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Matlis GC, Zhang Q, Benson EJ, Weeks MK, Andersen K, Jahnavi J, Lafontant A, Breimann J, Hallowell T, Lin Y, Licht DJ, Yodh AG, Kilbaugh TJ, Forti RM, White BR, Baker WB, Xiao R, Ko TS. Chassis-based fiber-coupled optical probe design for reproducible quantitative diffuse optical spectroscopy measurements. PLoS One 2024; 19:e0305254. [PMID: 39052686 PMCID: PMC11271963 DOI: 10.1371/journal.pone.0305254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/27/2024] [Indexed: 07/27/2024] Open
Abstract
Advanced optical neuromonitoring of cerebral hemodynamics with hybrid diffuse optical spectroscopy (DOS) and diffuse correlation spectroscopy (DCS) methods holds promise for non-invasive characterization of brain health in critically ill patients. However, the methods' fiber-coupled patient interfaces (probes) are challenging to apply in emergent clinical scenarios that require rapid and reproducible attachment to the head. To address this challenge, we developed a novel chassis-based optical probe design for DOS/DCS measurements and validated its measurement accuracy and reproducibility against conventional, manually held measurements of cerebral hemodynamics in pediatric swine (n = 20). The chassis-based probe design comprises a detachable fiber housing which snaps into a 3D-printed, circumferential chassis piece that is secured to the skin. To validate its reproducibility, eight measurement repetitions of cerebral tissue blood flow index (BFI), oxygen saturation (StO2), and oxy-, deoxy- and total hemoglobin concentration were acquired at the same demarcated measurement location for each pig. The probe was detached after each measurement. Of the eight measurements, four were acquired by placing the probe into a secured chassis, and four were visually aligned and manually held. We compared the absolute value and intra-subject coefficient of variation (CV) of chassis versus manual measurements. No significant differences were observed in either absolute value or CV between chassis and manual measurements (p > 0.05). However, the CV for BFI (mean ± SD: manual, 19.5% ± 9.6; chassis, 19.0% ± 10.8) was significantly higher than StO2 (manual, 5.8% ± 6.7; chassis, 6.6% ± 7.1) regardless of measurement methodology (p<0.001). The chassis-based DOS/DCS probe design facilitated rapid probe attachment/re-attachment and demonstrated comparable accuracy and reproducibility to conventional, manual alignment. In the future, this design may be adapted for clinical applications to allow for non-invasive monitoring of cerebral health during pediatric critical care.
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Affiliation(s)
- Giselle C. Matlis
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Qihuang Zhang
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Emilie J. Benson
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, United States of America
| | - M. Katie Weeks
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Kristen Andersen
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Jharna Jahnavi
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Alec Lafontant
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Jake Breimann
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Thomas Hallowell
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Yuxi Lin
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Daniel J. Licht
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
- Division of Neurology, Department of Pediatrics, Children’s National, Washington, District of Columbia, United States of America
- Division of Neurology, George Washington University, Washington, District of Columbia, United States of America
| | - Arjun G. Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Todd J. Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
| | - Rodrigo M. Forti
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Brian R. White
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
- Division of Pediatric Cardiology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Wesley B. Baker
- Division of Neurology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
| | - Rui Xiao
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States of America
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
| | - Tiffany S. Ko
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
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Gemignani J, Gervain J. Brain responses to repetition-based rule-learning do not exhibit sex differences: an aggregated analysis of infant fNIRS studies. Sci Rep 2024; 14:2611. [PMID: 38297068 PMCID: PMC10831066 DOI: 10.1038/s41598-024-53092-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/27/2024] [Indexed: 02/02/2024] Open
Abstract
Studies have repeatedly shown sex differences in some areas of language development, typically with an advantage for female over male children. However, the tested samples are typically small and the effects do not always replicate. Here, we used a meta-analytic approach to address this issue in a larger sample, combining seven fNIRS studies on the neural correlates of repetition- and non-repetition-based rule learning in newborns and 6-month-old infants. The ability to extract structural regularities from the speech input is fundamental for language development, it is therefore highly relevant to understand whether this ability shows sex differences. The meta-analysis tested the effect of Sex, as well as of other moderators on infants' hemodynamic responses to repetition-based (e.g. ABB: "mubaba") and non-repetition-based (e.g. ABC: "mubage") sequences in both anatomically and functionally defined regions of interests. Our analyses did not reveal any sex differences at birth or at 6 months, suggesting that the ability to encode these regularities is robust across sexes. Interestingly, the meta-analysis revealed other moderator effects. Thus in newborns, we found a greater involvement of the bilateral temporal areas compared to the frontal areas for both repetition and non-repetition sequences. Further, non-repetition sequences elicited greater responses in 6-month-olds than in newborns, especially in the bilateral frontal areas. When analyzing functional clusters of HbR timetraces, we found that a larger right-left asymmetry for newborn boys in brain responses compared to girls, which may be interpreted in terms of a larger right-left asymmetry in cerebral blood flow in boys than in girls early in life. We conclude that extracting repetition-based regularities from speech is a robust ability with a well-defined neural substrate present from birth and it does not exhibit sex differences.
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Affiliation(s)
- Jessica Gemignani
- Department of Developmental and Social Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy.
- Padova Neuroscience Center, University of Padua, Padua, Italy.
| | - Judit Gervain
- Department of Developmental and Social Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy
- Padova Neuroscience Center, University of Padua, Padua, Italy
- Integrative Neuroscience and Cognition Center, CNRS &, Université Paris Cité, Paris, France
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3
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Abaci Turk E, Yun HJ, Feldman HA, Lee JY, Lee HJ, Bibbo C, Zhou C, Tamen R, Grant PE, Im K. Association between placental oxygen transport and fetal brain cortical development: a study in monochorionic diamniotic twins. Cereb Cortex 2024; 34:bhad383. [PMID: 37885155 PMCID: PMC11032198 DOI: 10.1093/cercor/bhad383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Normal cortical growth and the resulting folding patterns are crucial for normal brain function. Although cortical development is largely influenced by genetic factors, environmental factors in fetal life can modify the gene expression associated with brain development. As the placenta plays a vital role in shaping the fetal environment, affecting fetal growth through the exchange of oxygen and nutrients, placental oxygen transport might be one of the environmental factors that also affect early human cortical growth. In this study, we aimed to assess the placental oxygen transport during maternal hyperoxia and its impact on fetal brain development using MRI in identical twins to control for genetic and maternal factors. We enrolled 9 pregnant subjects with monochorionic diamniotic twins (30.03 ± 2.39 gestational weeks [mean ± SD]). We observed that the fetuses with slower placental oxygen delivery had reduced volumetric and surface growth of the cerebral cortex. Moreover, when the difference between placenta oxygen delivery increased between the twin pairs, sulcal folding patterns were more divergent. Thus, there is a significant relationship between placental oxygen transport and fetal brain cortical growth and folding in monochorionic twins.
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Affiliation(s)
- Esra Abaci Turk
- Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
- Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, 401 Park Dr, Boston, MA 02115, United States
| | - Hyuk Jin Yun
- Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
- Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, 401 Park Dr, Boston, MA 02115, United States
| | - Henry A Feldman
- Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
- Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
| | - Joo Young Lee
- Department of Pediatrics, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea
| | - Carolina Bibbo
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Cindy Zhou
- Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, 401 Park Dr, Boston, MA 02115, United States
| | - Rubii Tamen
- Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, 401 Park Dr, Boston, MA 02115, United States
| | - Patricia Ellen Grant
- Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
- Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, 401 Park Dr, Boston, MA 02115, United States
- Department of Radiology, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
| | - Kiho Im
- Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
- Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, 401 Park Dr, Boston, MA 02115, United States
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Hijman AIS, Wehrle FM, Latal B, Hagmann CF, O'Gorman RL. Cerebral perfusion differences are linked to executive function performance in very preterm-born children and adolescents. Neuroimage 2024; 285:120500. [PMID: 38135171 DOI: 10.1016/j.neuroimage.2023.120500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Children and adolescents born very preterm are at risk of cognitive impairment, particularly affecting executive functions. To date, the neural correlates of these cognitive differences are not yet fully understood, although converging evidence points to a pattern of structural and functional brain alterations, including reduced brain volumes, altered connectivity, and altered brain activation patterns. In very preterm neonates, alterations in brain perfusion have also been reported, but the extent to which these perfusion alterations persist into later childhood is not yet known. This study evaluated global and regional brain perfusion, measured with arterial spin labelling (ASL) MRI, in 26 very preterm children and adolescents and 34 term-born peers. Perfusion was compared between groups and relative to executive function (EF) scores, derived from an extensive EF battery assessing working memory, cognitive flexibility, and planning. Very preterm children and adolescents showed regions of altered perfusion, some of which were also related to EF scores. Most of these regions were located in the right hemisphere and included regions like the thalamus and hippocampus, which are known to play a role in executive functioning and can be affected by prematurity. In addition, perfusion decreased with age during adolescence and showed a significant interaction between birth status and sex, such that very preterm girls showed lower perfusion than term-born girls, but this trend was not seen in boys. Taken together, our results indicate a regionally altered perfusion in very preterm children and adolescents, with age and sex related changes during adolescence.
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Affiliation(s)
| | - Flavia M Wehrle
- Department of Neonatology, University Hospital Zürich, Zürich, Switzerland; Child Development Center, University Children's Hospital Zürich, Zürich, Switzerland; Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland
| | - Beatrice Latal
- Child Development Center, University Children's Hospital Zürich, Zürich, Switzerland; Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland
| | - Cornelia F Hagmann
- Department of Neonatology, University Hospital Zürich, Zürich, Switzerland; Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland
| | - Ruth L O'Gorman
- Center for MR Research, University Children's Hospital Zürich, Zürich, Switzerland; Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland; Zürich Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland.
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5
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Sutin J, Vyas R, Feldman HA, Ferradal S, Hsiao CH, Zampolli L, Pierce LJ, Nelson CA, Morton SU, Hay S, El-Dib M, Soul JS, Lin PY, Grant PE. Association of cerebral metabolic rate following therapeutic hypothermia with 18-month neurodevelopmental outcomes after neonatal hypoxic ischemic encephalopathy. EBioMedicine 2023; 94:104673. [PMID: 37392599 PMCID: PMC10338207 DOI: 10.1016/j.ebiom.2023.104673] [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: 01/12/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Therapeutic hypothermia (TH) is standard of care for moderate to severe neonatal hypoxic ischemic encephalopathy (HIE) but many survivors still suffer lifelong disabilities and benefits of TH for mild HIE are under active debate. Development of objective diagnostics, with sensitivity to mild HIE, are needed to select, guide, and assess response to treatment. The objective of this study was to determine if cerebral oxygen metabolism (CMRO2) in the days after TH is associated with 18-month neurodevelopmental outcomes as the first step in evaluating CMRO2's potential as a diagnostic for HIE. Secondary objectives were to compare associations with clinical exams and characterise the relationship between CMRO2 and temperature during TH. METHODS This was a prospective, multicentre, observational, cohort study of neonates clinically diagnosed with HIE and treated with TH recruited from the tertiary neonatal intensive care units (NICUs) of Boston Children's Hospital, Brigham and Women's Hospital, and Beth Israel Deaconess Medical Center between December 2015 and October 2019 with follow-up to 18 months. In total, 329 neonates ≥34 weeks gestational age admitted with perinatal asphyxia and suspected HIE were identified. 179 were approached, 103 enrolled, 73 received TH, and 64 were included. CMRO2 was measured at the NICU bedside by frequency-domain near-infrared and diffuse correlation spectroscopies (FDNIRS-DCS) during the late phases of hypothermia (C), rewarming (RW) and after return to normothermia (NT). Additional variables were body temperature and clinical neonatal encephalopathy (NE) scores, as well as findings from magnetic resonance imaging (MRI) and spectroscopy (MRS). Primary outcome was the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) at 18 months, normed (SD) to 100 (15). FINDINGS Data quality for 58 neonates was sufficient for analysis. CMRO2 changed by 14.4% per °C (95% CI, 14.2-14.6) relative to its baseline at NT while cerebral tissue oxygen extraction fraction (cFTOE) changed by only 2.2% per °C (95% CI, 2.1-2.4) for net changes from C to NT of 91% and 8%, respectively. Follow-up data for 2 were incomplete, 33 declined and 1 died, leaving 22 participants (mean [SD] postnatal age, 19.1 [1.2] month; 11 female) with mild to moderate HIE (median [IQR] NE score, 4 [3-6]) and 21 (95%) with BSID-III scores >85 at 18 months. CMRO2 at NT was positively associated with cognitive and motor composite scores (β (SE) = 4.49 (1.55) and 2.77 (1.00) BSID-III points per 10-10 moL/dl × mm2/s, P = 0.009 and P = 0.01 respectively; linear regression); none of the other measures were associated with the neurodevelopmental outcomes. INTERPRETATION Point of care measures of CMRO2 in the NICU during C and RW showed dramatic changes and potential to assess individual response to TH. CMRO2 following TH outperformed conventional clinical evaluations (NE score, cFTOE, and MRI/MRS) at predicting cognitive and motor outcomes at 18 months for mild to moderate HIE, providing a promising objective, physiologically-based diagnostic for HIE. FUNDING This clinical study was funded by an NIH grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, United States (R01HD076258).
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Affiliation(s)
- Jason Sutin
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.
| | - Rutvi Vyas
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
| | - Henry A Feldman
- Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Department of Pediatrics, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
| | - Silvina Ferradal
- Department of Intelligent Systems Engineering, Indiana University Bloomington, 107 S Indiana Ave., Bloomington, IN 47405, USA
| | - Chuan-Heng Hsiao
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
| | - Lucca Zampolli
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
| | - Lara J Pierce
- Department of Psychology, York University, 198 York Blvd., North York, ON M3J 2S5, Canada
| | - Charles A Nelson
- Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
| | - Sarah U Morton
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA
| | - Susanne Hay
- Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Department of Neonatology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, USA
| | - Mohamed El-Dib
- Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA
| | - Janet S Soul
- Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Department of Neurology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
| | - Pei-Yi Lin
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA
| | - Patricia E Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
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Zhou X, Xia Y, Uchitel J, Collins-Jones L, Yang S, Loureiro R, Cooper RJ, Zhao H. Review of recent advances in frequency-domain near-infrared spectroscopy technologies [Invited]. BIOMEDICAL OPTICS EXPRESS 2023; 14:3234-3258. [PMID: 37497520 PMCID: PMC10368025 DOI: 10.1364/boe.484044] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/29/2023] [Accepted: 05/25/2023] [Indexed: 07/28/2023]
Abstract
Over the past several decades, near-infrared spectroscopy (NIRS) has become a popular research and clinical tool for non-invasively measuring the oxygenation of biological tissues, with particular emphasis on applications to the human brain. In most cases, NIRS studies are performed using continuous-wave NIRS (CW-NIRS), which can only provide information on relative changes in chromophore concentrations, such as oxygenated and deoxygenated hemoglobin, as well as estimates of tissue oxygen saturation. Another type of NIRS known as frequency-domain NIRS (FD-NIRS) has significant advantages: it can directly measure optical pathlength and thus quantify the scattering and absorption coefficients of sampled tissues and provide direct measurements of absolute chromophore concentrations. This review describes the current status of FD-NIRS technologies, their performance, their advantages, and their limitations as compared to other NIRS methods. Significant landmarks of technological progress include the development of both benchtop and portable/wearable FD-NIRS technologies, sensitive front-end photonic components, and high-frequency phase measurements. Clinical applications of FD-NIRS technologies are discussed to provide context on current applications and needed areas of improvement. The review concludes by providing a roadmap toward the next generation of fully wearable, low-cost FD-NIRS systems.
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Affiliation(s)
- Xinkai Zhou
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), London, HA7 4LP, UK
| | - Yunjia Xia
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), London, HA7 4LP, UK
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, UCL, London, WC1E 6BT, UK
| | - Julie Uchitel
- Department of Paediatrics, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Liam Collins-Jones
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, UCL, London, WC1E 6BT, UK
| | - Shufan Yang
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), London, HA7 4LP, UK
- School of Computing, Engineering & Build Environment, Edinburgh Napier University, Edinburgh, UK
| | - Rui Loureiro
- Aspire CREATe, Department of Orthopaedics & Musculoskeletal Science, UCL, London, HA7 4LP, UK
| | - Robert J. Cooper
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, UCL, London, WC1E 6BT, UK
| | - Hubin Zhao
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), London, HA7 4LP, UK
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, UCL, London, WC1E 6BT, UK
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Dong Y, Deng X, Xie M, Yu L, Qian L, Chen G, Zhang Y, Tang Y, Zhou Z, Long L. Gestational age-related changes in relaxation times of neonatal brain by quantitative synthetic magnetic resonance imaging. Brain Behav 2023:e3068. [PMID: 37248768 DOI: 10.1002/brb3.3068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/24/2023] [Accepted: 05/03/2023] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE This study aimed to explore the correlation between T1 and T2 relaxation times of synthetic MRI (SyMRI) and gestational age (GA) in each hemisphere of preterm and term newborns at the initial 28 days of birth. METHODS Seventy preterm and full-term infants were prospectively included in this study. All subjects completed 3.0 T routine MRI and SyMRI (MAGiC) one-stop scanning within 28 days of birth (aged 34-42 W at examination). The SyMRI postprocessing software (v8.0.4) was used to measure the T1 and T2 relaxation values of each brain region. The linear regression equations of quantitative relaxation values with GA were established to compare the variation speed in each brain region. RESULTS A significant linear and negative correlation was found between relaxation times and GA in the neonate cerebral cortex and subcortical gray and white matter regions (All p<.05). The relaxation time of the left centrum semiovale decreased with maximum variance with increasing GA among all white matter regions (T1: b = -51.45, β = -0.65, p < .0001; T2: b = -8.77, β = -0.71, p < .0001), whereas the right posterior limb of internal capsule showed minimal variance (T1: b = -27.94, β = -0.60, p < .0001; T2: b = -3.25, β = -0.68, p < .0001). Among all gray matter regions, the right globus pallidus and thalamus indicated the most significant decreasing degree of T1 and T2 relaxation values with GA (right globus pallidus T1: b = -33.14, β = -0.64, p < .0001; right thalamus T2: b = -3.94, β = -0.81, p < .0001), and the right and left occipital lobes indicated the least significant decreasing degree of T1 and T2 relaxation values with GA, respectively (right occipital lobes T1: b = -11.18, β = -0.26, p = .028; left occipital lobes T2: b = -1.22, β = -0.27, p = .024). CONCLUSIONS SyMRI could quantitatively evaluate the linear changes of T1 and T2 relaxation values with GA in brain gray and white matter of preterm and term neonates.
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Affiliation(s)
- Yan Dong
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Xianyu Deng
- Department of Cardiovascular, Guilin People's Hospital, Guilin, China
| | - Meizhen Xie
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lan Yu
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Long Qian
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, China
| | - Ge Chen
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Yali Zhang
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Yanyun Tang
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Zhipeng Zhou
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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8
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Sathialingam E, Cowdrick KR, Liew AY, Fang Z, Lee SY, McCracken CE, Akbik F, Samuels OB, Kandiah P, Sadan O, Buckley EM. Microvascular cerebral blood flow response to intrathecal nicardipine is associated with delayed cerebral ischemia. Front Neurol 2023; 14:1052232. [PMID: 37006474 PMCID: PMC10064128 DOI: 10.3389/fneur.2023.1052232] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/06/2023] [Indexed: 03/19/2023] Open
Abstract
One of the common complications of non-traumatic subarachnoid hemorrhage (SAH) is delayed cerebral ischemia (DCI). Intrathecal (IT) administration of nicardipine, a calcium channel blocker (CCB), upon detection of large-artery cerebral vasospasm holds promise as a treatment that reduces the incidence of DCI. In this observational study, we prospectively employed a non-invasive optical modality called diffuse correlation spectroscopy (DCS) to quantify the acute microvascular cerebral blood flow (CBF) response to IT nicardipine (up to 90 min) in 20 patients with medium-high grade non-traumatic SAH. On average, CBF increased significantly with time post-administration. However, the CBF response was heterogeneous across subjects. A latent class mixture model was able to classify 19 out of 20 patients into two distinct classes of CBF response: patients in Class 1 (n = 6) showed no significant change in CBF, while patients in Class 2 (n = 13) showed a pronounced increase in CBF in response to nicardipine. The incidence of DCI was 5 out of 6 in Class 1 and 1 out of 13 in Class 2 (p < 0.001). These results suggest that the acute (<90 min) DCS-measured CBF response to IT nicardipine is associated with intermediate-term (up to 3 weeks) development of DCI.
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Affiliation(s)
- Eashani Sathialingam
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Kyle R. Cowdrick
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Amanda Y. Liew
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Zhou Fang
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Seung Yup Lee
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
- Department of Electrical and Computer Engineering, Kennesaw State University, Marietta, GA, United States
| | - Courtney E. McCracken
- Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, United States
| | - Feras Akbik
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Owen B. Samuels
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Prem Kandiah
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Ofer Sadan
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Erin M. Buckley
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, United States
- Children's Research Scholar, Children's Healthcare of Atlanta, Atlanta, GA, United States
- *Correspondence: Erin M. Buckley
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9
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Charbonneau L, Chowdhury RA, Marandyuk B, Wu R, Poirier N, Miró J, Nuyt AM, Raboisson MJ, Dehaes M. Fetal cardiac and neonatal cerebral hemodynamics and oxygen metabolism in transposition of the great arteries. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:346-355. [PMID: 36565437 DOI: 10.1002/uog.26146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Hemodynamic abnormalities and brain development disorders have been reported previously in fetuses and infants with transposition of the great arteries and intact ventricular septum (TGA-IVS). A ventricular septal defect (VSD) is thought to be an additional risk factor for adverse neurodevelopment, but literature describing this population is sparse. The objectives of this study were to assess fetal cardiac hemodynamics throughout pregnancy, to monitor cerebral hemodynamics and oxygen metabolism in neonates, and to compare these data between patients with TGA-IVS, those with TGA-VSD and age-matched controls. METHODS Cardiac hemodynamics were assessed in TGA-IVS and TGA-VSD fetuses and compared with healthy controls matched for gestational age (GA) during three periods: ≤ 22 + 5 weeks (GA1), 27 + 0 to 32 + 5 weeks (GA2) and ≥ 34 + 5 weeks (GA3). Left (LVO), right (RVO) and combined (CVO) ventricular outputs, ductus arteriosus flow (DAF, sum of ante- and retrograde flow in systole and diastole), diastolic DAF, transpulmonary flow (TPF) and foramen ovale diameter were measured. Aortic (AoF) and main pulmonary artery (MPAF) flows were derived as a percentage of CVO. Fetal middle cerebral artery and umbilical artery (UA) pulsatility indices (PI) were measured and the cerebroplacental ratio (CPR) was derived. Bedside optical brain monitoring was used to measure cerebral hemoglobin oxygen saturation (SO2 ) and an index of microvascular cerebral blood flow (CBFi ), along with peripheral arterial oxygen saturation (SpO2 ), in TGA-IVS and TGA-VSD neonates. Using hemoglobin (Hb) concentration measurements, these parameters were used to derive cerebral oxygen delivery and extraction fraction (OEF), as well as an index of cerebral oxygen metabolism (CMRO2i ). These data were acquired in the early preoperative period (within 3 days after birth and following balloon atrial septostomy) and compared with those of age-matched healthy controls, and repeat measurements were collected before discharge when vital signs were stable. RESULTS LVO was increased in both TGA groups compared with controls throughout pregnancy. Compared with controls, TPF was increased and diastolic DAF was decreased in TGA-IVS fetuses throughout pregnancy, but only during GA1 and GA2 in TGA-VSD fetuses. Compared with controls, DAF was decreased in TGA-IVS fetuses throughout pregnancy and in TGA-VSD fetuses at GA2 and GA3. At GA2, AoF was higher in TGA-IVS and TGA-VSD fetuses than in controls, while MPAF was lower. At GA3, RVO and CVO were higher in the TGA-IVS group than in the TGA-VSD group. In addition, UA-PI was lower at GA2 and CPR higher at GA3 in TGA-VSD fetuses compared with TGA-IVS fetuses. Within 3 days after birth, SpO2 and SO2 were lower in both TGA groups than in controls, while Hb, cerebral OEF and CMRO2i were higher. Preoperative SpO2 was also lower in TGA-VSD neonates than in those with TGA-IVS. From preoperative to predischarge periods, SpO2 and OEF increased in both TGA groups, but CBFi and CMRO2i increased only in the TGA-VSD group. During the predischarge period, SO2 was higher in TGA-IVS than in TGA-VSD neonates, while CBFi was lower. CONCLUSIONS Fetal cardiac and neonatal cerebral hemodynamic/metabolic differences were observed in both TGA groups compared with controls. Compared to those with TGA-IVS, fetuses with TGA-VSD had lower RVO and CVO in late gestation. A higher level of preoperative hypoxemia was observed in the TGA-VSD group. Postsurgical cerebral adaptive mechanisms probably differ between TGA groups. Patients with TGA-VSD have a specific physiology that warrants further study to improve neonatal care and neurodevelopmental outcome. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- L Charbonneau
- Research Centre, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
- Department of Biomedical Sciences, University of Montreal, Montreal, Quebec, Canada
| | - R A Chowdhury
- Research Centre, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
| | - B Marandyuk
- Research Centre, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
| | - R Wu
- Department of Fetal Cardiology, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
| | - N Poirier
- Department of Cardiac Surgery, University of Montreal, Montreal, Quebec, Canada
| | - J Miró
- Department of Fetal Cardiology, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
- Division of Pediatric Cardiology, University of Montreal, Montreal, Quebec, Canada
| | - A-M Nuyt
- Research Centre, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
- Division of Neonatology, Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - M-J Raboisson
- Department of Fetal Cardiology, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
- Division of Pediatric Cardiology, University of Montreal, Montreal, Quebec, Canada
| | - M Dehaes
- Research Centre, CHU Sainte-Justine Hospital University Centre, Montreal, Quebec, Canada
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Department of Radiology, Radio-oncology and Nuclear Medicine, University of Montreal, Montreal, Quebec, Canada
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10
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Juhász C, Luat AF, Behen ME, Gjolaj N, Jeong JW, Chugani HT, Kumar A. Deep Venous Remodeling in Unilateral Sturge-Weber Syndrome: Robust Hemispheric Differences and Clinical Correlates. Pediatr Neurol 2023; 139:49-58. [PMID: 36521316 PMCID: PMC9840672 DOI: 10.1016/j.pediatrneurol.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/01/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Enlarged deep medullary veins (EDMVs) in patients with Sturge-Weber syndrome (SWS) may provide compensatory venous drainage for brain regions affected by the leptomeningeal venous malformation (LVM). We evaluated the prevalence, extent, hemispheric differences, and clinical correlates of EDMVs in SWS. METHODS Fifty children (median age: 4.5 years) with unilateral SWS underwent brain magnetic resonance imaging prospectively including susceptibility-weighted imaging (SWI); children aged 2.5 years or older also had a formal neurocognitive evaluation. The extent of EDMVs was assessed on SWI by using an EDMV hemispheric score, which was compared between patients with right and left SWS and correlated with clinical variables. RESULTS EDMVs were present in 89% (24 of 27) of right and 78% (18 of 23) of left SWS brains. Extensive EDMVs (score >6) were more frequent in right (33%) than in left SWS (9%; P = 0.046) and commonly occurred in young children with right SWS. Patients with EDMV scores >4 had rare (less than monthly) seizures, whereas 35% (11 of 31) of patients with EDMV scores ≤4 had monthly or more frequent seizures (P = 0.003). In patients with right SWS and at least two LVM-affected lobes, higher EDMV scores were associated with higher intelligence quotient (P < 0.05). CONCLUSIONS Enlarged deep medullary veins are common in unilateral SWS, but extensive EDMVs appear to develop more commonly and earlier in right hemispheric SWS. Deep venous remodeling may be a compensatory mechanism contributing to better clinical outcomes in some patients with SWS.
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Affiliation(s)
- Csaba Juhász
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan.
| | - Aimee F Luat
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Central Michigan University, Mt Pleasant, Michigan
| | - Michael E Behen
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan
| | - Nore Gjolaj
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan
| | - Jeong-Won Jeong
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan
| | - Harry T Chugani
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan; Department of Neurology, NYU Langone School of Medicine, New York, New York
| | - Ajay Kumar
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan; Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan; Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan; Division of Neuroradiology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
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11
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Côté-Corriveau G, Simard MN, Beaulieu O, Chowdhury RA, Gagnon MM, Gagnon M, Ledjiar O, Bernard C, Nuyt AM, Dehaes M, Luu TM. Associations between neurological examination at term-equivalent age and cerebral hemodynamics and oxygen metabolism in infants born preterm. Front Neurosci 2023; 17:1105638. [PMID: 36937667 PMCID: PMC10017489 DOI: 10.3389/fnins.2023.1105638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
Background Infants born at 29-36 weeks gestational age (GA) are at risk of experiencing neurodevelopmental challenges. We hypothesize that cerebral hemodynamics and oxygen metabolism measured by bedside optical brain monitoring are potential biomarkers of brain development and are associated with neurological examination at term-equivalent age (TEA). Methods Preterm infants (N = 133) born 29-36 weeks GA and admitted in the neonatal intensive care unit were enrolled in this prospective cohort study. Combined frequency-domain near infrared spectroscopy (FDNIRS) and diffuse correlation spectroscopy (DCS) were used from birth to TEA to measure cerebral hemoglobin oxygen saturation and an index of microvascular cerebral blood flow (CBF i ) along with peripheral arterial oxygen saturation (SpO2). In combination with hemoglobin concentration in the blood, these parameters were used to derive cerebral oxygen extraction fraction (OEF) and an index of cerebral oxygen metabolism (CMRO2i ). The Amiel-Tison and Gosselin Neurological Assessment was performed at TEA. Linear regression models were used to assess the associations between changes in FDNIRS-DCS parameters from birth to TEA and GA at birth. Logistic regression models were used to assess the associations between changes in FDNIRS-DCS parameters from birth to TEA and neurological examination at TEA. Results Steeper increases in CBF i (p < 0.0001) and CMRO2i (p = 0.0003) were associated with higher GA at birth. Changes in OEF, CBF i , and CMRO2i from birth to TEA were not associated with neurological examination at TEA. Conclusion In this population, cerebral FDNIRS-DCS parameters were not associated with neurological examination at TEA. Larger increases in CBF i and CMRO2i from birth to TEA were associated with higher GA. Non-invasive bedside FDNIRS-DCS monitoring provides cerebral hemodynamic and metabolic parameters that may complement neurological examination to assess brain development in preterm infants.
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Affiliation(s)
- Gabriel Côté-Corriveau
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, QC, Canada
| | - Marie-Noëlle Simard
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
- School of Rehabilitation, University of Montreal, Montreal, QC, Canada
| | - Olivia Beaulieu
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
| | - Rasheda Arman Chowdhury
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
- Institute of Biomedical Engineering, University of Montreal, Montreal, QC, Canada
| | - Marie-Michèle Gagnon
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
| | - Mélanie Gagnon
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
| | - Omar Ledjiar
- Unité de Recherche Clinique Appliquée, Sainte-Justine University Hospital Center, Montreal, QC, Canada
| | - Catherine Bernard
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
| | - Anne Monique Nuyt
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
- Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, QC, Canada
| | - Mathieu Dehaes
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
- Institute of Biomedical Engineering, University of Montreal, Montreal, QC, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, Canada
- *Correspondence: Mathieu Dehaes,
| | - Thuy Mai Luu
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC, Canada
- Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, QC, Canada
- Thuy Mai Luu,
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12
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Cerebral Arterial Asymmetries in the Neonate: Insight into the Pathogenesis of Stroke. Symmetry (Basel) 2022. [DOI: 10.3390/sym14030456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Neonatal and adult strokes are more common in the left than in the right cerebral hemisphere in the middle cerebral arterial territory, and adult extracranial and intracranial vessels are systematically left-dominant. The aim of the research reported here was to determine whether the asymmetric vascular ground plan found in adults was present in healthy term neonates (n = 97). A new transcranial Doppler ultrasonography dual-view scanning protocol, with concurrent B-flow and pulsed wave imaging, acquired multivariate data on the neonatal middle cerebral arterial structure and function. This study documents for the first-time systematic asymmetries in the middle cerebral artery origin and distal trunk of healthy term neonates and identifies commensurately asymmetric hemodynamic vulnerabilities. A systematic leftward arterial dominance was found in the arterial caliber and cortically directed blood flow. The endothelial wall shear stress was also asymmetric across the midline and varied according to vessels’ geometry. We conclude that the arterial structure and blood supply in the brain are laterally asymmetric in newborns. Unfavorable shearing forces, which are a by-product of the arterial asymmetries described here, might contribute to a greater risk of cerebrovascular pathology in the left hemisphere.
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13
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Endevelt-Shapira Y, Djalovski A, Dumas G, Feldman R. Maternal chemosignals enhance infant-adult brain-to-brain synchrony. SCIENCE ADVANCES 2021; 7:eabg6867. [PMID: 34890230 PMCID: PMC8664266 DOI: 10.1126/sciadv.abg6867] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/26/2021] [Indexed: 05/25/2023]
Abstract
Maternal body odors serve as important safety-promoting and social recognition signals, but their role in human brain maturation is largely unknown. Utilizing ecological paradigms and dual- electroencephalography recording, we examined the effects of maternal chemosignals on brain-to-brain synchrony during infant-mother and infant-stranger interactions with and without the presence of maternal body odors. Neural connectivity of right-to-right brain theta synchrony emerged across conditions, sensitizing key nodes of the infant’s social brain during its maturational period. Infant-mother interaction elicited greater brain-to-brain synchrony; however, maternal chemosignals attenuated this difference. Infants exhibited more social attention, positive arousal, and safety/approach behaviors in the maternal chemosignals condition, which augmented infant-stranger neural synchrony. Human mothers use interbrain mechanisms to tune the infant’s social brain, and chemosignals may sustain the transfer of infant sociality from the mother-infant bond to life within social groups.
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Affiliation(s)
- Yaara Endevelt-Shapira
- Center for Developmental Social Neuroscience, The Interdisciplinary Center, Herzliya, Israel
| | - Amir Djalovski
- Center for Developmental Social Neuroscience, The Interdisciplinary Center, Herzliya, Israel
| | - Guillaume Dumas
- Precision Psychiatry and Social Physiology Laboratory, CHU Sainte-Justine Research Center, Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
- Human Brain and Behavior Laboratory, Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, USA
| | - Ruth Feldman
- Center for Developmental Social Neuroscience, The Interdisciplinary Center, Herzliya, Israel
- Yale University, Child Study Center, New Haven, CT 06519, USA
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14
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Kagan MS, Mongerson CRL, Zurakowski D, Jennings RW, Bajic D. Infant study of hemispheric asymmetry after long-gap esophageal atresia repair. Ann Clin Transl Neurol 2021; 8:2132-2145. [PMID: 34662511 PMCID: PMC8607454 DOI: 10.1002/acn3.51465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Previous studies have demonstrated that infants are typically born with a left-greater-than-right forebrain asymmetry that reverses throughout the first year of life. We hypothesized that critically ill term-born and premature patients following surgical and critical care for long-gap esophageal atresia (LGEA) would exhibit alteration in expected forebrain asymmetry. METHODS Term-born (n = 13) and premature (n = 13) patients, and term-born controls (n = 23) <1 year corrected age underwent non-sedated research MRI following completion of LGEA treatment via Foker process. Structural T1- and T2-weighted images were collected, and ITK-SNAP was used for forebrain tissue segmentation and volume acquisition. Data were presented as absolute (cm3 ) and normalized (% total forebrain) volumes of the hemispheres. All measures were checked for normality, and group status was assessed using a general linear model with age at scan as a covariate. RESULTS Absolute volumes of both forebrain hemispheres were smaller in term-born and premature patients in comparison to controls (p < 0.001). Normalized hemispheric volume group differences were detected by T1-weighted analysis, with premature patients demonstrating right-greater-than-left hemisphere volumes in comparison to term-born patients and controls (p < 0.01). While normalized group differences were very subtle (a right hemispheric predominance of roughly 2% of forebrain volume), they represent a deviation from the expected pattern of hemispheric brain asymmetry. INTERPRETATION Our pilot quantitative MRI study of hemispheric volumes suggests that premature patients might be at risk of altered expected left-greater-than-right forebrain asymmetry following repair of LGEA. Future neurobehavioral studies in infants born with LGEA are needed to elucidate the functional significance of presented anatomical findings.
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Affiliation(s)
- Mackenzie S Kagan
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts, 02115, USA
| | - Chandler R L Mongerson
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts, 02115, USA
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts, 02115, USA.,Harvard Medical School, Harvard University, 25 Shattuck St., Boston, Massachusetts, 02115, USA
| | - Russell W Jennings
- Harvard Medical School, Harvard University, 25 Shattuck St., Boston, Massachusetts, 02115, USA.,Department of Surgery, Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts, 02115, USA.,Esophageal and Airway Treatment Center, Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts, 02115, USA
| | - Dusica Bajic
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts, 02115, USA.,Harvard Medical School, Harvard University, 25 Shattuck St., Boston, Massachusetts, 02115, USA
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15
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Abstract
The cerebral microcirculation undergoes dynamic changes in parallel with the development of neurons, glia, and their energy metabolism throughout gestation and postnatally. Cerebral blood flow (CBF), oxygen consumption, and glucose consumption are as low as 20% of adult levels in humans born prematurely but eventually exceed adult levels at ages 3 to 11 years, which coincide with the period of continued brain growth, synapse formation, synapse pruning, and myelination. Neurovascular coupling to sensory activation is present but attenuated at birth. By 2 postnatal months, the increase in CBF often is disproportionately smaller than the increase in oxygen consumption, in contrast to the relative hyperemia seen in adults. Vascular smooth muscle myogenic tone increases in parallel with developmental increases in arterial pressure. CBF autoregulatory response to increased arterial pressure is intact at birth but has a more limited range with arterial hypotension. Hypoxia-induced vasodilation in preterm fetal sheep with low oxygen consumption does not sustain cerebral oxygen transport, but the response becomes better developed for sustaining oxygen transport by term. Nitric oxide tonically inhibits vasomotor tone, and glutamate receptor activation can evoke its release in lambs and piglets. In piglets, astrocyte-derived carbon monoxide plays a central role in vasodilation evoked by glutamate, ADP, and seizures, and prostanoids play a large role in endothelial-dependent and hypercapnic vasodilation. Overall, homeostatic mechanisms of CBF regulation in response to arterial pressure, neuronal activity, carbon dioxide, and oxygenation are present at birth but continue to develop postnatally as neurovascular signaling pathways are dynamically altered and integrated. © 2021 American Physiological Society. Compr Physiol 11:1-62, 2021.
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16
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Bisiacchi P, Cainelli E. Structural and functional brain asymmetries in the early phases of life: a scoping review. Brain Struct Funct 2021; 227:479-496. [PMID: 33738578 PMCID: PMC8843922 DOI: 10.1007/s00429-021-02256-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/07/2021] [Indexed: 12/13/2022]
Abstract
Asymmetry characterizes the brain in both structure and function. Anatomical asymmetries explain only a fraction of functional variability in lateralization, with structural and functional asymmetries developing at different periods of life and in different ways. In this work, we perform a scoping review of the cerebral asymmetries in the first brain development phases. We included all English-written studies providing direct evidence of hemispheric asymmetries in full-term neonates, foetuses, and premature infants, both at term post-conception and before. The final analysis included 57 studies. The reviewed literature shows large variability in the used techniques and methodological procedures. Most structural studies investigated the temporal lobe, showing a temporal planum more pronounced on the left than on the right (although not all data agree), a morphological asymmetry already present from the 29th week of gestation. Other brain structures have been poorly investigated, and the results are even more discordant. Unlike data on structural asymmetries, functional data agree with each other, identifying a leftward dominance for speech stimuli and an overall dominance of the right hemisphere in all other functional conditions. This generalized dominance of the right hemisphere for all conditions (except linguistic stimuli) is in line with theories stating that the right hemisphere develops earlier and that its development is less subject to external influences because it sustains functions necessary to survive.
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Affiliation(s)
- Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy. .,Padova Neuroscience Centre, PNC, Padova, Italy.
| | - Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy
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17
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Lemaître H, Augé P, Saitovitch A, Vinçon-Leite A, Tacchella JM, Fillon L, Calmon R, Dangouloff-Ros V, Lévy R, Grévent D, Brunelle F, Boddaert N, Zilbovicius M. Rest Functional Brain Maturation during the First Year of Life. Cereb Cortex 2021; 31:1776-1785. [PMID: 33230520 PMCID: PMC7869100 DOI: 10.1093/cercor/bhaa325] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 11/28/2022] Open
Abstract
The first year of life is a key period of brain development, characterized by dramatic structural and functional modifications. Here, we measured rest cerebral blood flow (CBF) modifications throughout babies’ first year of life using arterial spin labeling magnetic resonance imaging sequence in 52 infants, from 3 to 12 months of age. Overall, global rest CBF significantly increased during this age span. In addition, we found marked regional differences in local functional brain maturation. While primary sensorimotor cortices and insula showed early maturation, temporal and prefrontal region presented great rest CBF increase across the first year of life. Moreover, we highlighted a late and remarkably synchronous maturation of the prefrontal and posterior superior temporal cortices. These different patterns of regional cortical rest CBF modifications reflect a timetable of local functional brain maturation and are consistent with baby’s cognitive development within the first year of life.
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Affiliation(s)
- Hervé Lemaître
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives (CNRS UMR 5293), Université de Bordeaux, Bordeaux 33000, France
| | - Pierre Augé
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Ana Saitovitch
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Alice Vinçon-Leite
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Jean-Marc Tacchella
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Ludovic Fillon
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Raphael Calmon
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Volodia Dangouloff-Ros
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Raphaël Lévy
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - David Grévent
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Francis Brunelle
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Nathalie Boddaert
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
| | - Monica Zilbovicius
- INSERM UA10, Department of Pediatric Radiology, Hôpital Necker Enfants Malades, AP-HP, Imagine Institute (UMR 1163), Paris Descartes University, Sorbonne Paris Cité University, Paris 75015, France
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18
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Portnova GV, Maslennikova AV, Proskurnina EV. The Relationship between Carotid Doppler Ultrasound and EEG Metrics in Healthy Preschoolers and Adults. Brain Sci 2020; 10:brainsci10100755. [PMID: 33092107 PMCID: PMC7589929 DOI: 10.3390/brainsci10100755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022] Open
Abstract
Despite widespread using electroencephalography (EEG) and Doppler ultrasound in pediatric neurology clinical practice, there are still no well-known correlations between these methods that could contribute to a better understanding of brain processes and development of neurological pathology. This study aims to reveal relationship between EEG and Doppler ultrasound methods. We compared two cohorts of adults and preschool children with no history of neurological or mental diseases. The data analysis included investigation of EEG and carotid blood flow indexes, which are significant in neurological diagnosis, as well as calculation of linear and non-linear EEG parameters and ratios between the systolic peak velocities of carotid arteries and carotid blood asymmetry. We have found age-dependent correlations between EEG and power Doppler ultrasound imaging (PDUI) data. Carotid blood flow asymmetry correlated with delta-rhythm power spectral density only in preschoolers. The ratios of blood flow velocities in the internal carotid arteries to those in the common carotid arteries correlated with higher peak alpha frequency and lower fractal dimension; moreover, they were associated with lower Epworth sleepiness scale scores. The study revealed significant correlations between EEG and PDUI imaging indexes, which are different for healthy children and adults. Despite the fact that the correlations were associated with non-clinical states such as overwork or stress, we assumed that the investigated parameters could be applicable for clinical trials.
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Affiliation(s)
- Galina V. Portnova
- Laboratory of the Human Higher Nervous Activity, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117485 Moscow, Russia;
- Correspondence:
| | - Aleksandra V. Maslennikova
- Laboratory of the Human Higher Nervous Activity, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117485 Moscow, Russia;
| | - Elena V. Proskurnina
- Laboratory of Molecular Biology, Research Centre for Medical Genetics, 115522 Moscow, Russia;
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19
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Giovannella M, Andresen B, Andersen JB, El-Mahdaoui S, Contini D, Spinelli L, Torricelli A, Greisen G, Durduran T, Weigel UM, Law I. Validation of diffuse correlation spectroscopy against 15O-water PET for regional cerebral blood flow measurement in neonatal piglets. J Cereb Blood Flow Metab 2020; 40:2055-2065. [PMID: 31665953 PMCID: PMC7786848 DOI: 10.1177/0271678x19883751] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 09/06/2019] [Accepted: 09/19/2019] [Indexed: 11/15/2022]
Abstract
Diffuse correlation spectroscopy (DCS) can non-invasively and continuously asses regional cerebral blood flow (rCBF) at the cot-side by measuring a blood flow index (BFI) in non-traditional units of cm2/s. We have validated DCS against positron emission tomography using 15O-labeled water (15O-water PET) in a piglet model allowing us to derive a conversion formula for BFI to rCBF in conventional units (ml/100g/min). Neonatal piglets were continuously monitored by the BabyLux device integrating DCS and time resolved near infrared spectroscopy (TRS) while acquiring 15O-water PET scans at baseline, after injection of acetazolamide and during induced hypoxic episodes. BFI by DCS was highly correlated with rCBF (R = 0.94, p < 0.001) by PET. A scaling factor of 0.89 (limits of agreement for individual measurement: 0.56, 1.39)×109× (ml/100g/min)/(cm2/s) was used to derive baseline rCBF from baseline BFI measurements of another group of piglets and of healthy newborn infants showing an agreement with expected values. These results pave the way towards non-invasive, cot-side absolute CBF measurements by DCS on neonates.
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Affiliation(s)
- Martina Giovannella
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Bjørn Andresen
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Julie B Andersen
- Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Sahla El-Mahdaoui
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Davide Contini
- Politecnico di Milano-Dipartimento di Fisica, Milan, Italy
| | - Lorenzo Spinelli
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Alessandro Torricelli
- Politecnico di Milano-Dipartimento di Fisica, Milan, Italy
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Udo M Weigel
- HemoPhotonics S.L., Castelldefels (Barcelona), Spain
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
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20
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Fantini S, Sassaroli A. Frequency-Domain Techniques for Cerebral and Functional Near-Infrared Spectroscopy. Front Neurosci 2020; 14:300. [PMID: 32317921 PMCID: PMC7154496 DOI: 10.3389/fnins.2020.00300] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/16/2020] [Indexed: 12/31/2022] Open
Abstract
This article reviews the basic principles of frequency-domain near-infrared spectroscopy (FD-NIRS), which relies on intensity-modulated light sources and phase-sensitive optical detection, and its non-invasive applications to the brain. The simpler instrumentation and more straightforward data analysis of continuous-wave NIRS (CW-NIRS) accounts for the fact that almost all the current commercial instruments for cerebral NIRS have embraced the CW technique. However, FD-NIRS provides data with richer information content, which complements or exceeds the capabilities of CW-NIRS. One example is the ability of FD-NIRS to measure the absolute optical properties (absorption and reduced scattering coefficients) of tissue, and thus the absolute concentrations of oxyhemoglobin and deoxyhemoglobin in brain tissue. This article reviews the measured values of such optical properties and hemoglobin concentrations reported in the literature for animal models and for the human brain in newborns, infants, children, and adults. We also review the application of FD-NIRS to functional brain studies that focused on slower hemodynamic responses to brain activity (time scale of seconds) and faster optical signals that have been linked to neuronal activation (time scale of 100 ms). Another example of the power of FD-NIRS data is related to the different regions of sensitivity featured by intensity and phase data. We report recent developments that take advantage of this feature to maximize the sensitivity of non-invasive optical signals to brain tissue relative to more superficial extracerebral tissue (scalp, skull, etc.). We contend that this latter capability is a highly appealing quality of FD-NIRS, which complements absolute optical measurements and may result in significant advances in the field of non-invasive optical sensing of the brain.
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Affiliation(s)
- Sergio Fantini
- Department of Biomedical Engineering, Tufts University, Medford, MA, United States
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21
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Wallois F, Routier L, Bourel-Ponchel E. Impact of prematurity on neurodevelopment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:341-375. [PMID: 32958184 DOI: 10.1016/b978-0-444-64150-2.00026-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The consequences of prematurity on brain functional development are numerous and diverse, and impact all brain functions at different levels. Prematurity occurs between 22 and 36 weeks of gestation. This period is marked by extreme dynamics in the physiologic maturation, structural, and functional processes. These different processes appear sequentially or simultaneously. They are dependent on genetic and/or environmental factors. Disturbance of these processes or of the fine-tuning between them, when caring for premature children, is likely to induce disturbances in the structural and functional development of the immature neural networks. These will appear as impairments in learning skills progress and are likely to have a lasting impact on the development of children born prematurely. The level of severity depends on the initial alteration, whether structural or functional. In this chapter, after having briefly reviewed the neurodevelopmental, structural, and functional processes, we describe, in a nonexhaustive manner, the impact of prematurity on the different brain, motor, sensory, and cognitive functions.
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Affiliation(s)
- Fabrice Wallois
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France.
| | - Laura Routier
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
| | - Emilie Bourel-Ponchel
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
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22
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Cerebral oxygenation and blood flow in normal term infants at rest measured by a hybrid near-infrared device (BabyLux). Pediatr Res 2019; 86:515-521. [PMID: 31234195 DOI: 10.1038/s41390-019-0474-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/17/2019] [Accepted: 06/14/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND The BabyLux device is a prototype optical neuro-monitor of cerebral oxygenation and blood flow for neonatology integrating time-resolved reflectance spectroscopy and diffuse correlation spectroscopy. METHODS Here we report the variability of six consecutive 30 s measurements performed in 27 healthy term infants at rest. Poor data quality excluded four infants. RESULTS Mean cerebral oxygenation was 59.6 ± 8.0%, with intra-subject standard deviation of 3.4%, that is, coefficient of variation (CV) of 5.7%. The inter-subject CV was 13.5%. Mean blood flow index was 2.7 × 10-8 ± 1.56 × 10-8 (cm2/s), with intra-subject CV of 27% and inter-subject CV of 56%. The variability in blood flow index was not reduced by the use of individual measures of tissue scattering, nor accompanied by a parallel variability in cerebral oxygenation. CONCLUSION The intra-subject variability for cerebral oxygenation variability was improved compared to spatially resolved spectroscopy devices, while for the blood flow index it was comparable to that of other modalities for estimating cerebral blood flow in newborn infants. Most importantly, the simultaneous measurement of oxygenation and flow allows for interpretation of the high inter-subject variability of cerebral blood flow as being due to error of measurement rather than to physiological instability.
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23
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Daneshvarfard F, Abrishami Moghaddam H, Dehaene-Lambertz G, Kongolo G, Wallois F, Mahmoudzadeh M. Neurodevelopment and asymmetry of auditory-related responses to repetitive syllabic stimuli in preterm neonates based on frequency-domain analysis. Sci Rep 2019; 9:10654. [PMID: 31337810 PMCID: PMC6650479 DOI: 10.1038/s41598-019-47064-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/01/2019] [Indexed: 11/20/2022] Open
Abstract
Sensory development of the human brain begins prenatally, allowing cortical auditory responses to be recorded at an early age in preterm infants. Despite several studies focusing on the temporal characteristics of preterm infants' cortical responses, few have been conducted on frequency analysis of these responses. In this study, we performed frequency and coherence analysis of preterm infants' auditory responses to series of syllables and also investigated the functional brain asymmetry of preterm infants for the detection of the regularity of auditory stimuli. Cortical auditory evoked potentials (CAEPs) were recorded in 16 preterm infants with a mean recording age of 31.48 weeks gestational age (29.57-34.14 wGA) in response to a repetitive syllabic stimulus. Peak amplitudes of the frequency response at the target frequency and the first harmonic, as well as the phase coherence (PC) at the target frequency were extracted as age-dependent variables. A functional asymmetry coefficient was defined as a lateralization index for the amplitude of the target frequency at each electrode site. While the findings revealed a significant positive correlation between the mean amplitude at the target frequency vs. age (R2 = 0.263, p = 0.042), no significant correlation was observed for age-related changes of the mean amplitude at the first harmonic. A significant correlation was also observed between the mean PC and age (R2 = 0.318, p = 0.023). A right hemisphere lateralization over many channels was also generally observed. The results demonstrate that rightward lateralization for slow rate modulation, previously observed in adults, children and newborns, appears to be in place at a very young age, even in preterm infants.
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Affiliation(s)
- Farveh Daneshvarfard
- INSERM U1105, Université de Picardie, CURS, Amiens, France
- Faculty of Electrical and Computer Engineering, K.N. Toosi University of Technology, Tehran, Iran
| | - Hamid Abrishami Moghaddam
- INSERM U1105, Université de Picardie, CURS, Amiens, France.
- Faculty of Electrical and Computer Engineering, K.N. Toosi University of Technology, Tehran, Iran.
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit, CEA DSV/I2BM, INSERM, CNRS, Université Paris-Sud, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France
| | - Guy Kongolo
- INSERM U1105, Université de Picardie, CURS, Amiens, France
- INSERM U1105, Neonatal ICU, South University Hospital, Amiens, France
| | - Fabrice Wallois
- INSERM U1105, Université de Picardie, CURS, Amiens, France.
- INSERM U1105, Unit Exploration Fonctionnelles du Système Nerveux Pédiatrique, South University Hospital, Amiens, France.
| | - Mahdi Mahmoudzadeh
- INSERM U1105, Université de Picardie, CURS, Amiens, France
- INSERM U1105, Unit Exploration Fonctionnelles du Système Nerveux Pédiatrique, South University Hospital, Amiens, France
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24
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Jiang D, Lu H, Parkinson C, Su P, Wei Z, Pan L, Tekes A, Huisman TAGM, Golden WC, Liu P. Vessel-specific quantification of neonatal cerebral venous oxygenation. Magn Reson Med 2019; 82:1129-1139. [PMID: 31066104 DOI: 10.1002/mrm.27788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/25/2019] [Accepted: 04/08/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Noninvasive measurement of cerebral venous oxygenation (Yv ) in neonates is important in the assessment of brain oxygen extraction and consumption, and may be useful in characterizing brain development and neonatal brain diseases. This study aims to develop a rapid method for vessel-specific measurement of Yv in neonates. METHODS We developed a pulse sequence, named accelerated T2 -relaxation-under-phase-contrast (aTRUPC), which consists of velocity-encoding phase-contrast module to isolate pure blood signal, flow-insensitive T2 -preparation to quantify blood T2 , and turbo-field-echo (TFE) scheme for rapid image acquisition, which is critical for neonatal MRI. A series of studies were conducted. First, the pulse sequence was optimized in terms of TFE factor, velocity encoding (VENC), and slice thickness for best sensitivity. Second, to account for the influence of TFE acquisition on T2 quantification, simulation and experiments were conducted to establish the relationship between TFE-T2 and standard T2 . Finally, the complete aTRUPC sequence was applied on a group of healthy neonates and normative Yv values were determined. RESULTS Optimal parameters of aTRUPC in neonates were found to be a TFE factor of 15, VENC of 5 cm/s, and slice thickness of 10 mm. The TFE-T2 was on average 3.9% lower than standard T2 . These two measures were strongly correlated (R2 = 0.86); thus their difference can be accounted for by a correction equation, T2,standard = 1.2002 × T2,TFE - 10.6276. Neonatal Yv values in veins draining cortical brain and those draining central brain were 64.8 ± 2.9% and 70.2 ± 3.3%, respectively, with a significant difference (P =.02). CONCLUSION The aTRUPC MRI has the potential to provide vessel-specific quantification of cerebral Yv in neonates.
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Affiliation(s)
- Dengrong Jiang
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland
| | - Charlamaine Parkinson
- Neurosciences Intensive Care Nursery, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Pan Su
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Zhiliang Wei
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland
| | - Li Pan
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Siemens Healthineers, Baltimore, Maryland
| | - Aylin Tekes
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Neurosciences Intensive Care Nursery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Thierry A G M Huisman
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Neurosciences Intensive Care Nursery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - W Christopher Golden
- Neurosciences Intensive Care Nursery, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Peiying Liu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
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25
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Vasung L, Abaci Turk E, Ferradal SL, Sutin J, Stout JN, Ahtam B, Lin PY, Grant PE. Exploring early human brain development with structural and physiological neuroimaging. Neuroimage 2019; 187:226-254. [PMID: 30041061 PMCID: PMC6537870 DOI: 10.1016/j.neuroimage.2018.07.041] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 12/11/2022] Open
Abstract
Early brain development, from the embryonic period to infancy, is characterized by rapid structural and functional changes. These changes can be studied using structural and physiological neuroimaging methods. In order to optimally acquire and accurately interpret this data, concepts from adult neuroimaging cannot be directly transferred. Instead, one must have a basic understanding of fetal and neonatal structural and physiological brain development, and the important modulators of this process. Here, we first review the major developmental milestones of transient cerebral structures and structural connectivity (axonal connectivity) followed by a summary of the contributions from ex vivo and in vivo MRI. Next, we discuss the basic biology of neuronal circuitry development (synaptic connectivity, i.e. ensemble of direct chemical and electrical connections between neurons), physiology of neurovascular coupling, baseline metabolic needs of the fetus and the infant, and functional connectivity (defined as statistical dependence of low-frequency spontaneous fluctuations seen with functional magnetic resonance imaging (fMRI)). The complementary roles of magnetic resonance imaging (MRI), electroencephalography (EEG), magnetoencephalography (MEG), and near-infrared spectroscopy (NIRS) are discussed. We include a section on modulators of brain development where we focus on the placenta and emerging placental MRI approaches. In each section we discuss key technical limitations of the imaging modalities and some of the limitations arising due to the biology of the system. Although neuroimaging approaches have contributed significantly to our understanding of early brain development, there is much yet to be done and a dire need for technical innovations and scientific discoveries to realize the future potential of early fetal and infant interventions to avert long term disease.
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Affiliation(s)
- Lana Vasung
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Esra Abaci Turk
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Silvina L Ferradal
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Jason Sutin
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Jeffrey N Stout
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Banu Ahtam
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Pei-Yi Lin
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - P Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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26
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Liu P, Qi Y, Lin Z, Guo Q, Wang X, Lu H. Assessment of cerebral blood flow in neonates and infants: A phase-contrast MRI study. Neuroimage 2019. [DOI: 10.1016/j.neuroimage.2018.03.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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27
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Arimitsu T, Minagawa Y, Yagihashi T, O Uchida M, Matsuzaki A, Ikeda K, Takahashi T. The cerebral hemodynamic response to phonetic changes of speech in preterm and term infants: The impact of postmenstrual age. NEUROIMAGE-CLINICAL 2018; 19:599-606. [PMID: 29984167 PMCID: PMC6029566 DOI: 10.1016/j.nicl.2018.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 03/28/2018] [Accepted: 05/08/2018] [Indexed: 12/02/2022]
Abstract
Higher brain dysfunction, such as language delay, is a major concern among preterm infants. Cerebral substrates of cognitive development in preterm infants remain elusive, partly because of limited methods. The present study focuses on hemodynamic response patterns for brain function by using near-infrared spectroscopy. Specifically, the study investigates gestational differences in the hemodynamic response pattern evoked in response to phonetic changes of speech and cerebral hemispheric specialization of the auditory area in preterm infants (n = 60) and term infants (n = 20). Eighty neonates born between 26 and 41 weeks of gestational age (GA) were tested from 33 to 41 weeks of postmenstrual age (PMA). We analyzed the hemodynamic response pattern to phonemic and prosodic contrasts for multiple channels on temporal regions and the laterality index of the auditory area. Preterm infants younger than 39 weeks of PMA showed significantly atypical hemodynamic patterns, with an inverted response shape. Partial correlation analysis of the typicality score of hemodynamic response revealed a significant positive correlation with PMA. The laterality index of preterm infants from 39 weeks of PMA demonstrated a tendency rightward dominance for prosodic changes similar to term infants. We provide new evidence that alterations in hemodynamic regulation and the functional system for phonemic and prosodic processing in preterm infants catch up by their projected due dates. Hemodynamic responses to speech were examined in 80 preterm and term neonates. fNIRS measured hemispheric specialization to phonemic and prosodic contrasts. Some preterm infants showed atypical hemodynamics with an inverted response shape. Postmenstrual age was related to hemodynamic patterns and functional lateralization. Functional hemodynamic regulation of preterm infants caught up by the expected dates.
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Key Words
- BOLD, blood oxygenation level dependent
- BPD, bronchopulmonary dysplasia
- Deoxy, deoxygenated
- GA, gestational age
- HRF, hemodynamic response function
- IQR, interquartile range
- Laterality
- MMN, mismatch negativity
- NEC, necrotizing enterocolitis
- Near-infrared spectroscopy
- Oxy, oxygenated
- PMA, postmenstrual age
- PNA, postnatal age
- Preterm infants
- ROI, region of interest
- SOA, stimulus onset asynchrony
- Speech perception
- fNIRS, functional near-infrared spectroscopy
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Affiliation(s)
- Takeshi Arimitsu
- Department of Pediatrics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
| | - Yasuyo Minagawa
- Department of Psychology, Faculty of Letters, Keio University, Kohoku-ku, Yokohama 223-8521, Japan.
| | - Tatsuhiko Yagihashi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
| | - Mariko O Uchida
- Graduate School of Human Relations, Keio University, Minato-ku, Tokyo 108-8345, Japan
| | - Atsuko Matsuzaki
- Graduate School of Human Relations, Keio University, Minato-ku, Tokyo 108-8345, Japan
| | - Kazushige Ikeda
- Department of Pediatrics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
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28
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Beausoleil TP, Janaillac M, Barrington KJ, Lapointe A, Dehaes M. Cerebral oxygen saturation and peripheral perfusion in the extremely premature infant with intraventricular and/or pulmonary haemorrhage early in life. Sci Rep 2018; 8:6511. [PMID: 29695729 PMCID: PMC5916916 DOI: 10.1038/s41598-018-24836-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/09/2018] [Indexed: 12/29/2022] Open
Abstract
Extremely preterm infants are at higher risk of pulmonary (PH) and intraventricular (IVH) haemorrhage during the transitioning physiology due to immature cardiovascular system. Monitoring of haemodynamics can detect early abnormal circulation that may lead to these complications. We described time-frequency relationships between near infrared spectroscopy (NIRS) cerebral regional haemoglobin oxygen saturation (CrSO2) and preductal peripheral perfusion index (PI), capillary oxygen saturation (SpO2) and heart rate (HR) in extremely preterm infants in the first 72 h of life. Patients were sub-grouped in infants with PH and/or IVH (N H = 8) and healthy controls (N C = 11). Data were decomposed in wavelets allowing the analysis of localized variations of power. This approach allowed to quantify the percentage of time of significant cross-correlation, semblance, gain (transfer function) and coherence between signals. Ultra-low frequencies (<0.28 mHz) were analyzed as slow and prolonged periods of impaired circulation are considered more detrimental than transient fluctuations. Cross-correlation between CrSO2 and oximetry (PI, SpO2 and HR) as well as in-phase semblance and gain between CrSO2 and HR were significantly lower while anti-phase semblance between CrSO2 and HR was significantly higher in PH-IVH infants compared to controls. These differences may reflect haemodynamic instability associated with cerebrovascular autoregulation and hemorrhagic complications observed during the transitioning physiology.
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Affiliation(s)
- Thierry P Beausoleil
- Institute of Biomedical Engineering, University of Montréal, Montréal, Canada.,Research Centre, CHU Sainte-Justine, Montréal, Canada
| | - Marie Janaillac
- Department of Pediatrics, Division of Neonatology, CHU Sainte-Justine and University of Montréal, Montréal, Canada
| | - Keith J Barrington
- Research Centre, CHU Sainte-Justine, Montréal, Canada.,Department of Pediatrics, Division of Neonatology, CHU Sainte-Justine and University of Montréal, Montréal, Canada
| | - Anie Lapointe
- Department of Pediatrics, Division of Neonatology, CHU Sainte-Justine and University of Montréal, Montréal, Canada
| | - Mathieu Dehaes
- Research Centre, CHU Sainte-Justine, Montréal, Canada. .,Department of Radiology, Radio-oncology and Nuclear Medicine, University of Montréal, Montréal, Canada.
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29
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Conte G, Righini A, Griffiths PD, Rustico M, Lanna M, Mackie FL, Pinelli L, Prefumo F, Persico N, Igra MS, Parazzini C, Doneda C, Fichera A, Ambrosi C, Kilby M, Severino M, Triulzi F, Rossi A, Skipper N. Brain-injured Survivors of Monochorionic Twin Pregnancies Complicated by Single Intrauterine Death: MR Findings in a Multicenter Study. Radiology 2018; 288:582-590. [PMID: 29688161 DOI: 10.1148/radiol.2018171267] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in co-twin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD. Results Forty-two surviving MC twins were described. The primary distinction of brain abnormalities was into nonfocal and focal lesions. The nonfocal lesions included periventricular leukomalacia (group 1; two fetuses), generalized encephalomalacia (group 2; nine fetuses), posterior encephalomalacia (group 3; seven fetuses), and bilateral parasagittal and perisylvian injury (group 4; three fetuses). The focal lesions included nonhemorrhagic lesions (group 5; 14 fetuses) and hemorrhagic lesions (group 6; seven fetuses). Focal brain lesions were more likely to be found in the surviving MC pregnancies complicated by twin-twin transfusion syndrome (TTTS) (odds ratio, 2.4; 95% confidence interval: 1.3, 18.5; P = .01) and in fetuses that underwent an obstetric intervention (odds ratio, 2.8; 95% confidence interval: 1.8, 23.6; P = .006). Conclusion Brain injury of the surviving co-twin after SIUD in MC pregnancies is usually of ischemic origin and spares the brainstem and cerebellum. Focal brain lesions are more frequent in pregnancies complicated by TTTS or in those where an intervention has been performed.
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Affiliation(s)
- Giorgio Conte
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Andrea Righini
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Paul D Griffiths
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Mariangela Rustico
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Mariano Lanna
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Fiona L Mackie
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Lorenzo Pinelli
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Federico Prefumo
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Nicola Persico
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Mark S Igra
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Cecilia Parazzini
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Chiara Doneda
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Anna Fichera
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Claudia Ambrosi
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Mark Kilby
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Mariasavina Severino
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Fabio Triulzi
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Andrea Rossi
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
| | - Nicholas Skipper
- From the Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20142, Milan, Italy (G.C., F.T.); Division of Paediatric Radiology and Neuroradiology, Ospedale dei Bambini V. Buzzi, Milan, Italy (G.C., A.R., C.P., C.D.); Academic Unit of Radiology, University of Sheffield, Sheffield, England (P.D.G.); Fetal Therapy Unit Umberto Nicolini, Department of Woman Mother and Neonate, Ospedale dei Bambini V. Buzzi, Milan, Italy (M.R., M.L.); Centre of Women's and Newborn's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, England (F.L.M.); Neuroradiology Unit, Spedali Civili, Brescia, Italy (L.P., C.A.); Department of Obstetrics and Gynecology, Università degli Studi di Brescia, Brescia, Italy (F.P., A.F.); Division of Prenatal Diagnosis, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy (N.P.); Department of Radiology, Sheffield Teaching Hospitals Foundation Trust, Sheffield, England (M.S.I., N.S.); Department of Fetal Medicine, University of Birmingham, Birmingham, England (M.K.); Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy (M.S., A.R.); and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy (F.T.)
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30
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Léveillé- P, Hamel M, Ardilouze JL, Pasquier JC, Deacon C, Whittingstall K, Plourde M. Pilot study of EEG in neonates born to mothers with gestational diabetes mellitus. Int J Dev Neurosci 2018; 66:37-44. [PMID: 29360555 DOI: 10.1016/j.ijdevneu.2018.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The goal was to evaluate whether there was neurodevelopmental deficits in newborns born to mothers with gestational diabetes mellitus (GDM) compared to control newborns born to healthy mothers. METHODS Forty-six pregnant women (21 controls and 25 GDM) were recruited. Electroencephalogram (EEG) was recorded in the newborns within 48 h after birth. The EEG signal was quantitatively analyzed using power spectral density (PSD); coherence between hemispheres was calculated in paired channels of frontal, temporal, central and occipital regions. RESULTS The left centro-occipital PSD in control newborns was 12% higher than in GDM newborns (p = 0.036) but was not significant after adjustment for gestational age. While coherence was higher in the frontal regions compared to the occipital regions (p < 0.001), there was no difference between the groups for the fronto-temporal, frontal-central, centro-occipital and tempo-occipital regions. CONCLUSION Our results support that EEG differences between groups were mainly modified by gestational age and less by GDM status of the mothers. However, there is a need to confirm this result with a higher number of mother-newborns. Quantitative EEG in GDM newborns within 48 h after birth is feasible. This study emphasizes the importance of controlling blood glucose during GDM to protect infant brain development.
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Affiliation(s)
- Pauline Léveillé-
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada; Department of Physiology, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Institute of Nutrition and Functional Foods, Laval University, Quebec, QC, Canada
| | - Mathieu Hamel
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada
| | - Jean-Luc Ardilouze
- Department of Physiology, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Jean-Charles Pasquier
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Charles Deacon
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Kevin Whittingstall
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
| | - Mélanie Plourde
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada; Institute of Nutrition and Functional Foods, Laval University, Quebec, QC, Canada; Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
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31
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Farzam P, Buckley EM, Lin PY, Hagan K, Grant PE, Inder TE, Carp SA, Franceschini MA. Shedding light on the neonatal brain: probing cerebral hemodynamics by diffuse optical spectroscopic methods. Sci Rep 2017; 7:15786. [PMID: 29150648 PMCID: PMC5693925 DOI: 10.1038/s41598-017-15995-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022] Open
Abstract
Investigating the cerebral physiology of healthy term newborns' brains is important for better understanding perinatal brain injuries, of which the most common etiologies are hypoxia and ischemia. Hence, cerebral blood flow and cerebral oxygenation are important biomarkers of brain health. In this study, we employed a hybrid diffuse optical system consisting of diffuse correlation spectroscopy (DCS) and frequency-domain near infrared spectroscopy (FDNIRS) to measure hemoglobin concentration, oxygen saturation, and indices of cerebral blood flow and metabolism. We measured 30 term infants to assess the optical and physiological characteristics of the healthy neonatal brain in the frontal, temporal, and parietal lobes. We observed higher metabolism in the right hemisphere compared to the left and a positive correlation between gestational age and the level of cerebral hemoglobin concentration, blood volume, and oxygen saturation. Moreover, we observed higher cerebral blood flow and lower oxygen saturation in females compared to males. The delayed maturation in males and the sexual dimorphism in cerebral hemodynamics may explain why males are more vulnerable to perinatal brain injuries than females.
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Affiliation(s)
- Parisa Farzam
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA.
| | - Erin M Buckley
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
- Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Pei-Yi Lin
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Katherine Hagan
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - P Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Terrie Eleanor Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Stefan A Carp
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Maria Angela Franceschini
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
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32
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Shedding light on the neonatal brain: probing cerebral hemodynamics by diffuse optical spectroscopic methods. Sci Rep 2017. [PMID: 29150648 DOI: 10.1038/s41598‐017‐15995‐1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Investigating the cerebral physiology of healthy term newborns' brains is important for better understanding perinatal brain injuries, of which the most common etiologies are hypoxia and ischemia. Hence, cerebral blood flow and cerebral oxygenation are important biomarkers of brain health. In this study, we employed a hybrid diffuse optical system consisting of diffuse correlation spectroscopy (DCS) and frequency-domain near infrared spectroscopy (FDNIRS) to measure hemoglobin concentration, oxygen saturation, and indices of cerebral blood flow and metabolism. We measured 30 term infants to assess the optical and physiological characteristics of the healthy neonatal brain in the frontal, temporal, and parietal lobes. We observed higher metabolism in the right hemisphere compared to the left and a positive correlation between gestational age and the level of cerebral hemoglobin concentration, blood volume, and oxygen saturation. Moreover, we observed higher cerebral blood flow and lower oxygen saturation in females compared to males. The delayed maturation in males and the sexual dimorphism in cerebral hemodynamics may explain why males are more vulnerable to perinatal brain injuries than females.
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Roberts SB, Franceschini MA, Krauss A, Lin PY, Braima de Sa A, Có R, Taylor S, Brown C, Chen O, Johnson EJ, Pruzensky W, Schlossman N, Balé C, Wu KC(T, Hagan K, Saltzman E, Muentener P. A Pilot Randomized Controlled Trial of a New Supplementary Food Designed to Enhance Cognitive Performance during Prevention and Treatment of Malnutrition in Childhood. Curr Dev Nutr 2017; 1:e000885. [PMID: 29658962 PMCID: PMC5898396 DOI: 10.3945/cdn.117.000885] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/11/2017] [Accepted: 10/12/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cognitive impairment associated with childhood malnutrition and stunting is generally considered irreversible. OBJECTIVE The aim was to test a new nutritional supplement for the prevention and treatment of moderate-acute malnutrition (MAM) focused on enhancing cognitive performance. METHODS An 11-wk, village-randomized, controlled pilot trial was conducted in 78 children aged 1-3 or 5-7 y living in villages in Guinea-Bissau. The supplement contained 291 kcal/d for young children and 350 kcal/d for older children and included 5 nutrients and 2 flavan-3-ol-rich ingredients not present in current food-based recommendations for MAM. Local bakers prepared the supplement from a combination of locally sourced items and an imported mix of ingredients, and it was administered by community health workers 5 d/wk. The primary outcome was executive function abilities at 11 wk. Secondary outcomes included additional cognitive measures and changes in z scores for weight (weight-for-age) and height (height-for-age) and hemoglobin concentrations at 11 wk. An index of cerebral blood flow (CBF) was also measured at 11 wk to explore the use of this measurement as a biological index of cognitive impairment. RESULTS There were no significant differences in any outcome between groups at baseline. There was a beneficial effect of random assignment to the supplement group on working memory at 11 wk in children aged 1-3 y (P < 0.05). This difference contrasted with no effect in older children and was not associated with faster growth rate. In addition, CBF correlated with task-switching performance (P < 0.05). CONCLUSIONS These preliminary data suggest that cognitive impairment can be monitored with measurement of CBF. In addition, the findings provide preliminary data that suggest that it may be possible to improve poor cognitive performance in young children through changes in the nutritional formulation of supplementary foods used to prevent and treat MAM. Powered studies of the new supplement formulation are needed. This trial was registered at clinicaltrials.gov as NCT03017209.
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Affiliation(s)
- Susan B Roberts
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | | | - Amy Krauss
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Pei-Yi Lin
- Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Augusto Braima de Sa
- International Partnership for Human Development, Leesburg, VA
- International Partnership for Human Development, Bissau, Guinea-Bissau
| | - Raimundo Có
- International Partnership for Human Development, Leesburg, VA
- International Partnership for Human Development, Bissau, Guinea-Bissau
| | - Salima Taylor
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Carrie Brown
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Oliver Chen
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Elizabeth J Johnson
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - William Pruzensky
- International Partnership for Human Development, Leesburg, VA
- International Partnership for Human Development, Bissau, Guinea-Bissau
| | | | - Carlito Balé
- International Partnership for Human Development, Leesburg, VA
- International Partnership for Human Development, Bissau, Guinea-Bissau
| | - Kuan-Cheng (Tony) Wu
- Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Katherine Hagan
- Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Edward Saltzman
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
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Diaz D, Lafontant A, Neidrauer M, Weingarten MS, DiMaria-Ghalili RA, Scruggs E, Rece J, Fried GW, Kuzmin VL, Zubkov L. Pressure injury prediction using diffusely scattered light. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:25003. [PMID: 28301656 DOI: 10.1117/1.jbo.22.2.025003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 01/23/2017] [Indexed: 06/06/2023]
Abstract
Pressure injuries (PIs) originate beneath the surface of the skin at the interface between bone and soft tissue. We used diffuse correlation spectroscopy (DCS) and diffuse near-infrared spectroscopy (DNIRS) to predict the development of PIs by measuring dermal and subcutaneous red cell motion and optical absorption and scattering properties in 11 spinal cord injury subjects with only nonbleachable redness in the sacrococcygeal area in a rehabilitation hospital and 20 healthy volunteers. A custom optical probe was developed to obtain continuous DCS and DNIRS data from sacrococcygeal tissue while the subjects were placed in supine and lateral positions to apply pressure from body weight and to release pressure, respectively. Rehabilitation patients were measured up to four times over a two-week period. Three rehabilitation patients developed open PIs (POs) within four weeks and eight patients did not (PNOs). Temporal correlation functions in the area of redness were significantly different ( p < 0.01 ) during both baseline and applied pressure stages for POs and PNOs. The results show that our optical method may be used for the early prediction of ulcer progression.
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Affiliation(s)
- David Diaz
- Drexel University, School of Biomedical Engineering, Philadelphia, Pennsylvania, United States
| | - Alec Lafontant
- Drexel University, School of Biomedical Engineering, Philadelphia, Pennsylvania, United States
| | - Michael Neidrauer
- Drexel University, School of Biomedical Engineering, Philadelphia, Pennsylvania, United States
| | - Michael S Weingarten
- Drexel University, College of Medicine, Department of Surgery, Philadelphia, Pennsylvania, United States
| | - Rose Ann DiMaria-Ghalili
- Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, United States
| | - Ericka Scruggs
- Magee Rehabilitation Hospital, Philadelphia, Pennsylvania, United States
| | - Julianne Rece
- Magee Rehabilitation Hospital, Philadelphia, Pennsylvania, United States
| | - Guy W Fried
- Magee Rehabilitation Hospital, Philadelphia, Pennsylvania, United States
| | | | - Leonid Zubkov
- Drexel University, School of Biomedical Engineering, Philadelphia, Pennsylvania, United States
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35
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Tortora D, Severino M, Malova M, Parodi A, Morana G, Ramenghi LA, Rossi A. Variability of Cerebral Deep Venous System in Preterm and Term Neonates Evaluated on MR SWI Venography. AJNR Am J Neuroradiol 2016; 37:2144-2149. [PMID: 27469213 DOI: 10.3174/ajnr.a4877] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 05/23/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The anatomy of the deep venous system is characterized by a great variability that might play an important role in the pathogenesis of brain lesions in the preterm brain. The aim of this study was to compare the anatomy of cerebral subependymal veins evaluated on SWI venography in 3 groups of neonates with normal brain MR imaging (very preterm [gestational age <32 weeks], moderate-to-late preterm [gestational age ≥32 to ≤37 weeks], and term neonates [gestational age >37 weeks]) and to evaluate the influence of preterm birth on development of subependymal veins. MATERIALS AND METHODS SWI venographies of 84 very preterm, 31 moderate-to-late preterm, and 50 term neonates were retrospectively evaluated. Subependymal vein anatomy was classified into 6 different patterns: type 1 represented the classic pattern and types 2-6 were considered anatomic variants. A χ2 test was used to evaluate differences between the distributions of subependymal vein patterns. RESULTS A significant difference (P = .011) was noticed between the 6 patterns based on gestational age. Type 1 was more frequent in term neonates (68%) than in both very preterm (41.7%) and moderate-to-late preterm neonates (56.5%). Anatomic variants were more common in very preterm neonates (66%) than in both moderate-to-late preterm (41%) and term neonates (36%). Interhemispheric asymmetry was more frequent in very preterm (59.5%) and moderate-to-late preterm neonates (51.6%) than in term neonates (34%; P = .017). Sex and monozygotic twin birth did not significantly affect the frequency of subependymal vein patterns (P = .0962). CONCLUSIONS The deep venous system of the neonatal brain shows a large spectrum of anatomic variants with higher variability of subependymal vein anatomy in preterm than term neonates, likely related to the influence of the preterm birth and epigenetic factors on subependymal vein development.
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Affiliation(s)
- D Tortora
- From the Neuroradiology Unit (D.T., M.S., G.M., A.R.)
| | - M Severino
- From the Neuroradiology Unit (D.T., M.S., G.M., A.R.)
| | - M Malova
- Neonatal Intensive Care Unit (M.M., A.P., L.A.R.), Istituto Giannina Gaslini, Genoa, Italy
| | - A Parodi
- Neonatal Intensive Care Unit (M.M., A.P., L.A.R.), Istituto Giannina Gaslini, Genoa, Italy
| | - G Morana
- From the Neuroradiology Unit (D.T., M.S., G.M., A.R.)
| | - L A Ramenghi
- Neonatal Intensive Care Unit (M.M., A.P., L.A.R.), Istituto Giannina Gaslini, Genoa, Italy
| | - A Rossi
- From the Neuroradiology Unit (D.T., M.S., G.M., A.R.)
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36
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Quast A, Hesse V, Hain J, Wermke P, Wermke K. Baby babbling at five months linked to sex hormone levels in early infancy. Infant Behav Dev 2016; 44:1-10. [PMID: 27208625 DOI: 10.1016/j.infbeh.2016.04.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 12/07/2015] [Accepted: 04/27/2016] [Indexed: 12/11/2022]
Abstract
Gender-dependent differentiation of the brain at morphological, neurochemical and functional levels of organization have been shown to be primarily controlled by sex differences in gonadal hormone concentrations during pre- and early postnatal development. Indeed, previous studies have reported that pre- and perinatal hormonal environments influence brain development and, consequently, affect sex specific long-term language outcomes. Herein, we investigated whether postnatal surges of estrogen (estradiol) and androgen (testosterone) may predict properties of pre-speech babbling at five months. This study is the first attempt to investigate a possible correlation between sex hormones and infants' articulatory skills during the typical postnatal period of extended hormonal activity known as 'mini-puberty.' A hierarchical, multiple regression approach revealed a significant, robust positive relationship between 4-week concentrations of estradiol and individual articulatory skills. In contrast, testosterone concentrations at five months negatively correlated with articulatory skills at the same age in both boys and girls. Our findings reinforce the assumption of the importance of sex hormones for auditory-vocal development towards language in human infants.
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Affiliation(s)
- Anja Quast
- Center for Pre-speech Development and Developmental Disorders, Department of Orthodontics, University of Wuerzburg, Germany
| | - Volker Hesse
- German Center for Growth, Development and Health Encouragement during Childhood and Youth, Children's Hospital Berlin-Lindenhof, Germany; Charité - University Medicine, Institute for Experimental Paediatric Endocrinology, Berlin, Germany
| | - Johannes Hain
- Department of Mathematics (Statistics), University of Wuerzburg, Germany
| | | | - Kathleen Wermke
- Center for Pre-speech Development and Developmental Disorders, Department of Orthodontics, University of Wuerzburg, Germany.
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Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage. Sci Rep 2016; 6:25903. [PMID: 27181339 PMCID: PMC4867629 DOI: 10.1038/srep25903] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/25/2016] [Indexed: 01/24/2023] Open
Abstract
Low-grade germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common complication in extremely premature neonates. The occurrence of GM-IVH is highly associated with hemodynamic instability in the premature brain, yet the long-term impact of low-grade GM-IVH on cerebral blood flow and neuronal health have not been fully investigated. We used an innovative combination of frequency-domain near infrared spectroscopy and diffuse correlation spectroscopy (FDNIRS-DCS) to measure cerebral oxygen saturation (SO2) and an index of cerebral blood flow (CBFi) at the infant’s bedside and compute an index of cerebral oxygen metabolism (CMRO2i). We enrolled twenty extremely low gestational age (ELGA) neonates (seven with low-grade GM-IVH) and monitored them weekly until they reached full-term equivalent age. During their hospital stay, we observed consistently lower CBFi and CMRO2i in ELGA neonates with low-grade GM-IVH compared to neonates without hemorrhages. Furthermore, lower CBFi and CMRO2i in the former group persists even after the resolution of the hemorrhage. In contrast, SO2 does not differ between groups. Thus, CBFi and CMRO2i may have better sensitivity than SO2 in detecting GM-IVH-related effects on infant brain development. FDNIRS-DCS methods may have clinical benefit for monitoring the evolution of GM-IVH, evaluating treatment response, and potentially predicting neurodevelopmental outcome.
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Dehaes M, Cheng HH, Buckley EM, Lin PY, Ferradal S, Williams K, Vyas R, Hagan K, Wigmore D, McDavitt E, Soul JS, Franceschini MA, Newburger JW, Ellen Grant P. Perioperative cerebral hemodynamics and oxygen metabolism in neonates with single-ventricle physiology. BIOMEDICAL OPTICS EXPRESS 2015; 6:4749-67. [PMID: 26713191 PMCID: PMC4679251 DOI: 10.1364/boe.6.004749] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/01/2015] [Accepted: 11/03/2015] [Indexed: 05/03/2023]
Abstract
Congenital heart disease (CHD) patients are at risk for neurodevelopmental delay. The etiology of these delays is unclear, but abnormal prenatal cerebral maturation and postoperative hemodynamic instability likely play a role. A better understanding of these factors is needed to improve neurodevelopmental outcome. In this study, we used bedside frequency-domain near infrared spectroscopy (FDNIRS) and diffuse correlation spectroscopy (DCS) to assess cerebral hemodynamics and oxygen metabolism in neonates with single-ventricle (SV) CHD undergoing surgery and compared them to controls. Our goals were 1) to compare cerebral hemodynamics between unanesthetized SV and healthy neonates, and 2) to determine if FDNIRS-DCS could detect alterations in cerebral hemodynamics beyond cerebral hemoglobin oxygen saturation (SO 2). Eleven SV neonates were recruited and compared to 13 controls. Preoperatively, SV patients showed decreased cerebral blood flow (CBFi ), cerebral oxygen metabolism (CMRO 2i ) and SO 2; and increased oxygen extraction fraction (OEF) compared to controls. Compared to preoperative values, unstable postoperative SV patients had decreased CMRO 2i and CBFi , which returned to baseline when stable. However, SO 2 showed no difference between unstable and stable states. Preoperative SV neonates are flow-limited and show signs of impaired cerebral development compared to controls. FDNIRS-DCS shows potential to improve assessment of cerebral development and postoperative hemodynamics compared to SO 2 alone.
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Affiliation(s)
- Mathieu Dehaes
- Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
- Mathieu Dehaes is currently at University of Montréal and Centre Hospitalier Universitaire Sainte-Justine, Montréal (QC), H3T 1C5,
Canada
- Mathieu Dehaes and Henry H. Cheng contributed equally to this work
| | - Henry H. Cheng
- Department of Cardiology, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
- Mathieu Dehaes and Henry H. Cheng contributed equally to this work
| | - Erin M. Buckley
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital & Harvard Medical School, Charlestown, MA 02129,
USA
- Erin M. Buckley is currently at Georgia Institute of Technology, Atlanta, GA 30322,
USA
| | - Pei-Yi Lin
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital & Harvard Medical School, Charlestown, MA 02129,
USA
| | - Silvina Ferradal
- Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - Kathryn Williams
- Department of Cardiology, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - Rutvi Vyas
- Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - Katherine Hagan
- Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - Daniel Wigmore
- Department of Cardiology, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - Erica McDavitt
- Department of Cardiology, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - Janet S. Soul
- Department of Neurology, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - Maria Angela Franceschini
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital & Harvard Medical School, Charlestown, MA 02129,
USA
| | - Jane W. Newburger
- Department of Cardiology, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
| | - P. Ellen Grant
- Fetal Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Boston Children’s Hospital & Harvard Medical School, Boston, MA 02115,
USA
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Wijeakumar S, Spencer JP, Bohache K, Boas DA, Magnotta VA. Validating a new methodology for optical probe design and image registration in fNIRS studies. Neuroimage 2015; 106:86-100. [PMID: 25705757 DOI: 10.1016/j.neuroimage.2014.11.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Functional near-infrared spectroscopy (fNIRS) is an imaging technique that relies on the principle of shining near-infrared light through tissue to detect changes in hemodynamic activation. An important methodological issue encountered is the creation of optimized probe geometry for fNIRS recordings. Here, across three experiments, we describe and validate a processing pipeline designed to create an optimized, yet scalable probe geometry based on selected regions of interest (ROIs) from the functional magnetic resonance imaging (fMRI) literature. In experiment 1, we created a probe geometry optimized to record changes in activation from target ROIs important for visual working memory. Positions of the sources and detectors of the probe geometry on an adult head were digitized using a motion sensor and projected onto a generic adult atlas and a segmented head obtained from the subject's MRI scan. In experiment 2, the same probe geometry was scaled down to fit a child's head and later digitized and projected onto the generic adult atlas and a segmented volume obtained from the child's MRI scan. Using visualization tools and by quantifying the amount of intersection between target ROIs and channels, we show that out of 21 ROIs, 17 and 19 ROIs intersected with fNIRS channels from the adult and child probe geometries, respectively. Further, both the adult atlas and adult subject-specific MRI approaches yielded similar results and can be used interchangeably. However, results suggest that segmented heads obtained from MRI scans be used for registering children's data. Finally, in experiment 3, we further validated our processing pipeline by creating a different probe geometry designed to record from target ROIs involved in language and motor processing.
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Ferradal SL, Liao SM, Eggebrecht AT, Shimony JS, Inder TE, Culver JP, Smyser CD. Functional Imaging of the Developing Brain at the Bedside Using Diffuse Optical Tomography. Cereb Cortex 2015; 26:1558-68. [PMID: 25595183 DOI: 10.1093/cercor/bhu320] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
While histological studies and conventional magnetic resonance imaging (MRI) investigations have elucidated the trajectory of structural changes in the developing brain, less is known regarding early functional cerebral development. Recent investigations have demonstrated that resting-state functional connectivity MRI (fcMRI) can identify networks of functional cerebral connections in infants. However, technical and logistical challenges frequently limit the ability to perform MRI scans early or repeatedly in neonates, particularly in those at greatest risk for adverse neurodevelopmental outcomes. High-density diffuse optical tomography (HD-DOT), a portable imaging modality, potentially enables early continuous and quantitative monitoring of brain function in infants. We introduce an HD-DOT imaging system that combines advancements in cap design, ergonomics, and data analysis methods to allow bedside mapping of functional brain development in infants. In a cohort of healthy, full-term neonates scanned within the first days of life, HD-DOT results demonstrate strong congruence with those obtained using co-registered, subject-matched fcMRI and reflect patterns of typical brain development. These findings represent a transformative advance in functional neuroimaging in infants, and introduce HD-DOT as a powerful and practical method for quantitative mapping of early functional brain development in normal and high-risk neonates.
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Affiliation(s)
- Silvina L Ferradal
- Department of Biomedical Engineering, Washington University, St Louis, MO, USA Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Steve M Liao
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Joseph P Culver
- Department of Biomedical Engineering, Washington University, St Louis, MO, USA Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Christopher D Smyser
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
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Kabdebon C, Leroy F, Simmonet H, Perrot M, Dubois J, Dehaene-Lambertz G. Anatomical correlations of the international 10–20 sensor placement system in infants. Neuroimage 2014; 99:342-56. [DOI: 10.1016/j.neuroimage.2014.05.046] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 05/09/2014] [Accepted: 05/15/2014] [Indexed: 10/25/2022] Open
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Buckley EM, Parthasarathy AB, Grant PE, Yodh AG, Franceschini MA. Diffuse correlation spectroscopy for measurement of cerebral blood flow: future prospects. NEUROPHOTONICS 2014; 1:011009. [PMID: 25593978 PMCID: PMC4292799 DOI: 10.1117/1.nph.1.1.011009] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Diffuse correlation spectroscopy (DCS) is an emerging optical modality used to measure cortical cerebral blood flow. This outlook presents a brief overview of the technology, summarizing the advantages and limitations of the method, and describing its recent applications to animal, adult, and infant cohorts. At last, the paper highlights future applications where DCS may play a pivotal role individualizing patient management and enhancing our understanding of neurovascular coupling, activation, and brain development.
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Affiliation(s)
- Erin M. Buckley
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts 02129
- Address all correspondence to: Erin M. Buckley,
| | - Ashwin B. Parthasarathy
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania 19104
| | - P. Ellen Grant
- Boston Children’s Hospital, Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston, Massachusetts 02115
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania 19104
| | - Maria Angela Franceschini
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts 02129
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Shang Y, Li T, Chen L, Lin Y, Toborek M, Yu G. Extraction of diffuse correlation spectroscopy flow index by integration of Nth-order linear model with Monte Carlo simulation. APPLIED PHYSICS LETTERS 2014; 104:193703. [PMID: 24926099 PMCID: PMC4032444 DOI: 10.1063/1.4876216] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/30/2014] [Indexed: 05/19/2023]
Abstract
Conventional semi-infinite solution for extracting blood flow index (BFI) from diffuse correlation spectroscopy (DCS) measurements may cause errors in estimation of BFI (αDB ) in tissues with small volume and large curvature. We proposed an algorithm integrating Nth-order linear model of autocorrelation function with the Monte Carlo simulation of photon migrations in tissue for the extraction of αDB . The volume and geometry of the measured tissue were incorporated in the Monte Carlo simulation, which overcome the semi-infinite restrictions. The algorithm was tested using computer simulations on four tissue models with varied volumes/geometries and applied on an in vivo stroke model of mouse. Computer simulations shows that the high-order (N ≥ 5) linear algorithm was more accurate in extracting αDB (errors < ±2%) from the noise-free DCS data than the semi-infinite solution (errors: -5.3% to -18.0%) for different tissue models. Although adding random noises to DCS data resulted in αDB variations, the mean values of errors in extracting αDB were similar to those reconstructed from the noise-free DCS data. In addition, the errors in extracting the relative changes of αDB using both linear algorithm and semi-infinite solution were fairly small (errors < ±2.0%) and did not rely on the tissue volume/geometry. The experimental results from the in vivo stroke mice agreed with those in simulations, demonstrating the robustness of the linear algorithm. DCS with the high-order linear algorithm shows the potential for the inter-subject comparison and longitudinal monitoring of absolute BFI in a variety of tissues/organs with different volumes/geometries.
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Affiliation(s)
- Yu Shang
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky 40506, USA
| | - Ting Li
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky 40506, USA ; State Key Laboratory for Electronic Thin Film and Integrated Device, University of Electronic Science and Technology of China, Chengdu 610054, People's Republic of China
| | - Lei Chen
- Department of Neurosurgery, University of Kentucky, Lexington, Kentucky 40536, USA
| | - Yu Lin
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky 40506, USA
| | - Michal Toborek
- Department of Neurosurgery, University of Kentucky, Lexington, Kentucky 40536, USA
| | - Guoqiang Yu
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky 40506, USA
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Jain V, Buckley EM, Licht DJ, Lynch JM, Schwab PJ, Naim MY, Lavin NA, Nicolson SC, Montenegro LM, Yodh AG, Wehrli FW. Cerebral oxygen metabolism in neonates with congenital heart disease quantified by MRI and optics. J Cereb Blood Flow Metab 2014; 34:380-8. [PMID: 24326385 PMCID: PMC3948119 DOI: 10.1038/jcbfm.2013.214] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/30/2013] [Accepted: 11/04/2013] [Indexed: 11/09/2022]
Abstract
Neonatal congenital heart disease (CHD) is associated with altered cerebral hemodynamics and increased risk of brain injury. Two novel noninvasive techniques, magnetic resonance imaging (MRI) and diffuse optical and correlation spectroscopies (diffuse optical spectroscopy (DOS), diffuse correlation spectroscopy (DCS)), were employed to quantify cerebral blood flow (CBF) and oxygen metabolism (CMRO(2)) of 32 anesthetized CHD neonates at rest and during hypercapnia. Cerebral venous oxygen saturation (S(v)O(2)) and CBF were measured simultaneously with MRI in the superior sagittal sinus, yielding global oxygen extraction fraction (OEF) and global CMRO(2) in physiologic units. In addition, microvascular tissue oxygenation (StO(2)) and indices of microvascular CBF (BFI) and CMRO(2) (CMRO(2)(i)) in the frontal cortex were determined by DOS/DCS. Median resting-state MRI-measured OEF, CBF, and CMRO(2) were 0.38, 9.7 mL/minute per 100 g and 0.52 mL O(2)/minute per 100 g, respectively. These CBF and CMRO(2) values are lower than literature reports for healthy term neonates (which are sparse and quantified using different methods) and resemble values reported for premature infants. Comparison of MRI measurements of global S(v)O(2), CBF, and CMRO(2) with corresponding local DOS/DCS measurements demonstrated strong linear correlations (R(2)=0.69, 0.67, 0.67; P<0.001), permitting calibration of DOS/DCS indices. The results suggest that MRI and optics offer new tools to evaluate cerebral hemodynamics and metabolism in CHD neonates.
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Affiliation(s)
- Varsha Jain
- Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA
| | - Erin M Buckley
- 1] Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA [2] Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel J Licht
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jennifer M Lynch
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Peter J Schwab
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Maryam Y Naim
- Division of Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Natasha A Lavin
- Division of Respiratory Therapy, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Susan C Nicolson
- Division of Cardiothoracic Anesthesia, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lisa M Montenegro
- Division of Cardiothoracic Anesthesia, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Felix W Wehrli
- Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA
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Durduran T, Yodh AG. Diffuse correlation spectroscopy for non-invasive, micro-vascular cerebral blood flow measurement. Neuroimage 2014; 85 Pt 1:51-63. [PMID: 23770408 PMCID: PMC3991554 DOI: 10.1016/j.neuroimage.2013.06.017] [Citation(s) in RCA: 289] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 05/10/2013] [Accepted: 06/06/2013] [Indexed: 12/25/2022] Open
Abstract
Diffuse correlation spectroscopy (DCS) uses the temporal fluctuations of near-infrared (NIR) light to measure cerebral blood flow (CBF) non-invasively. Here, we provide a brief history of DCS applications in the brain with an emphasis on the underlying physical ideas, common instrumentation and validation. Then we describe recent clinical research that employs DCS-measured CBF as a biomarker of patient well-being, and as an indicator of hemodynamic and metabolic responses to functional stimuli.
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Affiliation(s)
- Turgut Durduran
- ICFO- Institut de Ciències Fotòniques, Mediterranean Technology Park, 08860 Castelldefels, Barcelona, Spain.
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46
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Cerebral oxygen metabolism in neonatal hypoxic ischemic encephalopathy during and after therapeutic hypothermia. J Cereb Blood Flow Metab 2014; 34:87-94. [PMID: 24064492 PMCID: PMC3887346 DOI: 10.1038/jcbfm.2013.165] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/15/2013] [Accepted: 08/26/2013] [Indexed: 11/09/2022]
Abstract
Pathophysiologic mechanisms involved in neonatal hypoxic ischemic encephalopathy (HIE) are associated with complex changes of blood flow and metabolism. Therapeutic hypothermia (TH) is effective in reducing the extent of brain injury, but it remains uncertain how TH affects cerebral blood flow (CBF) and metabolism. Ten neonates undergoing TH for HIE and seventeen healthy controls were recruited from the NICU and the well baby nursery, respectively. A combination of frequency domain near infrared spectroscopy (FDNIRS) and diffuse correlation spectroscopy (DCS) systems was used to non-invasively measure cerebral hemodynamic and metabolic variables at the bedside. Results showed that cerebral oxygen metabolism (CMRO2i) and CBF indices (CBFi) in neonates with HIE during TH were significantly lower than post-TH and age-matched control values. Also, cerebral blood volume (CBV) and hemoglobin oxygen saturation (SO2) were significantly higher in neonates with HIE during TH compared with age-matched control neonates. Post-TH CBV was significantly decreased compared with values during TH whereas SO2 remained unchanged after the therapy. Thus, FDNIRS-DCS can provide information complimentary to SO2 and can assess individual cerebral metabolic responses to TH. Combined FDNIRS-DCS parameters improve the understanding of the underlying physiology and have the potential to serve as bedside biomarkers of treatment response and optimization.
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Lin JJ, Siddarth P, Riley JD, Gurbani SG, Ly R, Yee VW, Levitt JG, Toga AW, Caplan R. Neurobehavioral comorbidities of pediatric epilepsies are linked to thalamic structural abnormalities. Epilepsia 2013; 54:2116-24. [PMID: 24304435 DOI: 10.1111/epi.12428] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2013] [Indexed: 12/13/2022]
Abstract
PURPOSE Neurobehavioral comorbidities are common in pediatric epilepsy with enduring adverse effects on functioning, but their neuroanatomic underpinning is unclear. Striatal and thalamic abnormalities have been associated with childhood-onset epilepsies, suggesting that epilepsy-related changes in the subcortical circuit might be associated with the comorbidities of children with epilepsy. We aimed to compare subcortical volumes and their relationship with age in children with complex partial seizures (CPS), childhood absence epilepsy (CAE), and healthy controls (HC). We examined the shared versus unique structural-functional relationships of these volumes with behavior problems, intelligence, language, peer interaction, and epilepsy variables in these two epilepsy syndromes. METHODS We investigated volumetric differences of caudate, putamen, pallidum, and thalamus in children with CPS (N = 21), CAE (N = 20), and HC (N = 27). Study subjects underwent structural magnetic resonance imaging (MRI), intelligence, and language testing. Parent-completed Child Behavior Checklists provided behavior problem and peer interaction scores. We examined the association of age, intelligence quotient (IQ), language, behavioral problems, and epilepsy variables with subcortical volumes that were significantly different between the children with epilepsy and HC. KEY FINDINGS Both children with CPS and CAE exhibited significantly smaller left thalamic volume compared to HC. In terms of developmental trajectory, greater thalamic volume was significantly correlated with increasing age in children with CPS and CAE but not in HC. With regard to the comorbidities, reduced left thalamic volumes were related to more social problems in children with CPS and CAE. Smaller left thalamic volumes in children with CPS were also associated with poor attention, lower IQ and language scores, and impaired peer interaction. SIGNIFICANCE Our study is the first to directly compare and detect shared thalamic structural abnormalities in children with CPS and CAE. These findings highlight the vulnerability of the thalamus and provide important new insights on its possible role in the neurobehavioral comorbidities of childhood-onset epilepsy.
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Affiliation(s)
- Jack J Lin
- Department of Neurology, University of California Irvine, Irvine, California, U.S.A
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48
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Wintermark P, Hansen A, Warfield SK, Dukhovny D, Soul JS. Near-infrared spectroscopy versus magnetic resonance imaging to study brain perfusion in newborns with hypoxic-ischemic encephalopathy treated with hypothermia. Neuroimage 2013; 85 Pt 1:287-93. [PMID: 23631990 DOI: 10.1016/j.neuroimage.2013.04.072] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 04/17/2013] [Accepted: 04/18/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The measurement of brain perfusion may provide valuable information for assessment and treatment of newborns with hypoxic-ischemic encephalopathy (HIE). While arterial spin labeled perfusion (ASL) magnetic resonance imaging (MRI) provides noninvasive and direct measurements of regional cerebral blood flow (CBF) values, it is logistically challenging to obtain. Near-infrared spectroscopy (NIRS) might be an alternative, as it permits noninvasive and continuous monitoring of cerebral hemodynamics and oxygenation at the bedside. OBJECTIVE The purpose of this study is to determine the correlation between measurements of brain perfusion by NIRS and by MRI in term newborns with HIE treated with hypothermia. DESIGN/METHODS In this prospective cohort study, ASL-MRI and NIRS performed during hypothermia were used to assess brain perfusion in these newborns. Regional cerebral blood flow (CBF) values, measured from 1-2 MRI scans for each patient, were compared to mixed venous saturation values (SctO2) recorded by NIRS just before and after each MRI. Analysis included groupings into moderate versus severe HIE based on their initial background pattern of amplitude-integrated electroencephalogram. RESULTS Twelve concomitant recordings were obtained of seven neonates. Strong correlation was found between SctO2 and CBF in asphyxiated newborns with severe HIE (r=0.88; p value=0.0085). Moreover, newborns with severe HIE had lower CBF (likely lower oxygen supply) and extracted less oxygen (likely lower oxygen demand or utilization) when comparing SctO2 and CBF to those with moderate HIE. CONCLUSIONS NIRS is an effective bedside tool to monitor and understand brain perfusion changes in term asphyxiated newborns, which in conjunction with precise measurements of CBF obtained by MRI at particular times, may help tailor neuroprotective strategies in term newborns with HIE.
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Affiliation(s)
- P Wintermark
- Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, 2300 Tupper Street, Montreal, QC H3H 1P3, Canada; Division of Newborn Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
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Lin PY, Roche-Labarbe N, Dehaes M, Carp S, Fenoglio A, Barbieri B, Hagan K, Grant PE, Franceschini MA. Non-invasive optical measurement of cerebral metabolism and hemodynamics in infants. J Vis Exp 2013:e4379. [PMID: 23524854 PMCID: PMC3639513 DOI: 10.3791/4379] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Perinatal brain injury remains a significant cause of infant mortality and morbidity, but there is not yet an effective bedside tool that can accurately screen for brain injury, monitor injury evolution, or assess response to therapy. The energy used by neurons is derived largely from tissue oxidative metabolism, and neural hyperactivity and cell death are reflected by corresponding changes in cerebral oxygen metabolism (CMRO2). Thus, measures of CMRO2 are reflective of neuronal viability and provide critical diagnostic information, making CMRO2 an ideal target for bedside measurement of brain health. Brain-imaging techniques such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) yield measures of cerebral glucose and oxygen metabolism, but these techniques require the administration of radionucleotides, so they are used in only the most acute cases. Continuous-wave near-infrared spectroscopy (CWNIRS) provides non-invasive and non-ionizing radiation measures of hemoglobin oxygen saturation (SO2) as a surrogate for cerebral oxygen consumption. However, SO2 is less than ideal as a surrogate for cerebral oxygen metabolism as it is influenced by both oxygen delivery and consumption. Furthermore, measurements of SO2 are not sensitive enough to detect brain injury hours after the insult 1,2, because oxygen consumption and delivery reach equilibrium after acute transients3. We investigated the possibility of using more sophisticated NIRS optical methods to quantify cerebral oxygen metabolism at the bedside in healthy and brain-injured newborns. More specifically, we combined the frequency-domain NIRS (FDNIRS) measure of SO2 with the diffuse correlation spectroscopy (DCS) measure of blood flow index (CBFi) to yield an index of CMRO2 (CMRO2i) 4,5. With the combined FDNIRS/DCS system we are able to quantify cerebral metabolism and hemodynamics. This represents an improvement over CWNIRS for detecting brain health, brain development, and response to therapy in neonates. Moreover, this method adheres to all neonatal intensive care unit (NICU) policies on infection control and institutional policies on laser safety. Future work will seek to integrate the two instruments to reduce acquisition time at the bedside and to implement real-time feedback on data quality to reduce the rate of data rejection.
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Affiliation(s)
- Pei-Yi Lin
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, USA.
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Syllabic discrimination in premature human infants prior to complete formation of cortical layers. Proc Natl Acad Sci U S A 2013; 110:4846-51. [PMID: 23440196 DOI: 10.1073/pnas.1212220110] [Citation(s) in RCA: 250] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The ontogeny of linguistic functions in the human brain remains elusive. Although some auditory capacities are described before term, whether and how such immature cortical circuits might process speech are unknown. Here we used functional optical imaging to evaluate the cerebral responses to syllables at the earliest age at which cortical responses to external stimuli can be recorded in humans (28- to 32-wk gestational age). At this age, the cortical organization in layers is not completed. Many neurons are still located in the subplate and in the process of migrating to their final location. Nevertheless, we observed several points of similarity with the adult linguistic network. First, whereas syllables elicited larger right than left responses, the posterior temporal region escaped this general pattern, showing faster and more sustained responses over the left than over the right hemisphere. Second, discrimination responses to a change of phoneme (ba vs. ga) and a change of human voice (male vs. female) were already present and involved inferior frontal areas, even in the youngest infants (29-wk gestational age). Third, whereas both types of changes elicited responses in the right frontal region, the left frontal region only reacted to a change of phoneme. These results demonstrate a sophisticated organization of perisylvian areas at the very onset of cortical circuitry, 3 mo before term. They emphasize the influence of innate factors on regions involved in linguistic processing and social communication in humans.
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