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White TA, Miller SL, Sutherland AE, Allison BJ, Camm EJ. Perinatal compromise affects development, form, and function of the hippocampus part one; clinical studies. Pediatr Res 2024; 95:1698-1708. [PMID: 38519794 PMCID: PMC11245394 DOI: 10.1038/s41390-024-03105-7] [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: 10/24/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 03/25/2024]
Abstract
The hippocampus is a neuron-rich specialised brain structure that plays a central role in the regulation of emotions, learning and memory, cognition, spatial navigation, and motivational processes. In human fetal development, hippocampal neurogenesis is principally complete by mid-gestation, with subsequent maturation comprising dendritogenesis and synaptogenesis in the third trimester of pregnancy and infancy. Dendritogenesis and synaptogenesis underpin connectivity. Hippocampal development is exquisitely sensitive to perturbations during pregnancy and at birth. Clinical investigations demonstrate that preterm birth, fetal growth restriction (FGR), and acute hypoxic-ischaemic encephalopathy (HIE) are common perinatal complications that alter hippocampal development. In turn, deficits in hippocampal development and structure mediate a range of neurodevelopmental disorders, including cognitive and learning problems, autism, and Attention-Deficit/Hyperactivity Disorder (ADHD). In this review, we summarise the developmental profile of the hippocampus during fetal and neonatal life and examine the hippocampal deficits observed following common human pregnancy complications. IMPACT: The review provides a comprehensive summary of the developmental profile of the hippocampus in normal fetal and neonatal life. We address a significant knowledge gap in paediatric research by providing a comprehensive summary of the relationship between pregnancy complications and subsequent hippocampal damage, shedding new light on this critical aspect of early neurodevelopment.
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Affiliation(s)
- Tegan A White
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia.
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.
| | - Suzanne L Miller
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Amy E Sutherland
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Beth J Allison
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Emily J Camm
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia.
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.
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2
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Moloney RA, Palliser HK, Dyson RM, Pavy CL, Berry M, Hirst JJ, Shaw JC. Ongoing effects of preterm birth on the dopaminergic and noradrenergic pathways in the frontal cortex and hippocampus of guinea pigs. Dev Neurobiol 2024; 84:93-110. [PMID: 38526217 DOI: 10.1002/dneu.22937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
Children born preterm have an increased likelihood of developing neurobehavioral disorders such as attention-deficit hyperactivity disorder (ADHD) and anxiety. These disorders have a sex bias, with males having a higher incidence of ADHD, whereas anxiety disorder tends to be more prevalent in females. Both disorders are underpinned by imbalances to key neurotransmitter systems, with dopamine and noradrenaline in particular having major roles in attention regulation and stress modulation. Preterm birth disturbances to neurodevelopment may affect this neurotransmission in a sexually dimorphic manner. Time-mated guinea pig dams were allocated to deliver by preterm induction of labor (gestational age 62 [GA62]) or spontaneously at term (GA69). The resultant offspring were randomized to endpoints as neonates (24 h after term-equivalence age) or juveniles (corrected postnatal day 40, childhood equivalence). Relative mRNA expressions of key dopamine and noradrenaline pathway genes were examined in the frontal cortex and hippocampus and quantified with real-time PCR. Myelin basic protein and neuronal nuclei immunostaining were performed to characterize the impact of preterm birth. Within the frontal cortex, there were persisting reductions in the expression of dopaminergic pathway components that occurred in preterm males only. Conversely, preterm-born females had increased expression of key noradrenergic receptors and a reduction of the noradrenergic transporter within the hippocampus. This study demonstrated that preterm birth results in major changes in dopaminergic and noradrenergic receptor, transporter, and synthesis enzyme gene expression in a sex- and region-based manner that may contribute to the sex differences in susceptibility to neurobehavioral disorders. These findings highlight the need for the development of sex-based treatments for improving these conditions.
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Affiliation(s)
- Roisin A Moloney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Hannah K Palliser
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Rebecca M Dyson
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Biomedical Research Unit, University of Otago, Wellington, New Zealand
| | - Carlton L Pavy
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Max Berry
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Biomedical Research Unit, University of Otago, Wellington, New Zealand
| | - Jonathon J Hirst
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Julia C Shaw
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
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Molloy EJ, El-Dib M, Soul J, Juul S, Gunn AJ, Bender M, Gonzalez F, Bearer C, Wu Y, Robertson NJ, Cotton M, Branagan A, Hurley T, Tan S, Laptook A, Austin T, Mohammad K, Rogers E, Luyt K, Wintermark P, Bonifacio SL. Neuroprotective therapies in the NICU in preterm infants: present and future (Neonatal Neurocritical Care Series). Pediatr Res 2024; 95:1224-1236. [PMID: 38114609 PMCID: PMC11035150 DOI: 10.1038/s41390-023-02895-6] [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: 07/06/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/21/2023]
Abstract
The survival of preterm infants has steadily improved thanks to advances in perinatal and neonatal intensive clinical care. The focus is now on finding ways to improve morbidities, especially neurological outcomes. Although antenatal steroids and magnesium for preterm infants have become routine therapies, studies have mainly demonstrated short-term benefits for antenatal steroid therapy but limited evidence for impact on long-term neurodevelopmental outcomes. Further advances in neuroprotective and neurorestorative therapies, improved neuromonitoring modalities to optimize recruitment in trials, and improved biomarkers to assess the response to treatment are essential. Among the most promising agents, multipotential stem cells, immunomodulation, and anti-inflammatory therapies can improve neural outcomes in preclinical studies and are the subject of considerable ongoing research. In the meantime, bundles of care protecting and nurturing the brain in the neonatal intensive care unit and beyond should be widely implemented in an effort to limit injury and promote neuroplasticity. IMPACT: With improved survival of preterm infants due to improved antenatal and neonatal care, our focus must now be to improve long-term neurological and neurodevelopmental outcomes. This review details the multifactorial pathogenesis of preterm brain injury and neuroprotective strategies in use at present, including antenatal care, seizure management and non-pharmacological NICU care. We discuss treatment strategies that are being evaluated as potential interventions to improve the neurodevelopmental outcomes of infants born prematurely.
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Affiliation(s)
- Eleanor J Molloy
- Paediatrics, Trinity College Dublin, Trinity Research in Childhood Centre (TRICC), Dublin, Ireland.
- Children's Hospital Ireland (CHI) at Tallaght, Dublin, Ireland.
- Neonatology, CHI at Crumlin, Dublin, Ireland.
- Neonatology, Coombe Women's and Infants University Hospital, Dublin, Ireland.
| | - Mohamed El-Dib
- Department of Pediatrics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Janet Soul
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandra Juul
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Alistair J Gunn
- Departments of Physiology and Paediatrics, School of Medical Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Manon Bender
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Fernando Gonzalez
- Department of Neurology, Division of Child Neurology, University of California, San Francisco, California, USA
| | - Cynthia Bearer
- Division of Neonatology, Department of Pediatrics, Rainbow Babies & Children's Hospital, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Yvonne Wu
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Nicola J Robertson
- Institute for Women's Health, University College London, London, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Mike Cotton
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - Aoife Branagan
- Paediatrics, Trinity College Dublin, Trinity Research in Childhood Centre (TRICC), Dublin, Ireland
- Neonatology, Coombe Women's and Infants University Hospital, Dublin, Ireland
| | - Tim Hurley
- Paediatrics, Trinity College Dublin, Trinity Research in Childhood Centre (TRICC), Dublin, Ireland
| | - Sidhartha Tan
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Abbot Laptook
- Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, Rhode Island, USA
| | - Topun Austin
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Khorshid Mohammad
- Section of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Elizabeth Rogers
- Department of Pediatrics, University of California, San Francisco Benioff Children's Hospital, San Francisco, California, USA
| | - Karen Luyt
- Translational Health Sciences, University of Bristol, Bristol, UK
- Neonatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Pia Wintermark
- Division of Neonatology, Montreal Children's Hospital, Montreal, Quebec, Canada
- McGill University Health Centre - Research Institute, Montreal, Quebec, Canada
| | - Sonia Lomeli Bonifacio
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
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Lapidaire W, Clayden JD, Fewtrell MS, Clark CA. Increased white matter fibre dispersion and lower IQ scores in adults born preterm. Hum Brain Mapp 2024; 45:e26545. [PMID: 38070181 PMCID: PMC10789207 DOI: 10.1002/hbm.26545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024] Open
Abstract
Preterm birth has been associated with altered microstructural properties of the white matter and lower cognitive ability in childhood and adulthood. Due to methodological limitations of the diffusion tensor model, it is not clear whether alterations in myelination or variation in fibre orientation are driving these differences. Novel models applied to multi-shell diffusion imaging have been used to disentangle these effects, but to date this has not been used to study the preterm brain in adulthood. This study investigated whether novel advanced diffusion MRI metrics such as microscopic anisotropy and orientation dispersion are altered in adults born preterm, and whether this was associated with cognitive performance. Seventy-two preterm born participants (<37 weeks gestational age) were recruited from a 1982-1984 cohort (33 males, mean age 33.5 ± 1.0 years). Seventy-two term born (>37 weeks gestational age) controls (34 males, mean age 30.9 ± 4.0 years) were recruited from the general population. Tensor FA was calculated with FSL, while microscopic FA and orientation dispersion entropy (ODE) were estimated using the Spherical Mean Technique (SMT). Estimated Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) were obtained from the WASI-II (abbreviated) IQ test. Voxel-wise comparisons using FSL's tract-based spatial statistics were performed to test between-group differences in diffusion MRI metrics as well as within-group associations of diffusion MRI metrics and IQ outcomes. The preterm group had significantly lower FSIQ, VCI and PRI scores. Preterm subjects demonstrated widespread decreases in ODE reflecting increased fibre dispersion, but no differences in microscopic FA. Tensor FA was increased in a small area in the anterior corona radiata. Lower FA values in the preterm population were associated with lower FSIQ and PRI scores. An increase in fibre dispersion in white matter and lower IQ scores after preterm birth exist in adulthood. Advanced diffusion MRI metrics such as the orientation dispersion entropy can be used to monitor white matter alterations across the lifespan in preterm born individuals. Although not significantly different between preterm and term groups, tensor FA values in the preterm group were associated with cognitive outcome.
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Affiliation(s)
- Winok Lapidaire
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of Oxford, John Radcliffe HospitalOxfordUK
| | - Jonathan D. Clayden
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Mary S. Fewtrell
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Christopher A. Clark
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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5
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Iskusnykh IY, Chizhikov VV. Cerebellar development after preterm birth. Front Cell Dev Biol 2022; 10:1068288. [PMID: 36523506 PMCID: PMC9744950 DOI: 10.3389/fcell.2022.1068288] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
Preterm birth and its complications and the associated adverse factors, including brain hemorrhage, inflammation, and the side effects of medical treatments, are the leading causes of neurodevelopmental disability. Growing evidence suggests that preterm birth affects the cerebellum, which is the brain region involved in motor coordination, cognition, learning, memory, and social communication. The cerebellum is particularly vulnerable to the adverse effects of preterm birth because key cerebellar developmental processes, including the proliferation of neural progenitors, and differentiation and migration of neurons, occur in the third trimester of a human pregnancy. This review discusses the negative impacts of preterm birth and its associated factors on cerebellar development, focusing on the cellular and molecular mechanisms that mediate cerebellar pathology. A better understanding of the cerebellar developmental mechanisms affected by preterm birth is necessary for developing novel treatment and neuroprotective strategies to ameliorate the cognitive, behavioral, and motor deficits experienced by preterm subjects.
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Alva R, Mirza M, Baiton A, Lazuran L, Samokysh L, Bobinski A, Cowan C, Jaimon A, Obioru D, Al Makhoul T, Stuart JA. Oxygen toxicity: cellular mechanisms in normobaric hyperoxia. Cell Biol Toxicol 2022; 39:111-143. [PMID: 36112262 PMCID: PMC9483325 DOI: 10.1007/s10565-022-09773-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/07/2022] [Indexed: 12/15/2022]
Abstract
In clinical settings, oxygen therapy is administered to preterm neonates and to adults with acute and chronic conditions such as COVID-19, pulmonary fibrosis, sepsis, cardiac arrest, carbon monoxide poisoning, and acute heart failure. In non-clinical settings, divers and astronauts may also receive supplemental oxygen. In addition, under current standard cell culture practices, cells are maintained in atmospheric oxygen, which is several times higher than what most cells experience in vivo. In all the above scenarios, the elevated oxygen levels (hyperoxia) can lead to increased production of reactive oxygen species from mitochondria, NADPH oxidases, and other sources. This can cause cell dysfunction or death. Acute hyperoxia injury impairs various cellular functions, manifesting ultimately as physiological deficits. Chronic hyperoxia, particularly in the neonate, can disrupt development, leading to permanent deficiencies. In this review, we discuss the cellular activities and pathways affected by hyperoxia, as well as strategies that have been developed to ameliorate injury.
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Affiliation(s)
- Ricardo Alva
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Maha Mirza
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Adam Baiton
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Lucas Lazuran
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Lyuda Samokysh
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Ava Bobinski
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Cale Cowan
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Alvin Jaimon
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Dede Obioru
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Tala Al Makhoul
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Jeffrey A Stuart
- Department of Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada.
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7
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Vohr BR, McGowan EC, Brumbaugh JE, Hintz SR. Overview of Perinatal Practices with Potential Neurodevelopmental Impact for Children Affected by Preterm Birth. J Pediatr 2022; 241:12-21. [PMID: 34673090 DOI: 10.1016/j.jpeds.2021.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/27/2021] [Accepted: 10/15/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Betty R Vohr
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI.
| | - Elisabeth C McGowan
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI
| | - Jane E Brumbaugh
- Children's Center of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Susan R Hintz
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA
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8
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Reiss JD, Peterson LS, Nesamoney SN, Chang AL, Pasca AM, Marić I, Shaw GM, Gaudilliere B, Wong RJ, Sylvester KG, Bonifacio SL, Aghaeepour N, Gibbs RS, Stevenson DK. Perinatal infection, inflammation, preterm birth, and brain injury: A review with proposals for future investigations. Exp Neurol 2022; 351:113988. [DOI: 10.1016/j.expneurol.2022.113988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/26/2022]
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9
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Buffet-Bataillon S, Bellanger A, Boudry G, Gangneux JP, Yverneau M, Beuchée A, Blat S, Le Huërou-Luron I. New Insights Into Microbiota Modulation-Based Nutritional Interventions for Neurodevelopmental Outcomes in Preterm Infants. Front Microbiol 2021; 12:676622. [PMID: 34177860 PMCID: PMC8232935 DOI: 10.3389/fmicb.2021.676622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022] Open
Abstract
Gut microbiota and the central nervous system have parallel developmental windows during pre and post-natal life. Increasing evidences suggest that intestinal dysbiosis in preterm infants predisposes the neonate to adverse neurological outcomes later in life. Understanding the link between gut microbiota colonization and brain development to tailor therapies aimed at optimizing initial colonization and microbiota development are promising strategies to warrant adequate brain development and enhance neurological outcomes in preterm infants. Breast-feeding has been associated with both adequate cognitive development and healthy microbiota in preterms. Infant formula are industrially produced substitutes for infant nutrition that do not completely recapitulate breast-feeding benefices and could be largely improved by the understanding of the role of breast milk components upon gut microbiota. In this review, we will first discuss the nutritional and bioactive component information on breast milk composition and its contribution to the assembly of the neonatal gut microbiota in preterms. We will then discuss the emerging pathways connecting the gut microbiota and brain development. Finally, we will discuss the promising microbiota modulation-based nutritional interventions (including probiotic and prebiotic supplementation of infant formula and maternal nutrition) for improving neurodevelopmental outcomes.
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Affiliation(s)
- Sylvie Buffet-Bataillon
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
- Department of Clinical Microbiology, CHU Rennes, Rennes, France
| | - Amandine Bellanger
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
- Department of Pediatrics-Neonatology, CHU Rennes, Rennes, France
| | - Gaelle Boudry
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
| | | | | | - Alain Beuchée
- Department of Pediatrics-Neonatology, Univ Rennes, CHU Rennes, LTSI-UMR 1099, Rennes, France
| | - Sophie Blat
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
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10
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Prasad JD, van de Looij Y, Gunn KC, Ranchhod SM, White PB, Berry MJ, Bennet L, Sizonenko SV, Gunn AJ, Dean JM. Long-term coordinated microstructural disruptions of the developing neocortex and subcortical white matter after early postnatal systemic inflammation. Brain Behav Immun 2021; 94:338-356. [PMID: 33307171 DOI: 10.1016/j.bbi.2020.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/16/2020] [Accepted: 12/06/2020] [Indexed: 12/21/2022] Open
Abstract
Severe postnatal systemic infection is highly associated with persistent disturbances in brain development and neurobehavioral outcomes in survivors of preterm birth. However, the contribution of less severe but prolonged postnatal infection and inflammation to such disturbances is unclear. Further, the ability of modern imaging techniques to detect the underlying changes in cellular microstructure of the brain in these infants remains to be validated. We used high-field ex-vivo MRI, neurohistopathology, and behavioral tests in newborn rats to demonstrate that prolonged postnatal systemic inflammation causes subtle, persisting disturbances in brain development, with neurodevelopmental delays and mild motor impairments. Diffusion-tensor MRI and neurite orientation dispersion and density imaging (NODDI) revealed delayed maturation of neocortical and subcortical white matter microstructure. Analysis of pyramidal neurons showed that the cortical deficits involved impaired dendritic arborization and spine formation. Analysis of oligodendrocytes showed that the white matter deficits involved impaired oligodendrocyte maturation and axonal myelination. These findings indicate that prolonged postnatal inflammation, without severe infection, may critically contribute to the diffuse spectrum of brain pathology and subtle long-term disability in preterm infants, with a cellular mechanism involving oligodendrocyte and neuronal dysmaturation. NODDI may be useful for clinical detection of these microstructural deficits.
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Affiliation(s)
- Jaya D Prasad
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Yohan van de Looij
- Division of Child Development and Growth, Department of Pediatrics and Gynecology Obstetrics, University of Geneva, Geneva, Switzerland; Center for Biomedical Imaging - Animal Imaging and Technology, Lausanne Federal Polytechnic School, Lausanne, Switzerland
| | - Katherine C Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Sonya M Ranchhod
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Petra B White
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Mary J Berry
- The Department of Pediatrics and Health Care, University of Otago, New Zealand
| | - Laura Bennet
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Stéphane V Sizonenko
- Division of Child Development and Growth, Department of Pediatrics and Gynecology Obstetrics, University of Geneva, Geneva, Switzerland
| | - Alistair J Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Justin M Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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11
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Jaeger DA, Gawehn N, Schneider DT, Suchan B. Phasic and tonic alertness in preterm 5-year-old healthy children. Child Neuropsychol 2021; 27:1073-1087. [PMID: 33899687 DOI: 10.1080/09297049.2021.1919297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Preterm delivery may interrupt the intrauterine brain development and implies a risk factor for the developing brain. In the long term, most frequently particular forms of attention deficits are described which refer to the basic aspects of attention i.e., arousal or tonic alertness. As this reflects top-down processes, the current study focuses on bottom-up processed phasic alertness in preschool aged preterm children. Additionally, we made a division of response times into decision and movement time to quantify more exactly the contribution of cognitive and motor performance to reaction times. We investigated basic aspects of attention functioning and contrasted phasic and tonic alertness in 31 low-risk healthy preterm (28-36 weeks of gestation) and 22 term children of five to 6 years of age by using a self-designed computerized test. Preterm children exhibited delayed decision and reaction time in the tonic non-cued alertness condition but not in the phasic cued alertness condition compared to term children. Current results suggest that preterm birth, even when clinically relevant symptoms are absent, may have long-term consequences on basic aspects of attention functioning. Results further suggest that preterm children may profit from auditory cues to overcome these deviations, which yield evidence for a clear distinction between impaired top-down and intact bottom-up controlled processes. These findings might provide a promising groundwork for the development of therapeutical interventions and prevention strategies, whose use and impact to support preterm children should be addressed in further investigations.
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Affiliation(s)
- Dominique A Jaeger
- Outpatients´ Department for Developmental Neuropsychology, Department of Social Paediatrics and Neuropediatrics, Clinic of Pediatrics, Municipal Hospital Dortmund, Dortmund, Germany
| | - Nina Gawehn
- University of Health Sciences, Bochum, Germany
| | | | - Boris Suchan
- Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
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12
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Morrison JL, Ayonrinde OT, Care AS, Clarke GD, Darby JRT, David AL, Dean JM, Hooper SB, Kitchen MJ, Macgowan CK, Melbourne A, McGillick EV, McKenzie CA, Michael N, Mohammed N, Sadananthan SA, Schrauben E, Regnault TRH, Velan SS. Seeing the fetus from a DOHaD perspective: discussion paper from the advanced imaging techniques of DOHaD applications workshop held at the 2019 DOHaD World Congress. J Dev Orig Health Dis 2021; 12:153-167. [PMID: 32955011 DOI: 10.1017/s2040174420000884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Advanced imaging techniques are enhancing research capacity focussed on the developmental origins of adult health and disease (DOHaD) hypothesis, and consequently increasing awareness of future health risks across various subareas of DOHaD research themes. Understanding how these advanced imaging techniques in animal models and human population studies can be both additively and synergistically used alongside traditional techniques in DOHaD-focussed laboratories is therefore of great interest. Global experts in advanced imaging techniques congregated at the advanced imaging workshop at the 2019 DOHaD World Congress in Melbourne, Australia. This review summarizes the presentations of new imaging modalities and novel applications to DOHaD research and discussions had by DOHaD researchers that are currently utilizing advanced imaging techniques including MRI, hyperpolarized MRI, ultrasound, and synchrotron-based techniques to aid their DOHaD research focus.
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Affiliation(s)
- Janna L Morrison
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Oyekoya T Ayonrinde
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Alison S Care
- The Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Geoffrey D Clarke
- Department of Radiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Jack R T Darby
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Justin M Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Stuart B Hooper
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- The Department of Obstetrics and Gynecology, Monash University, Melbourne, Victoria, Australia
| | - Marcus J Kitchen
- School of Physics and Astronomy, Monash University, Melbourne, Victoria, Australia
| | | | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, Kings College London, London, UK
| | - Erin V McGillick
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- The Department of Obstetrics and Gynecology, Monash University, Melbourne, Victoria, Australia
| | - Charles A McKenzie
- Department of Medical Biophysics, Western University, London, ON, Canada
- Lawson Health Research Institute and Children's Health Research Institute, London, ON, Canada
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Nuruddin Mohammed
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Aga Khan University Hospital, Karachi, Pakistan
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Eric Schrauben
- Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Timothy R H Regnault
- Lawson Health Research Institute and Children's Health Research Institute, London, ON, Canada
- Department of Obstetrics and Gynecology, Western University, London, ON, Canada
- Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - S Sendhil Velan
- Singapore Bioimaging Consortium, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
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13
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Hadaya L, Nosarti C. The neurobiological correlates of cognitive outcomes in adolescence and adulthood following very preterm birth. Semin Fetal Neonatal Med 2020; 25:101117. [PMID: 32451305 DOI: 10.1016/j.siny.2020.101117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Very preterm birth (<33 weeks of gestation) has been associated with alterations in structural and functional brain development in regions that are believed to underlie a variety of cognitive processes. While such alterations have been often studied in the context of cognitive vulnerability, early disruption to programmed developmental processes may also lead to neuroplastic and functional adaptations, which support cognitive performance. In this review, we will focus on executive function and intelligence as the main cognitive outcomes following very preterm birth in adolescence and adulthood in relation to their structural and functional neurobiological correlates. The neuroimaging modalities we review provide quantitative assessments of brain morphology, white matter macro and micro-structure, structural and functional connectivity and haemodynamic responses associated with specific cognitive operations. Identifying the neurobiological underpinning of the long-term sequelae associated with very preterm birth may guide the development and implementation of targeted neurobehaviourally-informed interventions for those at high risk.
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Affiliation(s)
- Laila Hadaya
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Science and Medicine, King's College London, London, United Kingdom; Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Chiara Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom.
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14
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Galinsky R, Dhillon SK, Dean JM, Davidson JO, Lear CA, Wassink G, Nott F, Kelly SB, Fraser M, Yuill C, Bennet L, Gunn AJ. Tumor necrosis factor inhibition attenuates white matter gliosis after systemic inflammation in preterm fetal sheep. J Neuroinflammation 2020; 17:92. [PMID: 32293473 PMCID: PMC7087378 DOI: 10.1186/s12974-020-01769-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/09/2020] [Indexed: 12/21/2022] Open
Abstract
Background Increased circulating levels of tumor necrosis factor (TNF) are associated with greater risk of impaired neurodevelopment after preterm birth. In this study, we tested the hypothesis that systemic TNF inhibition, using the soluble TNF receptor Etanercept, would attenuate neuroinflammation in preterm fetal sheep exposed to lipopolysaccharide (LPS). Methods Chronically instrumented preterm fetal sheep at 0.7 of gestation were randomly assigned to receive saline (control; n = 7), LPS infusion (100 ng/kg i.v. over 24 h then 250 ng/kg/24 h for 96 h plus 1 μg LPS boluses at 48, 72, and 96 h, to induce inflammation; n = 8) or LPS plus two i.v. infusions of Etanercept (2 doses, 5 mg/kg infused over 30 min, 48 h apart) started immediately before LPS-exposure (n = 8). Sheep were killed 10 days after starting infusions, for histology. Results LPS boluses were associated with increased circulating TNF, interleukin (IL)-6 and IL-10, electroencephalogram (EEG) suppression, hypotension, tachycardia, and increased carotid artery perfusion (P < 0.05 vs. control). In the periventricular and intragyral white matter, LPS exposure increased gliosis, TNF-positive cells, total oligodendrocytes, and cell proliferation (P < 0.05 vs control), but did not affect myelin expression or numbers of neurons in the cortex and subcortical regions. Etanercept delayed the rise in circulating IL-6, prolonged the increase in IL-10 (P < 0.05 vs. LPS), and attenuated EEG suppression, hypotension, and tachycardia after LPS boluses. Histologically, Etanercept normalized LPS-induced gliosis, and increase in TNF-positive cells, proliferation, and total oligodendrocytes. Conclusion TNF inhibition markedly attenuated white matter gliosis but did not affect mature oligodendrocytes after prolonged systemic inflammation in preterm fetal sheep. Further studies of long-term brain maturation are now needed.
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Affiliation(s)
- Robert Galinsky
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand.,The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Simerdeep K Dhillon
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Justin M Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Joanne O Davidson
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Christopher A Lear
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Guido Wassink
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Fraser Nott
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia
| | - Sharmony B Kelly
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia
| | - Mhoyra Fraser
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Caroline Yuill
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Laura Bennet
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand
| | - Alistair Jan Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland, 1023, New Zealand.
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15
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Ismail FY, Ljubisavljevic MR, Johnston MV. A conceptual framework for plasticity in the developing brain. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:57-66. [PMID: 32958193 DOI: 10.1016/b978-0-444-64150-2.00007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this chapter, we highlight the various definitions of early brain plasticity commonly used in the scientific literature. We then present a conceptual framework of early brain plasticity that focuses on plasticity at the level of the synapse (synaptic plasticity) and the level of the network (connectivity). The proposed framework is organized around three main domains through which current theories and principles of early brain plasticity can be integrated: (1) the mechanisms of plasticity and constraints at the synaptic level and network connectivity, (2) the importance of temporal considerations related to the development of the immature brain, and (3) the functions early brain plasticity serve. We then apply this framework to discuss some clinical disorders caused by and/or associated with impaired plasticity mechanisms. We propose that a careful examination of the relationship between mechanisms, constraints, and functions of early brain plasticity in health and disease may provide an integrative understanding of the current theories and principles generated by experimental and observational studies.
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Affiliation(s)
- Fatima Y Ismail
- Department of Pediatrics, United Arab Emirates University, Al-Ain, United Arab Emirates; Department of Neurology (adjunct), Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | | | - Michael V Johnston
- Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, United States
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16
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Synaptic Injury in the Thalamus Accompanies White Matter Injury in Hypoxia/Ischemia-Mediated Brain Injury in Neonatal Rats. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5249675. [PMID: 31687391 PMCID: PMC6803747 DOI: 10.1155/2019/5249675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/15/2019] [Accepted: 09/13/2019] [Indexed: 12/01/2022]
Abstract
The broad spectrum of disabilities caused by white matter injury (WMI) cannot be explained simply by hypomyelination. Synaptic injury in the thalamus may be related to disabilities in WMI survivors. Neuronal injury in the thalamus has been found most commonly in autopsy cases of preterm WMI. We hypothesized that hypoxia/ischemia (HI) in neonatal rats results in synaptic abnormalities in the thalamus that contribute to disabilities in WMI survivors. We examined changes in synapses in a neonatal rat model of HI-induced WMI. Right common carotid artery ligation and hypoxia (8% oxygen for 2.5 hours (h)) were performed in three-day-old Sprague-Dawley rats. We found HI rats performed worse in the Morris water maze test than sham rats, suggesting long-term cognition impairment after HI injury. A loss of synapses in the thalamus accompanied by hypomyelination and oligodendrocytes (OLs) reduction was observed. At the ultrastructural level, reductions in active zone (AZ) length and postsynaptic density (PSD) thickness were detected at 2 weeks after HI exposure. Furthermore, increased expression of synaptophysin and PSD-95 in both groups was observed from 3 days (d) to 21 d after hypoxic/ischemic (HI) injury. PSD-95 expression was significantly lower in HI rats than in sham rats from 14 d to 21 d after HI injury, and synaptophysin expression was significantly lower in HI rats from 7 d to 14 d after HI injury. However, no significant difference in synaptophysin expression was observed between HI rats and sham rats at 21 d after HI injury. The results demonstrated synaptic abnormalities in the thalamus accompanied by hypomyelination in WMI in response to HI exposure, which may contribute to the diverse neurological defects observed in WMI patients. Although synaptic reorganization occurred as a compensatory response to HI injury, the impairments in synaptic transmission were not reversed.
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17
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Herzmann CS, Snyder AZ, Kenley JK, Rogers CE, Shimony JS, Smyser CD. Cerebellar Functional Connectivity in Term- and Very Preterm-Born Infants. Cereb Cortex 2019; 29:1174-1184. [PMID: 29420701 PMCID: PMC6373668 DOI: 10.1093/cercor/bhy023] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 01/12/2018] [Accepted: 01/13/2018] [Indexed: 12/31/2022] Open
Abstract
Cortical resting state networks have been consistently identified in infants using resting state-functional connectivity magnetic resonance imaging (rs-fMRI). Comparable studies in adults have demonstrated cerebellar components of well-established cerebral networks. However, there has been limited investigation of early cerebellar functional connectivity. We acquired non-sedated rs-fMRI data in the first week of life in 57 healthy, term-born infants and at term-equivalent postmenstrual age in 20 very preterm infants (mean birth gestational age 27 ± 2 weeks) without significant cerebral or cerebellar injury. Seed correlation analyses were performed using regions of interests spanning the cortical and subcortical gray matter and cerebellum. Parallel analyses were performed using rs-fMRI data acquired in 100 healthy adults. Our results demonstrate that cortico-cerebellar functional connectivity is well-established by term. Intra- and cortico-cerebellar functional connectivity were largely similar in infants and adults. However, infants showed more functional connectivity structure within the cerebellum, including stronger homotopic correlations and more robust anterior-posterior anticorrelations. Prematurity was associated with reduced correlation magnitudes, but no alterations in intra- and cortico-cerebellar functional connectivity topography. These results add to the growing evidence that the cerebellum plays an important role in shaping early brain development during infancy.
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Affiliation(s)
- Charlotte S Herzmann
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Abraham Z Snyder
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jeanette K Kenley
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
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18
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Reduced white matter fractional anisotropy mediates cortical thickening in adults born preterm with very low birthweight. Neuroimage 2019; 188:217-227. [DOI: 10.1016/j.neuroimage.2018.11.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/14/2018] [Accepted: 11/27/2018] [Indexed: 12/14/2022] Open
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19
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Corrigendum to “Beta version' of neuroplasticity or absolute beta power in preterm infants as electroencephalographic correlate of synaptogenesis” [International Journal of Psychophysiology, Volume 131, Supplement (October 2018), Pages S181-S182]. Int J Psychophysiol 2019. [DOI: 10.1016/j.ijpsycho.2018.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Abstract
Despite the advances in neonatal intensive care, the preterm brain remains vulnerable to white matter injury (WMI) and disruption of normal brain development (i.e., dysmaturation). Compared to severe cystic WMI encountered in the past decades, contemporary cohorts of preterm neonates experience milder WMIs. More than destructive lesions, disruption of the normal developmental trajectory of cellular elements of the white and the gray matter occurs. In the acute phase, in response to hypoxia-ischemia and/or infection and inflammation, multifocal areas of necrosis within the periventricular white matter involve all cellular elements. Later, chronic WMI is characterized by diffuse WMI with aberrant regeneration of oligodendrocytes, which fail to mature to myelinating oligodendrocytes, leading to myelination disturbances. Complete neuronal degeneration classically accompanies necrotic white matter lesions, while altered neurogenesis, represented by a reduction of the dendritic arbor and synapse formation, is observed in response to diffuse WMI. Neuroimaging studies now provide more insight in assessing both injury and dysmaturation of both gray and white matter. Preterm brain injury remains an important cause of neurodevelopmental disabilities, which are still observed in up to 50% of the preterm survivors and take the form of a complex combination of motor, cognitive, and behavioral concerns.
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Affiliation(s)
- Juliane Schneider
- Department of Woman-Mother-Child, Clinic of Neonatology, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Steven P Miller
- Division of Neurology and Centre for Brain and Mental Health, Hospital for Sick Children, Toronto, ON, Canada.
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21
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Neuroinflammation in preterm babies and autism spectrum disorders. Pediatr Res 2019; 85:155-165. [PMID: 30446768 DOI: 10.1038/s41390-018-0208-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 12/23/2022]
Abstract
Genetic anomalies have a role in autism spectrum disorders (ASD). Each genetic factor is responsible for a small fraction of cases. Environment factors, like preterm delivery, have an important role in ASD. Preterm infants have a 10-fold higher risk of developing ASD. Preterm birth is often associated with maternal/fetal inflammation, leading to a fetal/neonatal inflammatory syndrome. There are demonstrated experimental links between fetal inflammation and the later development of behavioral symptoms consistent with ASD. Preterm infants have deficits in connectivity. Most ASD genes encode synaptic proteins, suggesting that ASD are connectivity pathologies. Microglia are essential for normal synaptogenesis. Microglia are diverted from homeostatic functions towards inflammatory phenotypes during perinatal inflammation, impairing synaptogenesis. Preterm infants with ASD have a different phenotype from term born peers. Our original hypothesis is that exposure to inflammation in preterm infants, combined with at risk genetic background, deregulates brain development leading to ASD.
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22
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Leviton A, Joseph RM, Allred EN, O’Shea TM, Taylor HG, Kuban KKC. Antenatal and Neonatal Antecedents of Executive Dysfunctions in Extremely Preterm Children. J Child Neurol 2018; 33:198-208. [PMID: 29322860 PMCID: PMC5807158 DOI: 10.1177/0883073817750499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
To find out why children born extremely preterm are at heightened risk of executive dysfunctions, the authors assessed 716 children who were 10 years old born extremely preterm whose IQ was ≥ 70. A working memory dysfunction (n = 169), an inhibition dysfunction (n = 360), a switching dysfunction (355), and all 3 (executive dysfunction; n = 107) were defined on the basis of Z-scores ≤ -1 on the Differential Ability Scales-II Working Memory composite, and/or on the NEPSY-II Inhibition-Inhibition and Inhibition-Switching subtests. All risk profiles include an indicator of socioeconomic disadvantage. The risk profile of each of the 3 individual dysfunctions includes an indicator of the newborn's immaturity, and the risk profiles of the inhibition dysfunction and switching dysfunction also include an indicator of inflammation. Only the switching dysfunction was associated with fetal growth restriction. The risk factors for executive dysfunction can be subsumed under the 4 themes of socioeconomic disadvantage, immaturity/vulnerability, inflammation, and fetal growth restriction.
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Affiliation(s)
- Alan Leviton
- Boston Children’s Hospital and Harvard Medical School,
Boston MA, USA
| | | | | | - T. Michael O’Shea
- University of North Carolina School of Medicine, Chapel Hill NC,
USA
| | - H. Gerry Taylor
- Nationwide Children’s Hospital and The Ohio State
University, Columbus, OH, USA
| | - Karl KC Kuban
- Boston Medical Center and Boston University School of Medicine,
Boston, MA, USA
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23
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Bennet L, Dhillon S, Lear CA, van den Heuij L, King V, Dean JM, Wassink G, Davidson JO, Gunn AJ. Chronic inflammation and impaired development of the preterm brain. J Reprod Immunol 2018; 125:45-55. [DOI: 10.1016/j.jri.2017.11.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 11/13/2017] [Accepted: 11/24/2017] [Indexed: 12/17/2022]
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24
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Bouyssi-Kobar M, Murnick J, Brossard-Racine M, Chang T, Mahdi E, Jacobs M, Limperopoulos C. Altered Cerebral Perfusion in Infants Born Preterm Compared with Infants Born Full Term. J Pediatr 2018; 193:54-61.e2. [PMID: 29212618 PMCID: PMC5794508 DOI: 10.1016/j.jpeds.2017.09.083] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 08/18/2017] [Accepted: 09/29/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To compare regional cerebral cortical blood flow (CBF) in infants born very preterm at term-equivalent age (TEA) and healthy newborns born full term and to examine the impact of clinical risk factors on CBF in the cohort born preterm. STUDY DESIGN This prospective, cross-sectional study included infants born very preterm (gestational age at birth <32 weeks; birth weight <1500 g) and healthy infants born full term. Using noninvasive 3T arterial spin labeling magnetic resonance imaging, we quantified regional CBF in the cerebral cortex: sensorimotor/auditory/visual cortex, superior medial/dorsolateral prefrontal cortex, anterior cingulate cortex (ACC)/posterior cingulate cortex, insula, and lateral posterior parietal cortex, as well as in the brainstem, and deep gray matter. Analyses were performed controlling for sex, gestational age, and age at magnetic resonance imaging. RESULTS We studied 202 infants: 98 born preterm and 104 born full term at TEA. Infants born preterm demonstrated greater global CBF (β = 9.03; P < .0001) and greater absolute regional CBF in all brain regions except the insula. Relative CBF in the insula, ACC and auditory cortex were decreased significantly in infants born preterm compared with their peers born at full term (P < .0001; P = .026; P = .036, respectively). In addition, the presence of parenchymal brain injury correlated with lower global and regional CBF (insula, ACC, sensorimotor, auditory, and visual cortices) whereas the need for cardiac vasopressor support correlated with lower regional CBF in the insula and visual cortex. CONCLUSIONS Altered regional cortical CBF in infants born very preterm at TEA may reflect early brain dysmaturation despite the absence of cerebral cortical injury. Furthermore, specific cerebral cortical areas may be vulnerable to early hemodynamic instability and parenchymal brain injury.
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Affiliation(s)
- Marine Bouyssi-Kobar
- The Developing Brain Research Laboratory, Department of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC; Institute for Biomedical Sciences, George Washington University, Washington, DC
| | - Jonathan Murnick
- The Developing Brain Research Laboratory, Department of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC
| | - Marie Brossard-Racine
- Department of Pediatrics Neurology, Montreal Children's Hospital-McGill University Health Center, Montreal, Québec, Canada
| | - Taeun Chang
- Department of Neurology, Children's National Health System, Washington, DC
| | - Eman Mahdi
- The Developing Brain Research Laboratory, Department of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC
| | - Marni Jacobs
- Department of Epidemiology and Biostatistics, Children's Research Institute, Children's National Health System, Washington, DC
| | - Catherine Limperopoulos
- The Developing Brain Research Laboratory, Department of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC.
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25
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Young JM, Vandewouw MM, Morgan BR, Smith ML, Sled JG, Taylor MJ. Altered white matter development in children born very preterm. Brain Struct Funct 2018; 223:2129-2141. [PMID: 29380120 DOI: 10.1007/s00429-018-1614-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/17/2018] [Indexed: 12/31/2022]
Abstract
Children born very preterm (VPT) at less than 32 weeks' gestational age (GA) are prone to disrupted white matter maturation and impaired cognitive development. The aims of the present study were to identify differences in white matter microstructure and connectivity of children born VPT compared to term-born children, as well as relations between white matter measures with cognitive outcomes and early brain injury. Diffusion images and T1-weighted anatomical MR images were acquired along with developmental assessments in 31 VPT children (mean GA: 28.76 weeks) and 28 term-born children at 4 years of age. FSL's tract-based spatial statistics was used to create a cohort-specific template and mean fractional anisotropy (FA) skeleton that was applied to each child's DTI data. Whole brain deterministic tractography was performed and graph theoretical measures of connectivity were calculated based on the number of streamlines between cortical and subcortical nodes derived from the Desikan-Killiany atlas. Between-group analyses included FSL Randomise for voxel-wise statistics and permutation testing for connectivity analyses. Within-group analyses between FA values and graph measures with IQ, language and visual-motor scores as well as history of white matter injury (WMI) and germinal matrix/intraventricular haemorrhage (GMH/IVH) were performed. In the children born VPT, FA values within major white matter tracts were reduced compared to term-born children. Reduced measures of local strength, clustering coefficient, local and global efficiency were present in the children born VPT within nodes in the lateral frontal, middle and superior temporal, cingulate, precuneus and lateral occipital regions. Within-group analyses revealed associations in term-born children between FA, Verbal IQ, Performance IQ and Full scale IQ within regions of the superior longitudinal fasciculus, inferior fronto-occipital fasciculus, forceps minor and forceps major. No associations with outcome were found in the VPT group. Global efficiency was reduced in the children born VPT with a history of WMI and GMH/IVH. These findings are evidence for under-developed and less connected white matter in children born VPT, contributing to our understanding of white matter development within this population.
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Affiliation(s)
- Julia M Young
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada. .,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada. .,Department of Psychology, University of Toronto, Toronto, ON, Canada.
| | - Marlee M Vandewouw
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Benjamin R Morgan
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Mary Lou Smith
- Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - John G Sled
- Translational Medicine, SickKids Research Institute, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Margot J Taylor
- Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
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26
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Development of Activity in the Mouse Visual Cortex. J Neurosci 2017; 36:12259-12275. [PMID: 27903733 DOI: 10.1523/jneurosci.1903-16.2016] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/24/2016] [Accepted: 10/14/2016] [Indexed: 11/21/2022] Open
Abstract
A comprehensive developmental timeline of activity in the mouse cortex in vivo is lacking. Understanding the activity changes that accompany synapse and circuit formation is important to understand the mechanisms by which activity molds circuits and would help to identify critical checkpoints for normal development. To identify key principles of cortical activity maturation, we systematically tracked spontaneous and sensory-evoked activity with extracellular recordings of primary visual cortex (V1) in nonanesthetized mice. During the first postnatal week (postnatal days P4-P7), V1 was not visually responsive and exhibited long (>10 s) periods of network silence. Activation consisted exclusively of "slow-activity transients," 2-10 s periods of 6-10 Hz "spindle-burst' oscillations; the response to spontaneous retinal waves. By tracking daily changes in this activity, two key components of spontaneous activity maturation were revealed: (1) spindle-burst frequency acceleration (eventually becoming the 20-50 Hz broadband activity caused by the asynchronous state) and (2) "filling-in" of silent periods with low-frequency (2-4 Hz) activity (beginning on P10 and complete by P13). These two changes are sufficient to create the adult-like pattern of continuous activity, alternation between fast-asynchronous and slow-synchronous activity, by eye opening. Visual responses emerged on P8 as evoked spindle-bursts and neuronal firing with a signal-to-noise ratio higher than adult. Both were eliminated by eye opening, leaving only the mature, short-latency response. These results identify the developmental origins of mature cortical activity and implicate the period before eye opening as a critical checkpoint. By providing a systematic description of electrical activity development, we establish the murine visual cortex as a model for the electroencephalographic development of fetal humans. SIGNIFICANCE STATEMENT Cortical activity is an important indicator of long-term health and survival in preterm infants and molds circuit formation, but gaps remain in our understanding of the origin and normal progression of this activity in the developing cortex. We aimed to rectify this by monitoring daily changes in cortical activity in the nonanesthetized mouse, an important preclinical model of disease and development. At ages approximately equivalent to normal human term birth, mouse cortex exhibits primarily network silence, with spontaneous "spindle bursts" as the only form of activity. In contrast, mature cortex is noisy, alternating between asynchronous/discontinuous and synchronous/continuous states. This work identifies the key processes that produce this maturation and provides a normative reference for murine-based studies of cortical circuit development.
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Weber A, Harrison TM, Steward D, Sinnott L, Shoben A. Oxytocin trajectories and social engagement in extremely premature infants during NICU hospitalization. Infant Behav Dev 2017; 48:78-87. [PMID: 28552589 DOI: 10.1016/j.infbeh.2017.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
Abstract
Extremely premature infants, born 28 weeks gestation or less, are at high risk for impaired socioemotional development, due in part to exposure to early stressful social experiences that alter brain development. Understanding mediators that link experience with outcomes is necessary to assess premature infant responses to social experiences that are critical to brain development. The hormone oxytocin (OT), released during supportive interactions, has potential as a biomarker of the premature infant's responses to social experiences. The purpose of this study was to examine associations among infant plasma OT trajectories and maternal-infant social engagement behaviors during initial hospitalization. This study also examined demographic correlates of engagement behaviors in mothers and infants. Plasma from 28 extremely premature infants, born gestational ages 25-28 6/7 weeks, was collected at 14 days of life, then weekly until 34 weeks. Social engagement behaviors were measured by the Parent-Child Early Relational Assessment during a videotaped feeding when the infant was receiving one-quarter full oral feeds. Maternal-infant demographics were extracted from the medical record. Higher infant plasma OT was associated with lower infant social engagement, but no associations were found with maternal social engagement. Infant social engagement was positively related to maternal social engagement. Maternal parity was related to maternal social engagement, and infant demographics did not predict infant social engagement. The significant, yet negative, association between infant OT and engagement provides support for the measurement of OT as a neurobiological antecedent to infant social behaviors. Finally, this research suggests that during the earliest period of infant socio-behavioral development, premature infants are behaviorally reactive to the social engagement behaviors of their mothers.
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Affiliation(s)
- Ashley Weber
- Case Western Reserve University, N0B040 Frances Payne Bolton School of Nursing, 2120 Cornell Road, Cleveland, OH 44106, USA.
| | - Tondi M Harrison
- The Ohio State University College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA.
| | - Deborah Steward
- The Ohio State University College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA.
| | - Loraine Sinnott
- The Ohio State University College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA.
| | - Abigail Shoben
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, USA.
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Tordjman S, Chokron S, Delorme R, Charrier A, Bellissant E, Jaafari N, Fougerou C. Melatonin: Pharmacology, Functions and Therapeutic Benefits. Curr Neuropharmacol 2017; 15:434-443. [PMID: 28503116 PMCID: PMC5405617 DOI: 10.2174/1570159x14666161228122115] [Citation(s) in RCA: 427] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/13/2016] [Accepted: 12/27/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Melatonin synchronizes central but also peripheral oscillators (fetal adrenal gland, pancreas, liver, kidney, heart, lung, fat, gut, etc.), allowing temporal organization of biological functions through circadian rhythms (24-hour cycles) in relation to periodic environmental changes and therefore adaptation of the individual to his/her internal and external environment. Measures of melatonin are considered the best peripheral indices of human circadian timing based on an internal 24-hour clock. METHODS First, the pharmacology of melatonin (biosynthesis and circadian rhythms, pharmacokinetics and mechanisms of action) is described, allowing a better understanding of the short and long term effects of melatonin following its immediate or prolonged release. Then, research related to the physiological effects of melatonin is reviewed. RESULTS The physiological effects of melatonin are various and include detoxification of free radicals and antioxidant actions, bone formation and protection, reproduction, and cardiovascular, immune or body mass regulation. Also, protective and therapeutic effects of melatonin are reported, especially with regard to brain or gastrointestinal protection, psychiatric disorders, cardiovascular diseases and oncostatic effects. CONCLUSION This review highlights the high number and diversity of major melatonin effects and opens important perspectives for measuring melatonin as a biomarker (biomarker of early identification of certain disorders and also biomarker of their follow-up) and using melatonin with clinical preventive and therapeutic applications in newborns, children and adults based on its physiological regulatory effects.
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Affiliation(s)
- Sylvie Tordjman
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France
- Laboratory of Psychology of Perception, CNRS UMR 8158, Paris 75270, France
| | - Sylvie Chokron
- Laboratory of Psychology of Perception, CNRS UMR 8158, Paris 75270, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris 7 University, Paris 75019, France
| | - Annaëlle Charrier
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France
| | - Eric Bellissant
- Inserm CIC 1414 Clinical Investigation Centre, University Hospital, Rennes 1 University, Rennes 35033, France
- Department of Clinical Pharmacology, University Hospital, Rennes 1 University, Rennes 35033, France
| | - Nemat Jaafari
- Unité de recherche clinique Pierre Deniker du Centre Hospitalier Henri Laborit, INSERM CIC-P 1402, Poitiers 86022, France
- INSERM U 1084 Laboratoire expérimental et clinique en Neurosciences, University of Poitiers, Poitiers 86022, France
| | - Claire Fougerou
- Inserm CIC 1414 Clinical Investigation Centre, University Hospital, Rennes 1 University, Rennes 35033, France
- Department of Clinical Pharmacology, University Hospital, Rennes 1 University, Rennes 35033, France
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Effects of a Home-Based Family-Centred Early Habilitation Program on Neurobehavioural Outcomes of Very Preterm Born Infants: A Retrospective Cohort Study. Neural Plast 2017; 2016:4323792. [PMID: 28090357 PMCID: PMC5206446 DOI: 10.1155/2016/4323792] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/16/2016] [Accepted: 11/28/2016] [Indexed: 11/17/2022] Open
Abstract
Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years' corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects) or to the control group (62 subjects) depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months' corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and behavioural outcomes. In addition, males had significantly lower scores than females either before or after treatment. However, the treatment was effective in both genders to the same extent. In conclusion, a timely updated environment suitable to the infant's developmental needs could provide the best substrate where the parent-infant relationship can be practised with the ultimate goal of achieving further developmental steps.
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Abstract
Infants born at extreme preterm gestation are at risk for both death and disability. Although rates of survival have improved for this population, and some evidence suggests a trend toward decreased neuromotor impairment over the past decades, a significant improvement in overall early neurodevelopmental outcome has not yet been realized. This review will examine the rates and types of neurodevelopmental impairment seen after extremely preterm birth, including neurosensory, motor, cognitive, and behavioral outcomes. We focus on early outcomes in the first 18-36 months of life, as the majority of large neonatal studies examining neurodevelopmental outcomes stop at this age. However, this early age is clearly just a first glimpse into lifetime outcomes; the neurodevelopmental effects of extreme prematurity may last through school age, adolescence, and beyond. Importantly, prematurity appears to be an independent risk factor for adverse development, but this population demonstrates considerable variability in the types and severity of impairments. Understanding both the nature and prevalence of neurodevelopmental impairment among extremely preterm infants is important because it can lead to targeted interventions that in turn may lead to improved outcomes.
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Affiliation(s)
- Elizabeth E Rogers
- Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, 550 4th St, 5th Floor, Box 0743, San Francisco, CA 94143.
| | - Susan R Hintz
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Palo Alto, CA
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Abstract
There have been amazing changes in outcomes of preterm (PT) infants in the past decades. Whereas early studies reported only survival rates, Dr. Julius Hess published the first outcome study of PT infants in Chicago in 1953. Dr. Lubchenco then published the 10-year follow-up of premature infants born in 1947-1953 and identified a 68% handicap rate. As a result of these early studies, the importance of evaluating NICU graduates both for surveillance and as an outcome of trials was recognized. During the 1970s, there was a gradual expansion in the number of follow-up programs in the United States (US) with an increasing number of follow-up studies published. In the 1980s, the importance of multicenter clinical research networks was recognized and the NICHD Neonatal Research Network (NRN) was initiated in 1986. Follow-up protocols, definitions, and outcomes have evolved over the last 30 years and will be reviewed with a focus on NICHD NRN studies.
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Affiliation(s)
- Susan R Hintz
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, 750 Welch Rd, Suite 315, Palo Alto, CA 94304
| | - Jamie E Newman
- Public Health Research Division, RTI International, Research Triangle Park, NC
| | - Betty R Vohr
- Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics Women & Infants Hospital of Rhode Island, Providence, RI.
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Maduna T, Lelievre V. Neuropeptides shaping the central nervous system development: Spatiotemporal actions of VIP and PACAP through complementary signaling pathways. J Neurosci Res 2016; 94:1472-1487. [PMID: 27717098 DOI: 10.1002/jnr.23915] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/04/2016] [Accepted: 08/15/2016] [Indexed: 01/18/2023]
Abstract
Pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) are neuropeptides with wide, complementary, and overlapping distributions in the central and peripheral nervous systems, where they exert important regulatory roles in many physiological processes. VIP and PACAP display a large range of biological cellular targets and functions in the adult nervous system including regulation of neurotransmission and neuroendocrine secretion and neuroprotective and neuroimmune responses. As the main focus of the present review, VIP and PACAP also have been long implicated in nervous system development and maturation through their interaction with the seven transmembrane domain G protein-coupled receptors, PAC1, VPAC1, and VPAC2, initiating multiple signaling pathways. Compared with PAC1, which solely binds PACAP with very high affinity, VPACs exhibit high affinities for both VIP and PACAP but differ from each other because of their pharmacological profile for both natural accessory peptides and synthetic or chimeric molecules, with agonistic and antagonistic properties. Complementary to initial pharmacological studies, transgenic animals lacking these neuropeptides or their receptors have been used to further characterize the neuroanatomical, electrophysiological, and behavioral roles of PACAP and VIP in the developing central nervous system. In this review, we recapitulate the critical steps and processes guiding/driving neurodevelopment in vertebrates and superimposing the potential contribution of PACAP and VIP receptors on the given timeline. We also describe how alterations in VIP/PACAP signaling may contribute to both (neuro)developmental and adult pathologies and suggest that tuning of VIP/PACAP signaling in a spatiotemporal manner may represent a novel avenue for preventive therapies of neurological and psychiatric disorders. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Tando Maduna
- Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique UPR3212, Université de Strasbourg, Strasbourg, France
| | - Vincent Lelievre
- Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique UPR3212, Université de Strasbourg, Strasbourg, France.
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Erythropoietin Restores Long-Term Neurocognitive Function Involving Mechanisms of Neuronal Plasticity in a Model of Hyperoxia-Induced Preterm Brain Injury. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:9247493. [PMID: 27493706 PMCID: PMC4963567 DOI: 10.1155/2016/9247493] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/31/2016] [Accepted: 06/13/2016] [Indexed: 12/22/2022]
Abstract
Cerebral white and grey matter injury is the leading cause of an adverse neurodevelopmental outcome in prematurely born infants. High oxygen concentrations have been shown to contribute to the pathogenesis of neonatal brain damage. Here, we focused on motor-cognitive outcome up to the adolescent and adult age in an experimental model of preterm brain injury. In search of the putative mechanisms of action we evaluated oligodendrocyte degeneration, myelination, and modulation of synaptic plasticity-related molecules. A single dose of erythropoietin (20,000 IU/kg) at the onset of hyperoxia (24 hours, 80% oxygen) in 6-day-old Wistar rats improved long-lasting neurocognitive development up to the adolescent and adult stage. Analysis of white matter structures revealed a reduction of acute oligodendrocyte degeneration. However, erythropoietin did not influence hypomyelination occurring a few days after injury or long-term microstructural white matter abnormalities detected in adult animals. Erythropoietin administration reverted hyperoxia-induced reduction of neuronal plasticity-related mRNA expression up to four months after injury. Thus, our findings highlight the importance of erythropoietin as a neuroregenerative treatment option in neonatal brain injury, leading to improved memory function in adolescent and adult rats which may be linked to increased neuronal network connectivity.
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Moeskops P, Benders MJNL, Kersbergen KJ, Groenendaal F, de Vries LS, Viergever MA, Išgum I. Development of Cortical Morphology Evaluated with Longitudinal MR Brain Images of Preterm Infants. PLoS One 2015; 10:e0131552. [PMID: 26161536 PMCID: PMC4498793 DOI: 10.1371/journal.pone.0131552] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/03/2015] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The cerebral cortex develops rapidly in the last trimester of pregnancy. In preterm infants, brain development is very vulnerable because of their often complicated extra-uterine conditions. The aim of this study was to quantitatively describe cortical development in a cohort of 85 preterm infants with and without brain injury imaged at 30 and 40 weeks postmenstrual age (PMA). METHODS In the acquired T2-weighted MR images, unmyelinated white matter (UWM), cortical grey matter (CoGM), and cerebrospinal fluid in the extracerebral space (CSF) were automatically segmented. Based on these segmentations, cortical descriptors evaluating volume, surface area, thickness, gyrification index, and global mean curvature were computed at both time points, for the whole brain, as well as for the frontal, temporal, parietal, and occipital lobes separately. Additionally, visual scoring of brain abnormality was performed using a conventional scoring system at 40 weeks PMA. RESULTS The evaluated descriptors showed larger change in the occipital lobes than in the other lobes. Moreover, the cortical descriptors showed an association with the abnormality scores: gyrification index and global mean curvature decreased, whereas, interestingly, median cortical thickness increased with increasing abnormality score. This was more pronounced at 40 weeks PMA than at 30 weeks PMA, suggesting that the period between 30 and 40 weeks PMA might provide a window of opportunity for intervention to prevent delay in cortical development.
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Affiliation(s)
- Pim Moeskops
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Perinatal Imaging & Health, Division of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Karina J Kersbergen
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Floris Groenendaal
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Max A Viergever
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ivana Išgum
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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Wolke D, Strauss VYC, Johnson S, Gilmore C, Marlow N, Jaekel J. Universal gestational age effects on cognitive and basic mathematic processing: 2 cohorts in 2 countries. J Pediatr 2015; 166:1410-6.e1-2. [PMID: 25842966 PMCID: PMC4441098 DOI: 10.1016/j.jpeds.2015.02.065] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 01/15/2015] [Accepted: 02/26/2015] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To determine whether general cognitive ability, basic mathematic processing, and mathematic attainment are universally affected by gestation at birth, as well as whether mathematic attainment is more strongly associated with cohort-specific factors such as schooling than basic cognitive and mathematical abilities. STUDY DESIGN The Bavarian Longitudinal Study (BLS, 1289 children, 27-41 weeks gestational age [GA]) was used to estimate effects of GA on IQ, basic mathematic processing, and mathematic attainment. These estimations were used to predict IQ, mathematic processing, and mathematic attainment in the EPICure Study (171 children <26 weeks GA). RESULTS For children born <34 weeks GA, each lower week decreased IQ and mathematic attainment scores by 2.34 (95% CI: -2.99, -1.70) and 2.76 (95% CI: -3.40, -2.11) points, respectively. There were no differences among children born 34-41 weeks GA. Similarly, for children born <36 weeks GA, mathematic processing scores decreased by 1.77 (95% CI: -2.20, -1.34) points with each lower GA week. The prediction function generated using BLS data accurately predicted the effect of GA on IQ and mathematic processing among EPICure children. However, these children had better attainment than predicted by BLS. CONCLUSIONS Prematurity has adverse effects on basic mathematic processing following birth at all gestations <36 weeks and on IQ and mathematic attainment <34 weeks GA. The ability to predict IQ and mathematic processing scores from one cohort to another among children cared for in different eras and countries suggests that universal neurodevelopmental factors may explain the effects of gestation at birth. In contrast, mathematic attainment may be improved by schooling.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Warwick Medical School, University of Warwick, Coventry, United Kingdom.
| | | | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Camilla Gilmore
- Mathematics Education Center, Loughborough University, Loughborough, United Kingdom
| | - Neil Marlow
- University College London, London, United Kingdom
| | - Julia Jaekel
- Department of Psychology, University of Warwick, Coventry, United Kingdom,Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany
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Abstract
PURPOSE OF REVIEW Extremely low birth weight and very low birth weight infants are born immature and are commonly sick and are, therefore, not able to receive appropriate enteral or sufficient parenteral nutrition to meet the needs for optimal brain, lung and gut growth and development. RECENT FINDINGS We provide an updated view of essential fatty acid metabolism and discuss the potential protective effect of fatty acids that serve as precursors for eicosanoids and docosanoids. The balance of n-3 or n-6 long-chain polyunsaturated fatty acids (LCPUFAs) supplied may enhance or ameliorate the effects of hypoxia, inflammation, infection, thrombosis and oxidative damage of key organs (lung, brain and retina). In addition, n-3 and n-6 LCPUFAs are necessary for normal structure and function of the central nervous system and sensory organ development. These lipids generate eicosanoids that are mediators of oxidative damage, as well as potential protectors of retina, brain cortex, lung and vascular endothelium. SUMMARY n-3 and n-6 LCPUFAs may condition in part the long-term consequences of preterm birth. Early n-3 and n-6 LCPUFA supply may moderate the impact of hypoxia and oxidative damage, thus affecting the recovery from injury, later organ (brain, retina, lung, gut, liver and skin) growth and neurodevelopmental outcomes.
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Jantzie LL, Hu MY, Park HK, Jackson MC, Yu J, Maxwell JR, Jensen FE. Chloride cotransporter NKCC1 inhibitor bumetanide protects against white matter injury in a rodent model of periventricular leukomalacia. Pediatr Res 2015; 77:554-62. [PMID: 25585037 DOI: 10.1038/pr.2015.9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 10/25/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Periventricular leukomalacia (PVL) is a major form of preterm brain injury. Na(+)-K(+)-Cl(-) 1 cotransporter (NKCC1) expression on neurons and astrocytes is developmentally regulated and mediates Cl(-) reversal potential. We hypothesized that NKCC1 is highly expressed on oligodendrocytes (OLs) and increases vulnerability to hypoxia-ischemia (HI) mediated white matter injury, and that the NKCC1 inhibitor bumetanide would be protective in a rodent PVL model. METHODS Immunohistochemistry in Long-Evans rats and PLP-EGFP transgenic mice was used to establish cell-specific expression of NKCC1 in the immature rodent brain. HI was induced on postnatal day 6 (P6) in rats and the protective efficacy of bumetanide (0.3 mg/kg/i.p. q12h × 60 h) established. RESULTS NKCC1 was expressed on OLs and subplate neurons through the first 2 postnatal weeks, peaking in white matter and the subplate between P3-7. Following HI, NKCC1 is expressed on OLs and neurons. Bumetanide treatment significantly attenuates myelin basic protein loss and neuronal degeneration 7 d post-HI. CONCLUSION Presence and relative overexpression of NKCC1 in rodent cerebral cortex coincides with a period of developmental vulnerability to HI white matter injury in the immature prenatal brain. The protective efficacy of bumetanide in this model of preterm brain injury suggests that Cl(-) transport is a factor in PVL and that its inhibition may have clinical application in premature human infants.
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Affiliation(s)
- Lauren L Jantzie
- 1] Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts [2] Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Melody Y Hu
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Hyun-Kyung Park
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michele C Jackson
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jenny Yu
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jessie R Maxwell
- Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Frances E Jensen
- 1] Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts [2] Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Potential neuroprotective strategies for perinatal infection and inflammation. Int J Dev Neurosci 2015; 45:44-54. [DOI: 10.1016/j.ijdevneu.2015.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 02/16/2015] [Accepted: 02/16/2015] [Indexed: 01/17/2023] Open
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Hitzert MM, van Geert PLC, Hunnius S, Van Braeckel KNJA, Bos AF, Geuze RH. Associations between developmental trajectories of movement variety and visual attention in fullterm and preterm infants during the first six months postterm. Early Hum Dev 2015; 91:89-96. [PMID: 25556578 DOI: 10.1016/j.earlhumdev.2014.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 11/10/2014] [Accepted: 12/10/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND During early infancy major developmental changes, both in the variety of body movements and in visual attention, help the infant to explore its surroundings. Both behaviours depend on a gradual shift from subcortical to cortical functioning. AIMS First, to determine whether preterms reach mature levels of movement variety (the number of different movement patterns) and visual attention earlier than fullterms. Second, to determine whether individual developmental trajectories of movement variety and visual attention were associated. Finally, we compared the associations of developmental trajectories between fullterm and preterm infants. STUDY DESIGN In this longitudinal study, 20 fullterm and 9 low-risk preterm infants performed a visual disengagement task every four weeks from six weeks until six months postterm. For each infant we drew up developmental trajectories for movement variety, and for frequencies and latencies of looks. We analyzed the developmental trajectories by means of general linear model (GLM) repeated measures and Monte Carlo analyses. RESULTS In comparison to fullterms, preterm infants showed a similar increase in movement variety over time (F(4,108)=0.27; partial eta(2)=0.01; P=.90). Visual attention reached mature levels four weeks earlier than movement variety. This effect was stronger in fullterm infants. Neither in fullterm nor in preterm infants did we find an association between the developmental trajectories of movement variety and visual attention. P values ranged from .37 to .99. CONCLUSIONS During the first 6 months postterm, movement variety and visual attention developed independently. Temporarily, preterm exposure to the extrauterine environment led to shorter latencies of looks but it did not affect developmental trajectories of frequencies of looks and movement variety.
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Affiliation(s)
- Marrit M Hitzert
- Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Paul L C van Geert
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Sabine Hunnius
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Koenraad N J A Van Braeckel
- Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arend F Bos
- Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Reint H Geuze
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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40
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Rüegger CM, Hagmann CF, Bührer C, Held L, Bucher HU, Wellmann S. Erythropoietin for the Repair of Cerebral Injury in Very Preterm Infants (EpoRepair). Neonatology 2015; 108:198-204. [PMID: 26278911 DOI: 10.1159/000437248] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/25/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Preterm infants suffering from intraventricular hemorrhage (IVH) are at increased risk for neurodevelopmental impairment. Observational data suggest that recombinant human erythropoietin (rEPO) improves long-term cognitive outcome in infants with IVH. Recent studies revealed a beneficial effect of early high-dose rEPO on white matter development in preterm infants determined by magnetic resonance imaging (MRI). OBJECTIVES To summarize the current evidence and to delineate the study protocol of the EpoRepair trial (Erythropoietin for the Repair of Cerebral Injury in Very Preterm Infants). METHODS The study involves a review of the literature and the design of a double-blind, placebo-controlled, multicenter trial of repetitive high-dose rEPO administration, enrolling 120 very preterm infants with moderate-to-severe IVH diagnosed by cranial ultrasound in the first days of life, qualitative and quantitative MRI at term-equivalent age and long-term neurodevelopmental follow-up until 5 years of age. RESULTS AND CONCLUSIONS The hypothesis generated by observational data that rEPO may improve long-term cognitive outcomes of preterm infants suffering from IVH are to be confirmed or refuted by the randomized controlled trial, EpoRepair.
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Affiliation(s)
- Christoph M Rüegger
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Germany
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41
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Rogers CE, Barch DM, Sylvester CM, Pagliaccio D, Harms MP, Botteron KN, Luby JL. Altered gray matter volume and school age anxiety in children born late preterm. J Pediatr 2014; 165:928-35. [PMID: 25108541 PMCID: PMC4252475 DOI: 10.1016/j.jpeds.2014.06.063] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/28/2014] [Accepted: 06/27/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To determine if late preterm (LP) children differ from full term (FT) children in volumes of the cortex, hippocampus, corpus callosum, or amygdala and whether these differences are associated with anxiety symptoms at school-age. STUDY DESIGN LP children born between 34 and 36 weeks gestation and FT children born between 39 and 41 weeks gestation from a larger longitudinal cohort had magnetic resonance imaging scans at school-age. Brain volumes, cortical surface area, and thickness measures were obtained. Anxiety symptoms were assessed using a structured diagnostic interview annually beginning at preschool-age and following the magnetic resonance imaging. RESULTS LP children (n = 21) had a smaller percentage of total, right parietal, and right temporal lobe gray matter volume than FT children (n = 87). There were no differences in hippocampal, callosal, or amygdala volumes or cortical thickness. LP children also had a relative decrease in right parietal lobe cortical surface area. LP children had greater anxiety symptoms over all assessments. The relationship between late prematurity and school-age anxiety symptoms was mediated by the relative decrease in right temporal lobe volume. CONCLUSIONS LP children, comprising 70% of preterm children, are also at increased risk for altered brain development particularly in the right temporal and parietal cortices. Alterations in the right temporal lobe cortical volume may underlie the increased rate of anxiety symptoms among these LP children. These findings suggest that LP delivery may disrupt temporal and parietal cortical development that persists until school-age with the right temporal lobe conferring risk for elevated anxiety symptoms.
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Affiliation(s)
- Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO; Department of Psychology, Washington University in St. Louis, St. Louis, MO; The Program in Neuroscience, Washington University in St. Louis, St. Louis, MO
| | - Chad M Sylvester
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - David Pagliaccio
- The Program in Neuroscience, Washington University in St. Louis, St. Louis, MO
| | - Michael P Harms
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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42
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Abstract
Neonatal neurosonography is used commonly to evaluate the central nervous system in the neonatal intensive care setting. The procedure can be performed at the bedside in these critically ill patients who may suffer from hemodynamic and thermoregulatory instability and often require mechanical ventilation. This article reviews current recommendations regarding neurosonography technique, pathophysiology, and imaging of intracranial insults including hemorrhage, white matter injury, infarction, and hypoxic-ischemic encephalopathy.
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Affiliation(s)
- Joel Fritz
- Department of Radiology, Baystate Medical Center, Springfield, MA.
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43
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Kostović I, Kostović-Srzentić M, Benjak V, Jovanov-Milošević N, Radoš M. Developmental dynamics of radial vulnerability in the cerebral compartments in preterm infants and neonates. Front Neurol 2014; 5:139. [PMID: 25120530 PMCID: PMC4114264 DOI: 10.3389/fneur.2014.00139] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 07/14/2014] [Indexed: 01/06/2023] Open
Abstract
The developmental vulnerability of different classes of axonal pathways in preterm white matter is not known. We propose that laminar compartments of the developing cerebral wall serve as spatial framework for axonal growth and evaluate potential of anatomical landmarks for understanding reorganization of the cerebral wall after perinatal lesions. The 3-T MRI (in vivo) and histological analysis were performed in a series of cases ranging from 22 postconceptional weeks to 3 years. For the follow-up scans, three groups of children (control, normotypic, and preterms with lesions) were examined at the term equivalent age and after the first year of life. MRI and histological abnormalities were analyzed in the following compartments: (a) periventricular, with periventricular fiber system; (b) intermediate, with periventricular crossroads, sagittal strata, and centrum semiovale; (c) superficial, composed of gyral white matter, subplate, and cortical plate. Vulnerability of thalamocortical pathways within the crossroads and sagittal strata seems to be characteristic for early preterms, while vulnerability of long association pathways in the centrum semiovale seems to be predominant feature of late preterms. The structural indicator of the lesion of the long association pathways is the loss of delineation between centrum semiovale and subplate remnant, which is possible substrate of the diffuse periventricular leukomalacia. The enhanced difference in MR signal intensity of centrum semiovale and subplate remnant, observed in damaged children after first year, we interpret as structural plasticity of intact short cortico-cortical fibers, which grow postnatally through U-zones and enter the cortex through the subplate remnant. Our findings indicate that radial distribution of MRI signal abnormalities in the cerebral compartments may be related to lesion of different classes of axonal pathways and have prognostic value for predicting the likely outcome of prenatal and perinatal lesions.
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Affiliation(s)
- Ivica Kostović
- Croatian Institute for Brain Research, University of Zagreb School of Medicine , Zagreb , Croatia
| | | | - Vesna Benjak
- Department of Pediatrics, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine , Zagreb , Croatia
| | - Nataša Jovanov-Milošević
- Croatian Institute for Brain Research, University of Zagreb School of Medicine , Zagreb , Croatia
| | - Milan Radoš
- Croatian Institute for Brain Research, University of Zagreb School of Medicine , Zagreb , Croatia
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44
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van den Heuij LG, Mathai S, Davidson JO, Lear CA, Booth LC, Fraser M, Gunn AJ, Bennet L. Synergistic white matter protection with acute-on-chronic endotoxin and subsequent asphyxia in preterm fetal sheep. J Neuroinflammation 2014; 11:89. [PMID: 24886663 PMCID: PMC4039331 DOI: 10.1186/1742-2094-11-89] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 05/01/2014] [Indexed: 12/16/2022] Open
Abstract
Background Perinatal asphyxia and exposure to intrauterine infection are associated with impaired neurodevelopment in preterm infants. Acute exposure to non-injurious infection and/or inflammation can either protect or sensitize the brain to subsequent hypoxia-ischemia. However, the effects of subacute infection and/or inflammation are unclear. In this study we tested the hypothesis that acute-on-chronic exposure to lipopolysaccharide (LPS) would exacerbate white matter injury after subsequent asphyxia in preterm fetal sheep. Methods Fetal sheep at 0.7 gestational age received a continuous LPS infusion at 100 ng/kg for 24 hours, then 250 ng/kg/24 hours for 96 hours, plus 1 μg boluses of LPS at 48, 72, and 96 hours or the same volume of saline. Four hours after the last bolus, complete umbilical cord occlusion or sham occlusion was induced for 15 minutes. Sheep were sacrificed 10 days after the start of infusions. Results LPS exposure was associated with induction of microglia and astrocytes and loss of total and immature and mature oligodendrocytes (n = 9) compared to sham controls (n = 9). Umbilical cord occlusion with saline infusions was associated with induction of microglia, astrogliosis, and loss of immature and mature oligodendrocytes (n = 9). LPS exposure before asphyxia (n = 8) was associated with significantly reduced microglial activation and astrogliosis and improved numbers of immature and mature oligodendrocytes compared to either LPS exposure or asphyxia alone. Conclusions Contrary to our initial hypothesis, the combination of acute-on-chronic LPS with subsequent asphyxia reduced neuroinflammation and white matter injury compared with either intervention alone.
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Affiliation(s)
| | | | | | | | | | | | - Alistair J Gunn
- Department of Physiology, University of Auckland, Park Road, Grafton, Auckland 1023, New Zealand.
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