controls. SGA fetuses also presented a more pronounced left asymmetry in the posterior cortex and significantly lower fractional anisotropy values in the left insula. Insular measurements in the SGA group were significantly correlated with neurobehavior as assessed by NBAS scores. CONCLUSIONS Insular cortical morphometry was significantly different in late-onset SGA fetuses and correlated with poorer neurobehavioral performance. These data support the impact of growth restriction on brain development and the potential value of cortical assessment as a biomarker of neurodevelopment in at-risk fetuses.
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Affiliation(s)
- G Egaña-Ugrinovic
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), and University of Barcelona, Barcelona, Spain
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26
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Juárez SP, Wagner P, Merlo J. Applying measures of discriminatory accuracy to revisit traditional risk factors for being small for gestational age in Sweden: a national cross-sectional study. BMJ Open 2014; 4:e005388. [PMID: 25079936 PMCID: PMC4120345 DOI: 10.1136/bmjopen-2014-005388] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Small for gestational age (SGA) is considered as an indicator of intrauterine growth restriction, and multiple maternal and newborn characteristics have been identified as risk factors for SGA. This knowledge is mainly based on measures of average association (ie, OR) that quantify differences in average risk between exposed and unexposed groups. Nevertheless, average associations do not assess the discriminatory accuracy of the risk factors (ie, its ability to discriminate the babies who will develop SGA from those that will not). Therefore, applying measures of discriminatory accuracy rather than measures of association only, our study revisits known risk factors of SGA and discusses their role from a public health perspective. DESIGN Cross-sectional study. We measured maternal (ie, smoking, hypertension, age, marital status, education) and delivery (ie, sex, gestational age, birth order) characteristics and performed logistic regression models to estimate both ORs and measures of discriminatory accuracy, like the area under the receiver operating characteristic curve (AU-ROC) and the net reclassification improvement. SETTING Data were obtained from the Swedish Medical Birth Registry. PARTICIPANTS Our sample included 731 989 babies born during 1987-1993. RESULTS We replicated the expected associations. For instance, smoking (OR=2.57), having had a previous SGA baby (OR=5.48) and hypertension (OR=4.02) were strongly associated with SGA. However, they show a very small discriminatory accuracy (AU-ROC≈0.5). The discriminatory accuracy increased, but remained unsatisfactorily low (AU-ROC=0.6), when including all variables studied in the same model. CONCLUSIONS Traditional risk factors for SGA alone or in combination have a low accuracy for discriminating babies with SGA from those without SGA. A proper understanding of these findings is of fundamental relevance to address future research and to design policymaking recommendations in a more informed way.
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Affiliation(s)
- Sol Pía Juárez
- Center for Economic Demography, Lund University, Sweden
- Department of Clinical Sciences, Unit of Social Epidemiology, Lund University, Malmö, Skåne University Hospital (SUS Malmö), Malmö, Sweden
| | - Phillip Wagner
- Department of Clinical Sciences, Unit of Social Epidemiology, Lund University, Malmö, Skåne University Hospital (SUS Malmö), Malmö, Sweden
| | - Juan Merlo
- Department of Clinical Sciences, Unit of Social Epidemiology, Lund University, Malmö, Skåne University Hospital (SUS Malmö), Malmö, Sweden
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27
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Miller SL, Yawno T, Alers NO, Castillo-Melendez M, Supramaniam VG, VanZyl N, Sabaretnam T, Loose JM, Drummond GR, Walker DW, Jenkin G, Wallace EM. Antenatal antioxidant treatment with melatonin to decrease newborn neurodevelopmental deficits and brain injury caused by fetal growth restriction. J Pineal Res 2014; 56:283-94. [PMID: 24456220 DOI: 10.1111/jpi.12121] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 01/17/2014] [Indexed: 12/12/2022]
Abstract
Fetal intrauterine growth restriction (IUGR) is a serious pregnancy complication associated with increased rates of perinatal morbidity and mortality, and ultimately with long-term neurodevelopmental impairments. No intervention currently exists that can improve the structure and function of the IUGR brain before birth. Here, we investigated whether maternal antenatal melatonin administration reduced brain injury in ovine IUGR. IUGR was induced in pregnant sheep at 0.7 gestation and a subset of ewes received melatonin via intravenous infusion until term. IUGR, IUGR + melatonin (IUGR + MLT) and control lambs were born naturally, neonatal behavioral assessment was used to examine neurological function and at 24 hr after birth the brain was collected for the examination of neuropathology. Compared to control lambs, IUGR lambs took significantly longer to achieve normal neonatal lamb behaviors, such as standing and suckling. IUGR brains showed widespread cellular and axonal lipid peroxidation, and white matter hypomyelination and axonal damage. Maternal melatonin administration ameliorated oxidative stress, normalized myelination and rescued axonopathy within IUGR lamb brains, and IUGR + MLT lambs demonstrated significant functional improvements including a reduced time taken to attach to and suckle at the udder after birth. Based on these observations, we began a pilot clinical trial of oral melatonin administration to women with an IUGR fetus. Maternal melatonin was not associated with adverse maternal or fetal effects and it significantly reduced oxidative stress, as evidenced by reduced malondialdehyde levels, in the IUGR + MLT placenta compared to IUGR alone. Melatonin should be considered for antenatal neuroprotective therapy in human IUGR.
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Affiliation(s)
- Suzanne L Miller
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Vic., Australia; Department of Obstetrics & Gynaecology, Southern Clinical School, Monash University, Clayton, Vic., Australia
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Padilla N, Junqué C, Figueras F, Sanz-Cortes M, Bargalló N, Arranz A, Donaire A, Figueras J, Gratacos E. Differential vulnerability of gray matter and white matter to intrauterine growth restriction in preterm infants at 12 months corrected age. Brain Res 2013; 1545:1-11. [PMID: 24361462 DOI: 10.1016/j.brainres.2013.12.007] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 11/26/2013] [Accepted: 12/06/2013] [Indexed: 01/29/2023]
Abstract
Intrauterine growth restriction (IUGR) is associated with a high risk of abnormal neurodevelopment. Underlying neuroanatomical substrates are partially documented. We hypothesized that at 12 months preterm infants would evidence specific white-matter microstructure alterations and gray-matter differences induced by severe IUGR. Twenty preterm infants with IUGR (26-34 weeks of gestation) were compared with 20 term-born infants and 20 appropriate for gestational age preterm infants of similar gestational age. Preterm groups showed no evidence of brain abnormalities. At 12 months, infants were scanned sleeping naturally. Gray-matter volumes were studied with voxel-based morphometry. White-matter microstructure was examined using tract-based spatial statistics. The relationship between diffusivity indices in white matter, gray matter volumes, and perinatal data was also investigated. Gray-matter decrements attributable to IUGR comprised amygdala, basal ganglia, thalamus and insula bilaterally, left occipital and parietal lobes, and right perirolandic area. Gray-matter volumes positively correlated with birth weight exclusively. Preterm infants had reduced FA in the corpus callosum, and increased FA in the anterior corona radiata. Additionally, IUGR infants had increased FA in the forceps minor, internal and external capsules, uncinate and fronto-occipital white matter tracts. Increased axial diffusivity was observed in several white matter tracts. Fractional anisotropy positively correlated with birth weight and gestational age at birth. These data suggest that IUGR differentially affects gray and white matter development preferentially affecting gray matter. At 12 months IUGR is associated with a specific set of structural gray-matter decrements. White matter follows an unusual developmental pattern, and is apparently affected by IUGR and prematurity combined.
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Affiliation(s)
- Nelly Padilla
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain.
| | - Carme Junqué
- Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, Universidad de Barcelona, C/ Casanova 143, 08036 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain
| | - Francesc Figueras
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Magdalena Sanz-Cortes
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Núria Bargalló
- Department of Radiology, Centre de Diagnòstic per la Imatge (CDIC), Hospital Clínic, Universidad de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain
| | - Angela Arranz
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Antonio Donaire
- Department of Neurology, Institute of Neuroscience, Hospital Clínic, Universidad de Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Josep Figueras
- Department of Neonatology, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, 08028, Barcelona, Spain
| | - Eduard Gratacos
- Department of Maternal-Fetal Medicine, ICGON, Hospital Clínic, Universidad de Barcelona, C/Sabino de Arana 1, Helios III, 08028 Barcelona, Spain; Institut D'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Villarroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Corporació Sanitària Clínic, C/ Villarroel 170, 08036 Barcelona, Spain
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Long-term influence of normal variation in neonatal characteristics on human brain development. Proc Natl Acad Sci U S A 2012; 109:20089-94. [PMID: 23169628 DOI: 10.1073/pnas.1208180109] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
It is now recognized that a number of cognitive, behavioral, and mental health outcomes across the lifespan can be traced to fetal development. Although the direct mediation is unknown, the substantial variance in fetal growth, most commonly indexed by birth weight, may affect lifespan brain development. We investigated effects of normal variance in birth weight on MRI-derived measures of brain development in 628 healthy children, adolescents, and young adults in the large-scale multicenter Pediatric Imaging, Neurocognition, and Genetics study. This heterogeneous sample was recruited through geographically dispersed sites in the United States. The influence of birth weight on cortical thickness, surface area, and striatal and total brain volumes was investigated, controlling for variance in age, sex, household income, and genetic ancestry factors. Birth weight was found to exert robust positive effects on regional cortical surface area in multiple regions as well as total brain and caudate volumes. These effects were continuous across birth weight ranges and ages and were not confined to subsets of the sample. The findings show that (i) aspects of later child and adolescent brain development are influenced at birth and (ii) relatively small differences in birth weight across groups and conditions typically compared in neuropsychiatric research (e.g., Attention Deficit Hyperactivity Disorder, schizophrenia, and personality disorders) may influence group differences observed in brain parameters of interest at a later stage in life. These findings should serve to increase our attention to early influences.
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