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Murillo C, Eixarch E, Rueda C, Larroya M, Boada D, Grau L, Ponce J, Aldecoa V, Monterde E, Ferrero S, Andreu-Fernández V, Arca G, Oleaga L, Ros O, Hernández MP, Gratacós E, Palacio M, Cobo T. Evidence of brain injury in fetuses of mothers with preterm labor with intact membranes and preterm premature rupture of membranes. Am J Obstet Gynecol 2024:S0002-9378(24)00531-3. [PMID: 38685550 DOI: 10.1016/j.ajog.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/10/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Brain injury and poor neurodevelopment have been consistently reported in infants and adults born before term. These changes occur, at least in part, prenatally and are associated with intra-amniotic inflammation. The pattern of brain changes has been partially documented by magnetic resonance imaging but not by neurosonography along with amniotic fluid brain injury biomarkers. OBJECTIVE This study aimed to evaluate the prenatal features of brain remodeling and injury in fetuses from patients with preterm labor with intact membranes or preterm premature rupture of membranes and to investigate the potential influence of intra-amniotic inflammation as a risk mediator. STUDY DESIGN In this prospective cohort study, fetal brain remodeling and injury were evaluated using neurosonography and amniocentesis in singleton pregnant patients with preterm labor with intact membranes or preterm premature rupture of membranes between 24.0 and 34.0 weeks of gestation, with (n=41) and without (n=54) intra-amniotic inflammation. The controls for neurosonography were outpatient pregnant patients without preterm labor or preterm premature rupture of membranes matched 2:1 by gestational age at ultrasound. Amniotic fluid controls were patients with an amniocentesis performed for indications other than preterm labor or preterm premature rupture of membranes without brain or genetic defects whose amniotic fluid was collected in our biobank for research purposes matched by gestational age at amniocentesis. The group with intra-amniotic inflammation included those with intra-amniotic infection (microbial invasion of the amniotic cavity and intra-amniotic inflammation) and those with sterile inflammation. Microbial invasion of the amniotic cavity was defined as a positive amniotic fluid culture and/or positive 16S ribosomal RNA gene. Inflammation was defined by amniotic fluid interleukin 6 concentrations of >13.4 ng/mL in preterm labor and >1.43 ng/mL in preterm premature rupture of membranes. Neurosonography included the evaluation of brain structure biometric parameters and cortical development. Neuron-specific enolase, protein S100B, and glial fibrillary acidic protein were selected as amniotic fluid brain injury biomarkers. Data were adjusted for cephalic biometrics, fetal growth percentile, fetal sex, noncephalic presentation, and preterm premature rupture of membranes at admission. RESULTS Fetuses from mothers with preterm labor with intact membranes or preterm premature rupture of membranes showed signs of brain remodeling and injury. First, they had a smaller cerebellum. Thus, in the intra-amniotic inflammation, non-intra-amniotic inflammation, and control groups, the transcerebellar diameter measurements were 32.7 mm (interquartile range, 29.8-37.6), 35.3 mm (interquartile range, 31.2-39.6), and 35.0 mm (interquartile range, 31.3-38.3), respectively (P=.019), and the vermian height measurements were 16.9 mm (interquartile range, 15.5-19.6), 17.2 mm (interquartile range, 16.0-18.9), and 17.1 mm (interquartile range, 15.7-19.0), respectively (P=.041). Second, they presented a lower corpus callosum area (0.72 mm2 [interquartile range, 0.59-0.81], 0.71 mm2 [interquartile range, 0.63-0.82], and 0.78 mm2 [interquartile range, 0.71-0.91], respectively; P=.006). Third, they showed delayed cortical maturation (the Sylvian fissure depth-to-biparietal diameter ratios were 0.14 [interquartile range, 0.12-0.16], 0.14 [interquartile range, 0.13-0.16], and 0.16 [interquartile range, 0.15-0.17], respectively [P<.001], and the right parieto-occipital sulci depth ratios were 0.09 [interquartile range, 0.07-0.12], 0.11 [interquartile range, 0.09-0.14], and 0.11 [interquartile range, 0.09-0.14], respectively [P=.012]). Finally, regarding amniotic fluid brain injury biomarkers, fetuses from mothers with preterm labor with intact membranes or preterm premature rupture of membranes had higher concentrations of neuron-specific enolase (11,804.6 pg/mL [interquartile range, 6213.4-21,098.8], 8397.7 pg/mL [interquartile range, 3682.1-17,398.3], and 2393.7 pg/mL [interquartile range, 1717.1-3209.3], respectively; P<.001), protein S100B (2030.6 pg/mL [interquartile range, 993.0-4883.5], 1070.3 pg/mL [interquartile range, 365.1-1463.2], and 74.8 pg/mL [interquartile range, 44.7-93.7], respectively; P<.001), and glial fibrillary acidic protein (1.01 ng/mL [interquartile range, 0.54-3.88], 0.965 ng/mL [interquartile range, 0.59-2.07], and 0.24 mg/mL [interquartile range, 0.20-0.28], respectively; P=.002). CONCLUSION Fetuses with preterm labor with intact membranes or preterm premature rupture of membranes had prenatal signs of brain remodeling and injury at the time of clinical presentation. These changes were more pronounced in fetuses with intra-amniotic inflammation.
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Affiliation(s)
- Clara Murillo
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Elisenda Eixarch
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain; Center for Biomedical Research on Rare Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Claudia Rueda
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Marta Larroya
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - David Boada
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain
| | - Laia Grau
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain
| | - Júlia Ponce
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain
| | - Victoria Aldecoa
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain
| | - Elena Monterde
- Biosanitary Research Institute, Valencian International University (VIU), Valencia, Spain. Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - Silvia Ferrero
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain
| | - Vicente Andreu-Fernández
- Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain; Biosanitary Research Institute, Valencian International University, Valencia, Spain
| | - Gemma Arca
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Laura Oleaga
- Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain; Department of Radiology, Clinical Diagnostic Imaging Centre, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Olga Ros
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain
| | - Maria Pilar Hernández
- Department of Radiology, Clinical Diagnostic Imaging Centre, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eduard Gratacós
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain; Center for Biomedical Research on Rare Diseases, Institute of Health Carlos III, Madrid, Spain.
| | - Montse Palacio
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain; Center for Biomedical Research on Rare Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Teresa Cobo
- BCNatal Fetal Medicine Research Center, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic de Barcelona and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetrícia i Neonatología, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain; Center for Biomedical Research on Rare Diseases, Institute of Health Carlos III, Madrid, Spain
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Jiang L, Yang W, Chen H, Song H, Zhang S. Diagnosis and therapies for patients with cerebral palsy over the past 30 years: a bibliometric analysis. Front Neurol 2024; 15:1354311. [PMID: 38694779 PMCID: PMC11061478 DOI: 10.3389/fneur.2024.1354311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/20/2024] [Indexed: 05/04/2024] Open
Abstract
Background Currently, the incidence of cerebral palsy is high in newborns. However, the current methods for diagnosing and treating patients with cerebral palsy are complex and poorly targeted. Moreover, these studies lack the support of bibliometric analysis results. Objective Our study focused on a bibliometric analysis of published papers on the diagnosis and treatment of patients with cerebral palsy. This study identified the primary authors, institutions, and countries involved in analyzing the status and trends of research on the diagnosis and treatment of patients with cerebral palsy. Additionally, the study also involved screening pathways related to cerebral palsy. Methods The PubMed database was searched for publications on the diagnosis and treatment of patients with cerebral palsy between 1990 and 2023. R v4.2.2 and VOSviewer v1.6.18 software tools were utilized to perform bibliometric analysis and visualization. Results There were 1,965 publications on cerebral palsy diagnosis and 5,418 articles on the qualified treatment strategies, and the annual number of publications also increased. The United States dominated in this field of research. Gregory Y.H. Lip and Patrizio Lancellotti published the most number of papers. The Cleveland Clinic published the most number of papers in the field. According to the analysis of the co-occurrence of keywords, we found that the main research directions were age, sex, disease diagnosis, and treatment. Newly emerging research has focused mainly on heart failure, which is related to valvular heart disease. Conclusion The findings presented in this study offer valuable insights into ongoing research and potential future directions pertaining to cerebral palsy. These insights can assist researchers in identifying suitable collaborators and enhancing their investigations aimed at identifying the underlying molecular mechanisms associated with cerebral palsy, encompassing its etiology, preventive measures, and therapeutic interventions.
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Affiliation(s)
- Lili Jiang
- Department of Outpatient, Hangzhou Children's Hospital, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Weifang Yang
- Department of Radiology, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, China
| | - Huai Chen
- Department of Neurosurgery, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, China
| | - Huangcheng Song
- Department of Neurosurgery, People's Hospital of Haimen District, Nantong, Jiangsu, China
| | - Song Zhang
- Department of Neurosurgery, Hangzhou Children's Hospital, Hangzhou Normal University, Hangzhou, Zhejiang, China
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Fernández de Gamarra-Oca L, Lucas-Jiménez O, Ontañón JM, Loureiro-Gonzalez B, Peña J, Ibarretxe-Bilbao N, García-Guerrero MA, Ojeda N, Zubiaurre-Elorza L. Amygdala structure and function and its associations with social-emotional outcomes in a low-risk preterm sample. Brain Struct Funct 2024; 229:477-488. [PMID: 38236400 PMCID: PMC10917835 DOI: 10.1007/s00429-023-02749-1] [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: 05/04/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024]
Abstract
Amygdala atypical volume development and functional connectivity (FC) at small gestational ages (GA) have been found across childhood. This adult-oriented study assesses whether altered amygdala structure and function is present following low-risk preterm birth. T1-weighted and resting-state functional MRI images of 33 low-risk preterm (30-36 weeks' GA) and 29 full-term (37-42 weeks' GA) young adults of both sexes, aged between 20 and 32 years old, were analyzed using FreeSurfer (v6.0.0) and Coon Toolbox (v21.a). The social-emotional assessment included Happé's Strange Stories Test, the Moral Judgment Test, Delay-Discounting Test, Adult Self Report, and Emotion Regulation Questionnaire. No differences were found in social-emotional outcomes or amygdala volumes between the groups. Low-risk preterm young adults showed increased FC between the left amygdala, right amygdala and medial frontal cortex (MedFC) (F = 9.89, p-FWE = 0.009) at cluster level compared to their full-term peers. However, significant results at connection level were not observed between left and right amygdala. Lastly, increased FC at cluster level between the right amygdala and MedFC, and left amygdala and MedFC, was related to better social-emotional outcomes only in low-risk preterm young adults (F = 6.60, p-FWE = 0.036) at cluster level. At connection level, in contrast, only right amygdala-MedFC increased FC was significantly associated with better social-emotional outcomes. This study reveals that low-risk prematurity does not have an effect on social-emotional outcomes or structural amygdala volumes during young adulthood. However, individuals who were considered to be at a lower risk of exhibiting neurodevelopmental alterations following preterm birth demonstrated increased FC between the left and right amygdala and MedFC.
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Affiliation(s)
| | - O Lucas-Jiménez
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Bizkaia, Spain
| | - J M Ontañón
- OSATEK, MR Unit, Galdakao Hospital, Galdakao, Spain
| | - B Loureiro-Gonzalez
- Division of Neonatology, Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - J Peña
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Bizkaia, Spain
| | - N Ibarretxe-Bilbao
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Bizkaia, Spain
| | - M A García-Guerrero
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Bizkaia, Spain
| | - N Ojeda
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Bizkaia, Spain
| | - L Zubiaurre-Elorza
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Bizkaia, Spain.
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Fernández de Gamarra-Oca L, Zubiaurre-Elorza L, Gómez-Gastiasoro A, Molins-Sauri M, Loureiro B, Peña J, García-Guerrero MA, Ibarretxe-Bilbao N, Bruna O, Junqué C, Macaya A, Poca MA, Ojeda N. Preterm birth and early life environmental factors: neuropsychological profiles at adolescence and young adulthood. J Perinatol 2023; 43:1429-1436. [PMID: 37454175 DOI: 10.1038/s41372-023-01727-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES To establish neuropsychological profiles after high- and low-risk preterm birth (i.e., with and without neonatal brain injury) during adolescence and young adulthood and to assess the potential role of early life environmental factors in cognition. STUDY DESIGN Participants (N = 177; Mage = 20.11 years) of both sexes were evaluated when adolescent or in young adulthood. They were grouped according to their birth status: 30 high-risk preterm, 83 low-risk preterm and 64 born at full term. RESULTS Significant differences were found in several cognitive domains between groups. Furthermore, familial socioeconomic status (SES) moderated the relation between the degree of maturity/immaturity at birth and cognition (F(5,171) = 11.94, p < 0.001, R2 = 0.26). DISCUSSION The findings showed different neuropsychological profiles during adolescence and young adulthood, with the high-risk preterm sample evidencing lower cognitive values. In addition, higher scores in the familial SES score in this study seem to have a protective effect on cognition.
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Affiliation(s)
| | - Leire Zubiaurre-Elorza
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Vizcaya, Spain.
| | - Ainara Gómez-Gastiasoro
- Department of Basic Psychological Processes and Development, Faculty of Psychology, University of the Basque Country, Donostia, Gipuzkoa, Spain
| | - Marta Molins-Sauri
- School of Psychology, Education and Sport Science Blanquerna, Ramon Llull University, Barcelona, Catalonia, Spain
| | - Begoña Loureiro
- Neonatal Intensive Care Unit, Cruces University Hospital, Biocruces Health Research Institute, Barakaldo, Vizcaya, Spain
| | - Javier Peña
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Vizcaya, Spain
| | - M Acebo García-Guerrero
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Vizcaya, Spain
| | - Naroa Ibarretxe-Bilbao
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Vizcaya, Spain
| | - Olga Bruna
- School of Psychology, Education and Sport Science Blanquerna, Ramon Llull University, Barcelona, Catalonia, Spain
| | - Carme Junqué
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Alfons Macaya
- Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
| | - Maria A Poca
- Department of Neurosurgery and Neurotraumatology and Neurosurgery Research Unit, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Ojeda
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Vizcaya, Spain
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Neurodevelopmental consequences of preterm punctate white matter lesions: a systematic review. Pediatr Res 2022; 93:1480-1490. [PMID: 36085366 DOI: 10.1038/s41390-022-02232-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To evaluate punctate white matter lesion (PWML) influence in preterm infants on the long-term neurodevelopmental outcome (NDO). METHODS PubMed and EMBASE were searched from January 1, 2000, to May 31, 2021. Studies were included in which PWML in preterm infants on MRI around term-equivalent age (TEA) and NDO at ≥12 months were reported. Study and patient characteristics and NDO on motor, cognitive, and behavioral domains were extracted. The quality of studies was assessed using the Cochrane-approved Quality in Prognosis Studies tool. RESULTS This analysis included nine studies with a total of 1655 patients. Mean incidence of isolated PWML was 22.1%. All studies showed a relationship between PWML and motor delay. Two studies found a significant correlation between cognitive and behavioral outcomes and PWML. Number and PWML location are related to severity and impairment types. LIMITATIONS PWML were not always separately described from generalized WMI, only studies with imaging around TEA were included, and studies were heterogenic in design and quality. CONCLUSIONS PWML is common in preterm infants and predictive of adverse NDO, in particular on motor outcomes and less on cognitive and behavioral outcomes. The type and severity of impairments are related to the number and location of PMWL. IMPACT PWML is common in preterm infants and seems predictive of adverse NDO. DWI and SWI MRI sequences are informative because the different patterns suggest a difference in the underlying pathology. The type and severity of impairments are related to the number and location of PMWL. Our review can inform clinicians and parents about the NDO of preterm infants with a diagnosis of PWML. Prospective neuroimaging case-control cohort studies are recommended.
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Vanes LD, Murray RM, Nosarti C. Adult outcome of preterm birth: Implications for neurodevelopmental theories of psychosis. Schizophr Res 2022; 247:41-54. [PMID: 34006427 DOI: 10.1016/j.schres.2021.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/22/2022]
Abstract
Preterm birth is associated with an elevated risk of developmental and adult psychiatric disorders, including psychosis. In this review, we evaluate the implications of neurodevelopmental, cognitive, motor, and social sequelae of preterm birth for developing psychosis, with an emphasis on outcomes observed in adulthood. Abnormal brain development precipitated by early exposure to the extra-uterine environment, and exacerbated by neuroinflammation, neonatal brain injury, and genetic vulnerability, can result in alterations of brain structure and function persisting into adulthood. These alterations, including abnormal regional brain volumes and white matter macro- and micro-structure, can critically impair functional (e.g. frontoparietal and thalamocortical) network connectivity in a manner characteristic of psychotic illness. The resulting executive, social, and motor dysfunctions may constitute the basis for behavioural vulnerability ultimately giving rise to psychotic symptomatology. There are many pathways to psychosis, but elucidating more precisely the mechanisms whereby preterm birth increases risk may shed light on that route consequent upon early neurodevelopmental insult.
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Affiliation(s)
- Lucy D Vanes
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Sato J, Vandewouw MM, Bando N, Branson HM, O'Connor DL, Unger SL, Taylor MJ. White matter alterations and cognitive outcomes in children born very low birth weight. Neuroimage Clin 2021; 32:102843. [PMID: 34601309 PMCID: PMC8496319 DOI: 10.1016/j.nicl.2021.102843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Very low birth weight (VLBW) infants are at risk for disrupted white matter maturation, yet little is known about the contributing factors, particularly at preschool-age when cognitive difficulties begin to emerge. We examined white matter microstructure in five-year-old VLBW and full-term (FT) children, and its association with cognitive outcomes and birth weight. METHODS Multi-shell diffusion and MR images were obtained for 41 VLBW (mean birth weight: 1028.6 ± 256.8 g) and 26 FT (3295.4 ± 493.9 g) children. Fractional anisotropy (FA), radial diffusivity (RD), neurite orientation dispersion index (ODI) and density index (NDI) were estimated using diffusion tensor and neurite orientation dispersion and density imaging models. Between-group analyses used a general linear model with group and sex as explanatory variables. Within-group associations between white matter microstructure, cognitive outcomes and birth weight were also investigated. RESULTS VLBW compared to FT children showed lower FA and NDI across widespread white matter regions. Smaller clusters of atypical ODI were also found in VLBW children. Within-group analyses in FT children revealed that lower RD and higher NDI were associated with vocabulary acquisition and working memory. In VLBW children, higher FA and NDI, and lower RD and ODI, were associated with improved processing speed. In both groups, FA was positively associated with birth weight. CONCLUSIONS Our findings demonstrate white matter alterations in young VLBW children, including widespread reductions in axon density that may reflect sustained myelination disruptions. The associations with cognitive outcomes may also highlight which of the VLBW children are at higher risk for later cognitive difficulties.
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Affiliation(s)
- Julie Sato
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Psychology, University of Toronto, Toronto, Ontario, Canada; Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Marlee M Vandewouw
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada; Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Bando
- Translational Medicine, SickKids Research Institute, Toronto, Ontario, Canada
| | - Helen M Branson
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Medical Imaging, University of Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Translational Medicine, SickKids Research Institute, Toronto, Ontario, Canada; Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Paediatrics, Mount Sinai Health, Toronto, Ontario, Canada
| | - Sharon L Unger
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Paediatrics, University of Toronto, Toronto, Ontario, Canada; Paediatrics, Mount Sinai Health, Toronto, Ontario, Canada; Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Margot J Taylor
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Psychology, University of Toronto, Toronto, Ontario, Canada; Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada; Medical Imaging, University of Toronto, Ontario, Canada; Paediatrics, University of Toronto, Toronto, Ontario, Canada
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Pandya CD, Vekaria H, Joseph B, Slone SA, Gensel JC, Sullivan PG, Miller BA. Hemoglobin induces oxidative stress and mitochondrial dysfunction in oligodendrocyte progenitor cells. Transl Res 2021; 231:13-23. [PMID: 33460824 PMCID: PMC8016702 DOI: 10.1016/j.trsl.2021.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/11/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
Oligodendrocyte progenitor cells (OPCs) in the infant brain give rise to mature oligodendrocytes that myelinate CNS axons. OPCs are particularly vulnerable to oxidative stress that occurs in many forms of brain injury. One common cause of infant brain injury is neonatal intraventricular hemorrhage (IVH), which releases blood into the CSF and brain parenchyma of preterm infants. Although blood contains the powerful oxidant hemoglobin, the direct effects of hemoglobin on OPCs have not been studied. We utilized a cell culture system to test if hemoglobin induced free radical production and mitochondrial dysfunction in OPCs. We also tested if phenelzine (PLZ), an FDA-approved antioxidant drug, could protect OPCs from hemoglobin-induced oxidative stress. OPCs were isolated from Sprague Dawley rat pups and exposed to hemoglobin with and without PLZ. Outcomes assessed included intracellular reactive oxygen species levels using 2',7'-dichlorodihydrofluorescein diacetate (DCF-DA) fluorescent dye, oxygen consumption using the XFe96 Seahorse assay, and proliferation measured by BrdU incorporation assay. Hemoglobin induced oxidative stress and impaired mitochondrial function in OPCs. PLZ treatment reduced hemoglobin-induced oxidative stress and improved OPC mitochondrial bioenergetics. The effects of hemoglobin and PLZ on OPC proliferation were not statistically significant, but showed trends towards hemoglobin reducing OPC proliferation and PLZ increasing OPC proliferation (P=0.06 for both effects). Collectively, our results indicate that hemoglobin induces mitochondrial dysfunction in OPCs and that antioxidant therapy reduces these effects. Therefore, antioxidant therapy may hold promise for white matter diseases in which hemoglobin plays a role, such as neonatal IVH.
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Affiliation(s)
- Chirayu D Pandya
- Department of Neurosurgery, University of Kentucky, Lexington, Kentucky; Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky
| | - Hemendra Vekaria
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky
| | - Binoy Joseph
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky; Department of Physiology, University of Kentucky, Lexington, Kentucky
| | - Stacey A Slone
- Department of Statistics, University of Kentucky, Lexington, Kentucky
| | - John C Gensel
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky; Department of Physiology, University of Kentucky, Lexington, Kentucky
| | - Patrick G Sullivan
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky; Department of Neuroscience, University of Kentucky, Lexington, Kentucky; Lexington VA Health Care System, Lexington, Kentucky
| | - Brandon A Miller
- Department of Neurosurgery, University of Kentucky, Lexington, Kentucky; Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky.
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Fernández de Gamarra-Oca L, Zubiaurre-Elorza L, Junqué C, Solana E, Soria-Pastor S, Vázquez É, Delgado I, Macaya A, Ojeda N, Poca MA. Reduced hippocampal subfield volumes and memory performance in preterm children with and without germinal matrix-intraventricular hemorrhage. Sci Rep 2021; 11:2420. [PMID: 33510243 PMCID: PMC7844245 DOI: 10.1038/s41598-021-81802-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/08/2021] [Indexed: 01/30/2023] Open
Abstract
Preterm newborns with germinal matrix-intraventricular hemorrhage (GM-IVH) are at a higher risk of evidencing neurodevelopmental alterations. Present study aimed to explore the long-term effects that GM-IVH have on hippocampal subfields, and their correlates with memory. The sample consisted of 58 participants, including 36 preterm-born (16 with GM-IVH and 20 without neonatal brain injury), and 22 full-term children aged between 6 and 15 years old. All participants underwent a cognitive assessment and magnetic resonance imaging study. GM-IVH children evidenced lower scores in Full Intelligence Quotient and memory measures compared to their low-risk preterm and full-term peers. High-risk preterm children with GM-IVH evidenced significantly lower total hippocampal volumes bilaterally and hippocampal subfield volumes compared to both low-risk preterm and full-term groups. Finally, significant positive correlations between memory and hippocampal subfield volumes were only found in preterm participants together; memory and the right CA-field correlation remained significant after Bonferroni correction was applied (p = .002). In conclusion, memory alterations and both global and regional volumetric reductions in the hippocampus were found to be specifically related to a preterm sample with GM-IVH. Nevertheless, results also suggest that prematurity per se has a long-lasting impact on the association between the right CA-field volume and memory during childhood.
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Affiliation(s)
- Lexuri Fernández de Gamarra-Oca
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Leire Zubiaurre-Elorza
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain.
| | - Carme Junqué
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center on Neurodegenerative Diseases (CIBERNED), Hospital Clinic, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Elisabeth Solana
- Institute of Biomedical Research August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Sara Soria-Pastor
- Department of Psychiatry, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Catalonia, Spain
| | - Élida Vázquez
- Department of Pediatric Radiology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
| | - Ignacio Delgado
- Department of Pediatric Radiology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Macaya
- Grup de Recerca en Neurologia Pediàtrica, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Catalonia, Spain
| | - Natalia Ojeda
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Maria A Poca
- Department of Neurosurgery and Neurotraumatology and Neurosurgery Research Unit, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
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Goulding DS, Vogel RC, Gensel JC, Morganti JM, Stromberg AJ, Miller BA. Acute brain inflammation, white matter oxidative stress, and myelin deficiency in a model of neonatal intraventricular hemorrhage. J Neurosurg Pediatr 2020; 26:613-623. [PMID: 32858507 PMCID: PMC10193502 DOI: 10.3171/2020.5.peds20124] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/18/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Neonatal intraventricular hemorrhage (IVH) leads to posthemorrhagic hydrocephalus (PHH), brain injury, and long-term disability. Current therapy for IVH is based on treating PHH but does not address the underlying brain injury. In order to develop pharmacological treatment for IVH, there must be a better understanding of the underlying pathology of this disease. This study was designed to determine the time course of the acute inflammation and oxidative stress that may underlie the progressive pathology of IVH. The authors sought to understand the temporal relationships among inflammation, oxidative stress, and white matter pathology in a rat model of IVH. METHODS A rat model of IVH consisting of hemoglobin injection into the lateral ventricle was used. Tissue was analyzed via biochemical and histological methods to map the spatiotemporal distribution of innate immune activation and oxidative stress. White matter was quantified using both immunohistochemistry and Western blot for myelin basic protein (MBP) in the corpus callosum. RESULTS IVH led to acute induction of inflammatory cytokines, followed by oxidative stress. Oxidative stress was concentrated in white matter, adjacent to the lateral ventricles. Animals with IVH initially gained weight at a lower rate than control animals and had larger ventricles and less MBP than control animals. CONCLUSIONS Experimental IVH induces global inflammation throughout the brain and oxidative stress concentrated in the white matter. Both of these phenomena occur early after IVH. This has implications for human neonates with immature white matter that is exquisitely sensitive to inflammation and oxidative stress. Antiinflammatory or antioxidant therapy for IVH may need to be initiated early in order to protect developing white matter.
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Affiliation(s)
- Danielle S. Goulding
- Departments of Neurosurgery
- Spinal Cord and Brain Injury Research Center, University of Kentucky; and
| | - R. Caleb Vogel
- Departments of Neurosurgery
- Spinal Cord and Brain Injury Research Center, University of Kentucky; and
| | - John C. Gensel
- Physiology
- Spinal Cord and Brain Injury Research Center, University of Kentucky; and
| | - Josh M. Morganti
- Neuroscience, and
- Spinal Cord and Brain Injury Research Center, University of Kentucky; and
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky
| | | | - Brandon A. Miller
- Departments of Neurosurgery
- Neuroscience, and
- Spinal Cord and Brain Injury Research Center, University of Kentucky; and
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Specific cognitive deficits in preschool age correlated with qualitative and quantitative MRI parameters in prematurely born children. Pediatr Neonatol 2020; 61:160-167. [PMID: 31607639 DOI: 10.1016/j.pedneo.2019.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/15/2019] [Accepted: 09/04/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cognitive deficits after perinatal brain lesion in preterm infants are among the most common neurodevelopmental disturbances. The relationship between structural changes on at term magnetic resonance imaging (MRI) and cognitive deficits in the preschool age should be a special focus due to timely intervention. The aim of this study was to correlate qualitative and quantitative MRI parameters of perinatal brain lesion in preterm children, on early neonatal MRI and follow up MRI, with general and specific cognitive functions in the preschool age. METHODS Twenty-one preterm infants with verified perinatal lesions based on clinical and ultrasound data underwent a brain MRI at term-equivalent age and a second MRI between 3 and 5 years of age. Qualitative and quantitative MRI analyses were done. All subjects underwent cognitive assessment (3-5 years) using Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and Developmental Neuropsychological Assessment (NEPSY-II). RESULTS Results show that many structural changes on at term MRI and on follow up MRI in preterm born children moderately correlate with specific cognitive deficits in preschool age. At term equivalent MRI, white matter changes and cortical thickness correlate to general and specific cognitive functions in infants born preterm. By analyzing follow up MRI at preschool age, structural changes of different white matter segments, corpus callosum, cortical thickness and lobe volume correlate to some specific cognitive functions. CONCLUSION Besides general cognitive delay, specific cognitive deficits in preterm children should be targeted in research and intervention, optimally combined with MRI scanning, providing timely and early intervention of cognitive deficits after perinatal brain lesion. Our results, as well as previously published results, suggest the importance of detailed preschool neuropsychological assessment, prior to enrolment in the school system. Although preliminary, our results expand our understanding of the relationship between early brain developmental lesions and cognitive outcome following premature birth.
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Hong HS, Kim SS, Park GY. MRI Findings to Predict Neurodevelopmental Outcomes in Preterm Infants Near Term-Equivalent Age. ACTA ACUST UNITED AC 2020. [DOI: 10.13104/imri.2020.24.1.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Hyun Sook Hong
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sung Shin Kim
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ga Young Park
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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Hunt BAE, Scratch SE, Mossad SI, Emami Z, Taylor MJ, Dunkley BT. Disrupted Visual Cortex Neurophysiology Following Very Preterm Birth. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:951-960. [PMID: 31706907 DOI: 10.1016/j.bpsc.2019.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/22/2019] [Accepted: 08/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Visual regions develop rapidly in utero and throughout early childhood, but very preterm (VPT) birth can disrupt the typical maturation of primary cortices, with VPT children exhibiting mild visual impairments in early life and throughout development. This is thought to be due to dysfunctional maturation of occipital cortices. A way to readily index brain function is to examine neural oscillations; these mechanisms play a central role in the modeling and pruning of connections, providing an intrinsic temporal structure that refines the precise alignment of spiking, processing information in the brain, and coordinating networks. METHODS Using magnetoencephalography, we examined regional oscillatory patterns and functional coupling in VPT and full-term children. Five minutes of eyes-open resting-state data were acquired from 27 VPT and 32 full-term children at 8 years of age. RESULTS As hypothesized, the VPT group, when compared with control children, had elevated theta-band power, while alpha amplitude envelope coupling, a marker of connectivity, was found to be decreased. CONCLUSIONS These results support the hypothesis of spectral slowing in VPT children and more broadly suggest that the developmental arc of visual neurophysiology is disrupted by VPT birth. We conclude that these deficits underlie difficulties in complex visual perceptual processing evident during childhood and beyond.
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Affiliation(s)
- Benjamin A E Hunt
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Shannon E Scratch
- Holland Bloorview Rehabilitation Hospital, Toronto, Ontario, Canada; Bloorview Research Institute, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Sarah I Mossad
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Zahra Emami
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Margot J Taylor
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin T Dunkley
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
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Comparison of cranial ultrasound and MRI for detecting BRAIN injury in extremely preterm infants and correlation with neurological outcomes at 1 and 3 years. Eur J Pediatr 2019; 178:1053-1061. [PMID: 31065842 DOI: 10.1007/s00431-019-03388-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 10/26/2022]
Abstract
This study aimed to investigate the accuracy of different grades of brain injuries on serial and term equivalent age (TEA)-cranial ultrasound imaging (cUS) as compared to TEA magnetic resonance imaging (MRI) in extremely preterm infants < 28 weeks, and determine the predictive value of imaging abnormalities on neurodevelopmental outcome at 1 and 3 years. Seventy-five infants were included in the study. Severe TEA-cUS injury had high positive predictive value-PPV (100%) for predicting severe MRI injury compared to mild to moderate TEA-cUS injury or severe injury on worst cranial ultrasound scan. Absence of moderate to severe injury on TEA cUS or worst serial cUS was a good predictor of a normal MRI (negative predictive values > 93%). Severe grade 3 injuries on TEA-US had high predictive values in predicting abnormal neurodevelopment at both 1 and 3 years of age (PPV 100%). All grades of MRI and worst serial cUS injuries poorly predicted abnormal neurodevelopment at 1 and 3 years. Absence of an injury either on a cranial ultrasound or an MRI did not predict a normal outcome. Multiple logistic regression did not show a significant correlation between imaging injury and neurodevelopmental outcomes.Conclusion: This study demonstrates that TEA cUS can reliably identify severe brain abnormalities that would be seen on MRI imaging and positively predict abnormal neurodevelopment at both 1 and 3 years. Although MRI can pick up more subtle abnormalities that may be missed on cUS, their predictive value on neurodevelopmental impairment is poor. Normal cUS and MRI scan may not exclude abnormal neurodevelopment. Routine TEA-MRI scan provides limited benefit in predicting abnormal neurodevelopment in extremely preterm infants. What is Known: • Preterm neonates are at increased risk of white matter and other brain injuries, which may be associated with adverse neurodevelopmental outcome. • MRI is the most accurate method in detecting white matter injuries. What is New: • TEA-cUS can reliably detect severe brain injuries on MRI, but not mild/moderate lesions as well as abnormal neurodevelopment at 1 and 3 years. • TEA-MRI brain injury is poor in predicting abnormal neurodevelopment at 1 and 3 years and normal cUS or MRI brain injury may not guarantee normal neurodevelopment.
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Regional brain volume reduction and cognitive outcomes in preterm children at low risk at 9 years of age. Childs Nerv Syst 2017; 33:1317-1326. [PMID: 28484867 DOI: 10.1007/s00381-017-3421-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE More information is needed on "low-risk" preterm infants' neurological outcome so that they can be included in follow-up programs. A prospective study was performed to examine the regional brain volume changes compared to term children and to assess the relationship between the regional brain volumes to cognitive outcome of the low-risk preterm children at 9 years of age. PATIENTS Subjects comprised 22 preterm children who were determined to be at low risk for neurodevelopmental deficits with a gestational age between 28 and 33 weeks without a major neonatal morbidity in the neonatal period and 24 age-matched term control children term and matched for age, sex, and parental educational and occupational status. METHODS Regional volumetric analysis was performed for cerebellum, hippocampus, and corpus callosum area. Cognitive outcomes of both preterm and control subjects were assessed by Weschler Intelligence Scale for Children Revised (Turkish version), and attention and executive functions were assessed by Wisconsin Card Sorting Test and Stroop Test TBAG version. RESULTS Low-risk preterm children showed regional brain volume reduction in cerebellum, hippocampus, and corpus callosum area and achieved statistical significance when compared with term control. When the groups were compared for all WISC-R subscale scores, preterm children at low risk had significantly lower scores on information, vocabulary, similarities, arithmetics, picture completion, block design, object assembly, and coding compared to children born at term. Preterm and term groups were compared on the Stroop Test for mistakes and corrections made on each card, the time spent for completing each card, and total mistakes and corrections. In the preterm group, we found a positive correlation between regional volumes with IQ, attention, and executive function scores. Additionally, a significant correlation was found between cerebellar volume and attention and executive function scores in the preterm group. CONCLUSION Low-risk preterm children achieve lower scores in neurophysiological tests than children born at term. Preterm birth itself has a significant impact on regional brain volumes and cognitive outcome of children at 9 years of age. It is a risk factor for regional brain volume reductions in preterm children with low risk for neurodevelopmental deficits. The significant interaction between cerebellar volume reduction and executive function and attention may suggest that even in preterm children at low risk can have different trajectories in the growth and development of overall brain structure.
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16
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Kurpershoek T, Potharst-Sirag ES, Aarnoudse-Moens CSH, van Wassenaer-Leemhuis AG. Minor neurological dysfunction in five year old very preterm children is associated with lower processing speed. Early Hum Dev 2016; 103:55-60. [PMID: 27513713 DOI: 10.1016/j.earlhumdev.2016.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Minor neurological dysfunction (MND) is present in one quarter to one third of children born very preterm (VP). The more severe form, complex (c)-MND has been associated with learning disabilities, behavioural and motor problems. OBJECTIVE To study the association between c-MND and neurocognitive and motor disabilities at age five in VP children without CP. METHODS Ninety-four children born with gestational age<30weeks and/or a birth weight<1000g were assessed at five years corrected age. MND was classified according to Touwen. The Wechsler Preschool and Primary School Scale of Intelligence (WPPSI-III-NL) was used to measure intelligence. Simple reaction time, focused attention and visuomotor coordination were measured using the Amsterdam Neuropsychological Tasks, and working memory using a Digit Span Task. For motor skills the Movement Assessment Battery for children (M-ABC2) was used. RESULTS Eighty-one percent was classified as 'normal' (no or simple (s-)-MND) and 19% as 'abnormal'(c-MND or mild CP). The abnormal group had a significantly lower processing speed quotient (PSQ), M-ABC percentile score and slower simple Reaction Time than the normal group. Verbal IQ, Performance IQ, working memory, focused attention and visuomotor coordination did not differ between groups. Exclusion of the mild CP cases (n=4) led to similar results. CONCLUSIONS Five year old VP children with c-MND have lower PSQ, slower reaction time, and poorer motor skills, than those without c-MND. Neurological examination should include identification of MND to help identify children at risk for neurocognitive disabilities.
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Affiliation(s)
- Tinka Kurpershoek
- Department of Neonatology, Emma Children's Hospital, Academic Medical Centre, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Eva S Potharst-Sirag
- Psychosocial Department, Emma Children's Hospital, Academic Medical Centre, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
| | - Cornelieke S H Aarnoudse-Moens
- Psychosocial Department, Emma Children's Hospital, Academic Medical Centre, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
| | - Aleid G van Wassenaer-Leemhuis
- Department of Neonatology, Emma Children's Hospital, Academic Medical Centre, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
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18
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Hirst JJ, Cumberland AL, Shaw JC, Bennett GA, Kelleher MA, Walker DW, Palliser HK. Loss of neurosteroid-mediated protection following stress during fetal life. J Steroid Biochem Mol Biol 2016; 160:181-8. [PMID: 26365557 DOI: 10.1016/j.jsbmb.2015.09.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/01/2015] [Accepted: 09/08/2015] [Indexed: 11/22/2022]
Abstract
Elevated levels of neurosteroids during late gestation protect the fetal brain from hypoxia/ischaemia and promote neurodevelopment. Suppression of allopregnanolone production during pregnancy leads to the onset of seizure-like activity and potentiates hypoxia-induced brain injury. Markers of myelination are reduced and astrocyte activation is increased. The placenta has a key role in maintaining allopregnanolone concentrations in the fetal circulation and brain during gestation and levels decline markedly after both normal and preterm birth. This leads to the preterm neonate developing in a neurosteroid deficient environment between delivery and term equivalence. The expression of 5α-reductases is also lower in the fetus prior to term. These deficiencies in neurosteroid exposure may contribute to the increase in incidence of the adverse patterns of behaviour seen in children that are born preterm. Repeated exposure to glucocorticoid stimulation suppresses 5α-reductase expression and allopregnanolone levels in the fetus and results in reduced myelination. Both fetal growth restriction and prenatal maternal stress lead to increased cortisol concentrations in the maternal and fetal circulation. Prenatal stress results in reduced expression of key GABAA receptor subunits that normally heighten neurosteroid sensitivity. These stressors also result in altered placental allopregnanolone metabolism pathways. These findings suggest that reduced neurosteroid production and action in the perinatal period may contribute to some of the adverse neurodevelopmental and behavioural outcomes that result from these pregnancy compromises. Studies examining perinatal steroid supplementation therapy with non-metabolisable neurosteroid analogues to improve these outcomes are warranted.
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Affiliation(s)
- Jonathan J Hirst
- School of Biomedical Sciences, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Angela L Cumberland
- School of Biomedical Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Julia C Shaw
- School of Biomedical Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Greer A Bennett
- School of Biomedical Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | | | - David W Walker
- Ritchie Centre for Baby Health Research, Department of Obstetrics and Gynaecology, Monash University, VIC 3800, Australia
| | - Hannah K Palliser
- School of Biomedical Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
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Rothman AL, Mangalesh S, Chen X, Toth CA. Optical coherence tomography of the preterm eye: from retinopathy of prematurity to brain development. Eye Brain 2016; 8:123-133. [PMID: 28539807 PMCID: PMC5398750 DOI: 10.2147/eb.s97660] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Preterm infants with retinopathy of prematurity are at increased risk of poor neurodevelopmental outcomes. Because the neurosensory retina is an extension of the central nervous system, anatomic abnormalities in the anterior visual pathway often relate to system and central nervous system health. We describe optical coherence tomography as a powerful imaging modality that has recently been adapted to the infant population and provides noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside. Optical coherence tomography has increased understanding of normal eye development and has identified several potential biomarkers of brain abnormalities and poorer neurodevelopment.
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Affiliation(s)
- Adam L Rothman
- Department of Ophthalmology, Duke University School of Medicine, Durham.,Department of Internal Medicine, Cone Health, Greensboro
| | - Shwetha Mangalesh
- Department of Ophthalmology, Duke University School of Medicine, Durham
| | - Xi Chen
- Department of Ophthalmology, Duke University School of Medicine, Durham
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham.,Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA
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20
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Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment. Am J Ophthalmol 2015; 160:1296-1308.e2. [PMID: 26386157 DOI: 10.1016/j.ajo.2015.09.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/08/2015] [Accepted: 09/09/2015] [Indexed: 01/02/2023]
Abstract
PURPOSE To assess retinal nerve fiber layer (RNFL) thickness at term-equivalent age in very preterm (<32 weeks gestational age) vs term-born infant cohorts, and compare very preterm infant RNFL thickness with brain anatomy and neurodevelopment. DESIGN Cohort study. METHODS RNFL was semi-automatically segmented (1 eye per infant) in 57 very preterm and 50 term infants with adequate images from bedside portable, handheld spectral-domain optical coherence tomography imaging at 37-42 weeks postmenstrual age. Mean RNFL thickness was calculated for the papillomacular bundle (-15 degrees to +15 degrees) and temporal quadrant (-45 degrees to +45 degrees) relative to the fovea-optic nerve axis. Brain magnetic resonance imaging (MRI) scans clinically obtained in 26 very preterm infants were scored for global structural abnormalities by an expert masked to data except for age. Cognitive, language, and motor skills were assessed in 33 of the very preterm infants at 18-24 months corrected age. RESULTS RNFL was thinner for very preterm vs term infants at the papillomacular bundle ([mean ± standard deviation] 61 ± 17 vs 72 ± 13 μm, P < .001) and temporal quadrant (72 ± 21 vs 82 ± 16 μm, P = .005). In very preterm infants, thinner papillomacular bundle RNFL correlated with higher global brain MRI lesion burden index (R(2) = 0.35, P = .001) and lower cognitive (R(2) = 0.18, P = .01) and motor (R(2) = 0.17, P = .02) scores. Relationships were similar for temporal quadrant. CONCLUSIONS Thinner RNFL in very preterm infants relative to term-born infants may relate to brain structure and neurodevelopment.
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Reeb-Sutherland BC, Fox NA. Eyeblink conditioning: a non-invasive biomarker for neurodevelopmental disorders. J Autism Dev Disord 2015; 45:376-94. [PMID: 23942847 DOI: 10.1007/s10803-013-1905-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Eyeblink conditioning (EBC) is a classical conditioning paradigm typically used to study the underlying neural processes of learning and memory. EBC has a well-defined neural circuitry, is non-invasive, and can be employed in human infants shortly after birth making it an ideal tool to use in both developing and special populations. In addition, abnormalities in the cerebellum, a region of the brain highly involved in EBC, have been implicated in a number of neurodevelopmental disorders including autism spectrum disorders (ASDs). In the current paper, we review studies that have employed EBC as a biomarker for several neurodevelopmental disorders including fetal alcohol syndrome, Down syndrome, fragile X syndrome, attention deficit/hyperactivity disorder, dyslexia, specific language impairment, and schizophrenia. In addition, we discuss the benefits of using such a tool in individuals with ASD.
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Affiliation(s)
- Bethany C Reeb-Sutherland
- Department of Psychology, DM 256, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA,
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22
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Degnan AJ, Wisnowski JL, Choi S, Ceschin R, Bhushan C, Leahy RM, Corby P, Schmithorst VJ, Panigrahy A. Altered Structural and Functional Connectivity in Late Preterm Preadolescence: An Anatomic Seed-Based Study of Resting State Networks Related to the Posteromedial and Lateral Parietal Cortex. PLoS One 2015; 10:e0130686. [PMID: 26098888 PMCID: PMC4476681 DOI: 10.1371/journal.pone.0130686] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/22/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Late preterm birth confers increased risk of developmental delay, academic difficulties and social deficits. The late third trimester may represent a critical period of development of neural networks including the default mode network (DMN), which is essential to normal cognition. Our objective is to identify functional and structural connectivity differences in the posteromedial cortex related to late preterm birth. METHODS Thirty-eight preadolescents (ages 9-13; 19 born in the late preterm period (≥32 weeks gestational age) and 19 at term) without access to advanced neonatal care were recruited from a low socioeconomic status community in Brazil. Participants underwent neurocognitive testing, 3-dimensional T1-weighted imaging, diffusion-weighted imaging and resting state functional MRI (RS-fMRI). Seed-based probabilistic diffusion tractography and RS-fMRI analyses were performed using unilateral seeds within the posterior DMN (posterior cingulate cortex, precuneus) and lateral parietal DMN (superior marginal and angular gyri). RESULTS Late preterm children demonstrated increased functional connectivity within the posterior default mode networks and increased anti-correlation with the central-executive network when seeded from the posteromedial cortex (PMC). Key differences were demonstrated between PMC components with increased anti-correlation with the salience network seen only with posterior cingulate cortex seeding but not with precuneus seeding. Probabilistic tractography showed increased streamlines within the right inferior longitudinal fasciculus and inferior fronto-occipital fasciculus within late preterm children while decreased intrahemispheric streamlines were also observed. No significant differences in neurocognitive testing were demonstrated between groups. CONCLUSION Late preterm preadolescence is associated with altered functional connectivity from the PMC and lateral parietal cortex to known distributed functional cortical networks despite no significant executive neurocognitive differences. Selective increased structural connectivity was observed in the setting of decreased posterior interhemispheric connections. Future work is needed to determine if these findings represent a compensatory adaptation employing alternate neural circuitry or could reflect subtle pathology resulting in emotional processing deficits not seen with neurocognitive testing.
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Affiliation(s)
- Andrew J. Degnan
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Radiology, University of Pittsburgh Medical Center (UPMC), 3950 Presby South Tower, 200 Lothrop Street, Pittsburgh, PA 15213, United States of America
| | - Jessica L. Wisnowski
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
| | - SoYoung Choi
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
| | - Rafael Ceschin
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Chitresh Bhushan
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Richard M. Leahy
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Patricia Corby
- Twins Institute for Genetics Research, Montes Claros, Minas Gerais 39400–115, Brazil
- New York University Bluestone Center for Clinical Research, 421 1st Ave, New York, NY 10010, United States of America
| | - Vincent J. Schmithorst
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
| | - Ashok Panigrahy
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
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Young JM, Powell TL, Morgan BR, Card D, Lee W, Smith ML, Sled JG, Taylor MJ. Deep grey matter growth predicts neurodevelopmental outcomes in very preterm children. Neuroimage 2015; 111:360-8. [DOI: 10.1016/j.neuroimage.2015.02.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/02/2015] [Accepted: 02/13/2015] [Indexed: 11/26/2022] Open
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Moiseev A, Doesburg SM, Herdman AT, Ribary U, Grunau RE. Altered Network Oscillations and Functional Connectivity Dynamics in Children Born Very Preterm. Brain Topogr 2014; 28:726-745. [PMID: 25370485 DOI: 10.1007/s10548-014-0416-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/28/2014] [Indexed: 11/26/2022]
Abstract
Structural brain connections develop atypically in very preterm children, and altered functional connectivity is also evident in fMRI studies. Such alterations in brain network connectivity are associated with cognitive difficulties in this population. Little is known, however, about electrophysiological interactions among specific brain networks in children born very preterm. In the present study, we recorded magnetoencephalography while very preterm children and full-term controls performed a visual short-term memory task. Regions expressing task-dependent activity changes were identified using beamformer analysis, and inter-regional phase synchrony was calculated. Very preterm children expressed altered regional recruitment in distributed networks of brain areas, across standard physiological frequency ranges including the theta, alpha, beta and gamma bands. Reduced oscillatory synchrony was observed among task-activated brain regions in very preterm children, particularly for connections involving areas critical for executive abilities, including middle frontal gyrus. These findings suggest that inability to recruit neurophysiological activity and interactions in distributed networks including frontal regions may contribute to difficulties in cognitive development in children born very preterm.
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Affiliation(s)
- Alexander Moiseev
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Vancouver, Canada.
| | - Sam M Doesburg
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Anthony T Herdman
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Vancouver, Canada
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
| | - Urs Ribary
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Vancouver, Canada
- Department of Psychology, Simon Fraser University, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, Canada
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Lao Y, Wang Y, Shi J, Ceschin R, Nelson MD, Panigrahy A, Leporé N. Thalamic alterations in preterm neonates and their relation to ventral striatum disturbances revealed by a combined shape and pose analysis. Brain Struct Funct 2014; 221:487-506. [PMID: 25366970 DOI: 10.1007/s00429-014-0921-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
Abstract
Finding the neuroanatomical correlates of prematurity is vital to understanding which structures are affected, and to designing efficient prevention and treatment strategies. Converging results reveal that thalamic abnormalities are important indicators of prematurity. However, little is known about the localization of the abnormalities within the subnuclei of the thalamus, or on the association of altered thalamic development with other deep gray matter disturbances. Here, we aim to investigate the effect of prematurity on the thalamus and the putamen in the neonatal brain, and further investigate the associated abnormalities between these two structures. Using brain structural magnetic resonance imaging, we perform a novel combined shape and pose analysis of the thalamus and putamen between 17 preterm (41.12 ± 5.08 weeks) and 19 term-born (45.51 ± 5.40 weeks) neonates at term equivalent age. We also perform a set of correlation analyses between the thalamus and the putamen, based on the surface and pose results. We locate significant alterations on specific surface regions such as the anterior and ventral anterior (VA) thalamic nuclei, and significant relative pose changes of the left thalamus and the right putamen. In addition, we detect significant association between the thalamus and the putamen for both surface and pose parameters. The regions that are significantly associated include the VA, and the anterior and inferior putamen. We detect statistically significant surface deformations and pose changes on the thalamus and putamen, and for the first time, demonstrate the feasibility of using relative pose parameters as indicators for prematurity in neonates. Our methods show that regional abnormalities of the thalamus are associated with alterations of the putamen, possibly due to disturbed development of shared pre-frontal connectivity. More specifically, the significantly correlated regions in these two structures point to frontal-subcortical pathways including the dorsolateral prefrontal-subcortical circuit, the lateral orbitofrontal-subcortical circuit, the motor circuit, and the oculomotor circuit. These findings reveal new insight into potential subcortical structural covariates for poor neurodevelopmental outcomes in the preterm population.
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Affiliation(s)
- Yi Lao
- Department of Radiology, University of Southern California and Children's Hospital, 4650 Sunset Blvd, MS#81, Los Angeles, CA, 90027, USA
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, 85281, USA
| | - Jie Shi
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, 85281, USA
| | - Rafael Ceschin
- Department of Radiology, Children's Hospital of Pittsburgh UPMC, Pittsburgh, PA, USA
| | - Marvin D Nelson
- Department of Radiology, University of Southern California and Children's Hospital, 4650 Sunset Blvd, MS#81, Los Angeles, CA, 90027, USA
| | - Ashok Panigrahy
- Department of Radiology, University of Southern California and Children's Hospital, 4650 Sunset Blvd, MS#81, Los Angeles, CA, 90027, USA.,Department of Radiology, Children's Hospital of Pittsburgh UPMC, Pittsburgh, PA, USA
| | - Natasha Leporé
- Department of Radiology, University of Southern California and Children's Hospital, 4650 Sunset Blvd, MS#81, Los Angeles, CA, 90027, USA.
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Taylor MJ, Doesburg SM, Pang EW. Neuromagnetic vistas into typical and atypical development of frontal lobe functions. Front Hum Neurosci 2014; 8:453. [PMID: 24994980 PMCID: PMC4061489 DOI: 10.3389/fnhum.2014.00453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 06/03/2014] [Indexed: 11/24/2022] Open
Abstract
The frontal lobes are involved in many higher-order cognitive functions such as social cognition executive functions and language and speech. These functions are complex and follow a prolonged developmental course from childhood through to early adulthood. Magnetoencephalography (MEG) is ideal for the study of development of these functions, due to its combination of temporal and spatial resolution which allows the determination of age-related changes in both neural timing and location. There are several challenges for MEG developmental studies: to design tasks appropriate to capture the neurodevelopmental trajectory of these cognitive functions, and to develop appropriate analysis strategies to capture various aspects of neuromagnetic frontal lobe activity. Here, we review our MEG research on social and executive functions, and speech in typically developing children and in two clinical groups – children with autism spectrum disorder and children born very preterm. The studies include facial emotional processing, inhibition, visual short-term memory, speech production, and resting-state networks. We present data from event-related analyses as well as on oscillations and connectivity analyses and review their contributions to understanding frontal lobe cognitive development. We also discuss the challenges of testing young children in the MEG and the development of age-appropriate technologies and paradigms.
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Affiliation(s)
- Margot J Taylor
- Department of Diagnostic Imaging, Hospital for Sick Children , Toronto, ON , Canada ; Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Medical Imaging, University of Toronto , Toronto, ON , Canada ; Department of Psychology, University of Toronto , Toronto, ON , Canada ; Department of Paediatrics, University of Toronto , Toronto, ON , Canada
| | - Sam M Doesburg
- Department of Diagnostic Imaging, Hospital for Sick Children , Toronto, ON , Canada ; Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Medical Imaging, University of Toronto , Toronto, ON , Canada ; Department of Psychology, University of Toronto , Toronto, ON , Canada
| | - Elizabeth W Pang
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Paediatrics, University of Toronto , Toronto, ON , Canada ; Division of Neurology, Hospital for Sick Children , Toronto, ON , Canada
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Hart AR, Smith MF, Whitby EH, Alladi S, Wilkinson S, Paley MN, Griffiths PD. Diffusion-weighted imaging and magnetic resonance proton spectroscopy following preterm birth. Clin Radiol 2014; 69:870-9. [PMID: 24935906 DOI: 10.1016/j.crad.2014.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 04/03/2014] [Indexed: 10/25/2022]
Abstract
AIM To study the associations between magnetic resonance proton spectroscopy (MRS) data and apparent diffusion coefficients (ADC) from the preterm brain with developmental outcome at 18 months corrected age and clinical variables. MATERIALS AND METHODS A prospective observational cohort study of 67 infants born before 35 weeks gestational age who received both magnetic resonance imaging of the brain between 37 and 44 weeks corrected gestational age and developmental assessment around 18 months corrected age. RESULTS No relationships were found between ADC values and MRS results or outcome. MRS ratios involving N-acetyl aspartate (NAA) from the posterior white matter were associated with "severe" and "moderate to severe" difficulties, and fine motor scores were significantly lower in participants with a visible lactate doublet in the posterior white matter. The presence of a patent ductus arteriosus (PDA) was the only clinical factor related to NAA ratios. CONCLUSION Altered NAA levels in the posterior white matter may reflect subtle white matter injury associated with neuro-developmental difficulties, which may be related to a PDA. Further work is needed to assess the longer-term neuro-developmental implications of these findings, and to study the effect of PDAs on developmental outcome in later childhood/adolescence.
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Affiliation(s)
- A R Hart
- Department of Paediatric Neurology and Child Development, Ryegate Children's Centre, Sheffield Children's Hospital NHS Foundation Trust, Tapton Crescent Road, Sheffield S10 5DD, UK.
| | - M F Smith
- Department of Neonatology, Jessop Wing, Sheffield Teaching Hospitals NHS, Foundation Trust, Tree Root Walk, Sheffield S10 2SF, UK
| | - E H Whitby
- Academic Unit of Radiology, University of Sheffield, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
| | - S Alladi
- Department of Paediatric Neurology and Child Development, Ryegate Children's Centre, Sheffield Children's Hospital NHS Foundation Trust, Tapton Crescent Road, Sheffield S10 5DD, UK
| | - S Wilkinson
- Department of Neonatology, Jessop Wing, Sheffield Teaching Hospitals NHS, Foundation Trust, Tree Root Walk, Sheffield S10 2SF, UK
| | - M N Paley
- Academic Unit of Radiology, University of Sheffield, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
| | - P D Griffiths
- Academic Unit of Radiology, University of Sheffield, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
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Aukland SM, Elgen IB, Odberg MD, Chong WK, Eide GE, Rosendahl K. Ventricular dilatation in ex-prematures: only confined to the occipital region? MRI-based normative standards for 19-year-old ex-prematures without major handicaps. Acta Radiol 2014; 55:470-7. [PMID: 23939381 DOI: 10.1177/0284185113497476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Premature birth may be associated with white matter injury later developing with widening of the ventricles. However, population-based data on normal ventricular size by age are sparse, making the evaluation of possible ventricular dilatation difficult. PURPOSE To present the linear measurements of the ventricular system, to compare these to subjectively assessed ventricular size, and to examine differences in ventricular size between ex-prematures and controls. MATERIAL AND METHODS Eligible survivors (n = 113) from the initial birth cohort (n = 217, born in 1986-1988, birth weight <2000 g) underwent MRI during 2006-2007. One hundred and three were ex-premature and included in the study. The ventricular size was subjectively judged by a pediatric neuroradiologist, and scored as normal, mildly, moderately, or severely dilated. Objective measurements, including width and depth of the frontal and occipital horns, were performed in a blinded fashion, by a pediatric radiologist. RESULTS The normative standards for different parts of the ventricular system in ex-premature young adults varied considerably. We found significant associations between the objective measurements and the subjectively classification of ventricular dilatation. Ex-prematures had smaller heads than those born term (control group). After adjustment for head circumference, there were no significant group differences regarding the frontal horns, but the occipital horns were proportionately wider among ex-prematures. CONCLUSION Young adults born prematurely, with a birth weight <2000 g, do not have larger lateral ventricles than healthy controls born term, even after correcting for a smaller head size. However, they do have larger occipital horns, confirming previous studies and strengthening our belief of a specific vulnerability of the occipital region.
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Affiliation(s)
- Stein M Aukland
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Institute of Surgical Sciences, Section for Radiology, University of Bergen, Bergen, Norway
| | - Irene B Elgen
- Institute of Clinical Medicine, Section for Paediatrics, University of Bergen, Bergen, Norway
| | - Morten D Odberg
- Institute of Clinical Medicine, Section for Paediatrics, University of Bergen, Bergen, Norway
| | - W Kling Chong
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Geir E Eide
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
- Department of Public Health and Primary Health Care, University of Bergen, Norway
| | - Karen Rosendahl
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Institute of Surgical Sciences, Section for Radiology, University of Bergen, Bergen, Norway
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Abstract
Magnetic resonance imaging (MRI) is a safe and high-resolution neuroimaging modality that is increasingly used in the neonatal population to assess brain injury and its consequences on brain development. It is superior to cranial ultrasound for the definition of patterns of both white and gray matter maturation and injury and therefore has the potential to provide prognostic information on the neurodevelopmental outcomes of the preterm population. Furthermore, the development of sophisticated MRI strategies, including diffusion tensor imaging, resting state functional connectivity, and magnetic resonance spectroscopy, may increase the prognostic value, helping to guide parental counseling and allocate early intervention services.
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Doesburg SM, Moiseev A, Herdman AT, Ribary U, Grunau RE. Region-Specific Slowing of Alpha Oscillations is Associated with Visual-Perceptual Abilities in Children Born Very Preterm. Front Hum Neurosci 2013; 7:791. [PMID: 24298250 PMCID: PMC3828614 DOI: 10.3389/fnhum.2013.00791] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/30/2013] [Indexed: 01/16/2023] Open
Abstract
Children born very preterm (≤32 weeks gestational age) without major intellectual or neurological impairments often express selective deficits in visual-perceptual abilities. The alterations in neurophysiological development underlying these problems, however, remain poorly understood. Recent research has indicated that spontaneous alpha oscillations are slowed in children born very preterm, and that atypical alpha-mediated functional network connectivity may underlie selective developmental difficulties in visual-perceptual ability in this group. The present study provides the first source-resolved analysis of slowing of spontaneous alpha oscillations in very preterm children, indicating alterations in a distributed set of brain regions concentrated in areas of posterior parietal and inferior temporal regions associated with visual perception, as well as prefrontal cortical regions and thalamus. We also uniquely demonstrate that slowing of alpha oscillations is associated with selective difficulties in visual-perceptual ability in very preterm children. These results indicate that region-specific slowing of alpha oscillations contribute to selective developmental difficulties prevalent in this population.
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Affiliation(s)
- Sam M. Doesburg
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
- Neurosciences & Mental Health Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Alexander Moiseev
- Behavioral and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
| | - Anthony T. Herdman
- Behavioral and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
- Department of Audiology and Speech Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Urs Ribary
- Behavioral and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
| | - Ruth E. Grunau
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
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Wilke M, Hauser TK, Krägeloh-Mann I, Lidzba K. Specific impairment of functional connectivity between language regions in former early preterms. Hum Brain Mapp 2013; 35:3372-84. [PMID: 24243552 DOI: 10.1002/hbm.22408] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 08/08/2013] [Accepted: 09/12/2013] [Indexed: 11/09/2022] Open
Abstract
Very preterm (PT) birth (≤32 weeks of gestation) carries a high risk for an adverse neurodevelopmental outcome. In recent years, the importance of neurocognitive deficits in the language domain has been increasingly recognized, which can be well-characterized using neuropsychological testing and noninvasive imaging approaches. We compared former early PT born children and adolescents (PT, n = 29, 20M) and typically developing children (TD, n = 19, 7M), using conventional fMRI group analyses as well as functional connectivity analyses. We found only small regions with significantly different group activation (PT > TD) but significantly stronger connectivity between superior temporal lobe (STL) language regions in TD participants. There were also significant differences in local and global network efficiency (TD > PT). Surprisingly, there was a stronger connectivity of STL regions with non-STL regions both intrahemispherically and interhemispherically in PT participants, suggesting the coexistence of reduced and increased connectivity in the language network of former PTs. Very similar results were obtained when using task-based versus resting state functional connectivity approaches. Finally, lateralization of functional connectivity correlated with verbal comprehension abilities, suggesting that a more bilateral language comprehension representation is associated with better performance. Our results underline the importance of interhemispheric crosstalk for language comprehension.
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Affiliation(s)
- Marko Wilke
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, Eberhard Karls University Tübingen, Germany; Experimental Pediatric Neuroimaging, Children's Hospital and Department of Neuroradiology, Eberhard Karls University Tübingen, Germany
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Doesburg SM, Chau CM, Cheung TP, Moiseev A, Ribary U, Herdman AT, Miller SP, Cepeda IL, Synnes A, Grunau RE. Neonatal pain-related stress, functional cortical activity and visual-perceptual abilities in school-age children born at extremely low gestational age. Pain 2013; 154:1946-1952. [PMID: 23711638 PMCID: PMC3778166 DOI: 10.1016/j.pain.2013.04.009] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 03/06/2013] [Accepted: 04/02/2013] [Indexed: 01/05/2023]
Abstract
Children born very prematurely (< or =32 weeks) often exhibit visual-perceptual difficulties at school-age, even in the absence of major neurological impairment. The alterations in functional brain activity that give rise to such problems, as well as the relationship between adverse neonatal experience and neurodevelopment, remain poorly understood. Repeated procedural pain-related stress during neonatal intensive care has been proposed to contribute to altered neurocognitive development in these children. Due to critical periods in the development of thalamocortical systems, the immature brain of infants born at extremely low gestational age (ELGA; < or =28 weeks) may have heightened vulnerability to neonatal pain. In a cohort of school-age children followed since birth we assessed relations between functional brain activity measured using magnetoencephalogragy (MEG), visual-perceptual abilities and cumulative neonatal pain. We demonstrated alterations in the spectral structure of spontaneous cortical oscillatory activity in ELGA children at school-age. Cumulative neonatal pain-related stress was associated with changes in background cortical rhythmicity in these children, and these alterations in spontaneous brain oscillations were negatively correlated with visual-perceptual abilities at school-age, and were not driven by potentially confounding neonatal variables. These findings provide the first evidence linking neonatal pain-related stress, the development of functional brain activity, and school-age cognitive outcome in these vulnerable children.
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Affiliation(s)
- Sam M. Doesburg
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Cecil M. Chau
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
| | - Teresa P.L. Cheung
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
- Department of Physics, Simon Fraser University, Burnaby, BC, Canada
- Down Syndrome Research Foundation, Burnaby, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | | | - Urs Ribary
- Down Syndrome Research Foundation, Burnaby, BC, Canada
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Anthony T. Herdman
- Down Syndrome Research Foundation, Burnaby, BC, Canada
- Department of Audiology and Speech Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Steven P. Miller
- Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Neurology, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Ivan L. Cepeda
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
| | - Anne Synnes
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Ruth E. Grunau
- Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Ciambra G, Arachi S, Protano C, Cellitti R, Caoci S, Di Biasi C, Gualdi G, De Curtis M. Accuracy of transcranial ultrasound in the detection of mild white matter lesions in newborns. Neuroradiol J 2013; 26:284-9. [PMID: 23859283 DOI: 10.1177/197140091302600305] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 04/22/2013] [Indexed: 11/16/2022] Open
Abstract
Cranial Ultrasound (cUS) may not be sensitive enough to detect subtle white matter (WM) injuries. Our study compared serial cUS with MRI at term equivalent age (TEA) to determine if it is possible to identify an ultrasound representation of subtle diffuse WM injuries such as punctate lesions (PWMLs) and diffuse excessive high signal intensity (DEHSI). Fifty-six very preterm infants were scanned sequentially from birth to TEA, an MRI was performed at TEA. Each echodensity found on cUS was classified as absent, transient (≤7 days), or prolonged (>7 days). A transient periventricular echodensity was detected in seven infants (12.5%), and a prolonged echodensity in 15 (26.8%). MRI examinations were performed in all 56 infants. No altered signal intensity was found in 18 infants (32.1%). DEHSI was detected in 14 infants (25%), and PWMLs were detected in eight babies (14.3%). Both abnormalities were found in 16 infants (28.6%). The positive predictive values of the prolonged echodensity for DEHSI and PWMLs were 86.7% and 46.7% respectively. However, a significant statistical correspondence (p=0.002, Odds Ratio 11.9) was found comparing DEHSI with cUS abnormal echodensities. Serial cUS during the neonatal period in preterm infants is essential and cannot be replaced with MRI at TEA. MRI seems to be more reliable in detecting mild or moderate WM abnormalities. However, serial cUS performed by an experienced neonatologist can provide valuable information on early WM changes such as prolonged echodensities that could potentially lead to a diffuse injury.
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Affiliation(s)
- G Ciambra
- G. Salesi Pediatric Hospital, Ancona, Italy
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Mirmiran M. Prognostic value of neonatal brain imaging for very low birthweight preterm infants. Dev Med Child Neurol 2013; 55:398-9. [PMID: 23441903 DOI: 10.1111/dmcn.12112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Majid Mirmiran
- Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA, USA
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Lee AY, Jang SH, Lee E, Ahn SH, Cho HK, Jo HM, Son SM. Radiologic differences in white matter maturation between preterm and full-term infants: TBSS study. Pediatr Radiol 2013; 43:612-9. [PMID: 23149651 DOI: 10.1007/s00247-012-2545-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/06/2012] [Accepted: 09/13/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Widespread white matter (WM) pathology in preterm children has been proposed. OBJECTIVE The purpose of this study was to investigate maturational differences of WM between preterm infants with thinning of the corpus callosum and full-term infants. MATERIALS AND METHODS A total of 18 preterm children and 18 full-term children were divided into three subgroups according to the corrected age at the time of diffusion tensor imaging scanning. Tract-based spatial statistics was used for assessing differences in fractional anisotropy (FA) between preterm and full-term children, and between each age-related subgroup in preterm and in full-term children. RESULTS In the preterm group, FA values of overall WM showed an increase with age. This trend indicates that WM maturation is a gradual occurrence during a child's first 2 years. In the full-term group, most WM structures had reached maturation at around 1 year of age; however, centrum semiovale level showed sustained maturation during the first 2 years. CONCLUSION Results of our study demonstrate radiologic maturational differences of WM and provide evidence of the need for therapeutic intervention within 2 years of birth to prevent specific functional impairment and to improve clinical outcome in preterm children.
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Affiliation(s)
- Ah Young Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1 Daemyungdong, Namku, Taegu, South Korea, 705-717
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Byrne E, Campbell SK. Physical therapy observation and assessment in the neonatal intensive care unit. Phys Occup Ther Pediatr 2013; 33:39-74. [PMID: 23311522 DOI: 10.3109/01942638.2012.754827] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This article presents the elements of the Observation and Assessment section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy assessments presented in this path are evidence-based and the suggested timing of these assessments is primarily based on practice knowledge from expert therapists, with supporting evidence cited. Assessment in the NICU begins with a thorough review of the health care record. Assessment proceeds by using the least invasive methods of gathering the behavioral, developmental, physiologic, and musculoskeletal information needed to implement a physical therapy plan of care. As the neonate matures and can better tolerate handling, assessment methods include lengthier standardized tests with the psychometric properties needed for informing diagnosis and intervention planning. Standardized tests and measures for screening, diagnosis, and developmental assessment are appraised and special considerations for assessment of neonates in the NICU are discussed.
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Affiliation(s)
- Eilish Byrne
- Neonatal Intensive Care Unit, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA 94304, USA.
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Jo HM, Cho HK, Jang SH, Yeo SS, Lee E, Kim HS, Son SM. A comparison of microstructural maturational changes of the corpus callosum in preterm and full-term children: a diffusion tensor imaging study. Neuroradiology 2012; 54:997-1005. [PMID: 22562691 DOI: 10.1007/s00234-012-1042-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 04/19/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Preterm children with thinning of the corpus callosum (CC) frequently achieve poor neurodevelopmental outcomes despite the absence of a definite brain lesion. Here, the authors compared the microstructural characteristics of the CC in preterm and full-term children using diffusion tensor imaging (DTI). METHODS Twenty-two preterm children with no definite focal lesion but with thinning of the CC by conventional magnetic resonance imaging and 23 age-matched full-term children were investigated by DTI. CCs were subdivided into genu, rostral body, body, isthmus, and splenium, and voxel counts (VC), fractional anisotropies (FA), and apparent diffusion coefficients (ADC) were measured in each subdivision. Eleven preterm and 11 age-matched full-term subjects underwent follow-up scanning and interval changes in these parameters for each subdivision were compared. RESULTS VC and FA were significantly lower in the preterm group than in the full-term group, particularly in the isthmus. Furthermore, incremental changes in VC and FA were significantly smaller in the preterm group. Differences in maturation between the two groups were more pronounced with age in all subdivisions except the splenium. At all ages, noticeable FA differences between the two groups were observed in the isthmus. For white matter tracts, the preterm group displayed lower FA and fiber number, higher ADC values than the term group. CONCLUSIONS The present study shows that thinning of the CC is correlated with lower FA value and that it is more pronounced in preterm children. In addition, the isthmus was found to be the most vulnerable subdivision in preterm children.
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Affiliation(s)
- Hae Min Jo
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, University 317-1, Daemyungdong, Namku, Taegu 705-717, Republic of Korea
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Iwata S, Nakamura T, Hizume E, Kihara H, Takashima S, Matsuishi T, Iwata O. Qualitative brain MRI at term and cognitive outcomes at 9 years after very preterm birth. Pediatrics 2012; 129:e1138-47. [PMID: 22529280 DOI: 10.1542/peds.2011-1735] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE A prospective study was performed to assess the relationship between the appearance of cerebral MRI at term and the cognitive functioning at 9 years old in very preterm born infants. METHODS Seventy-six very preterm born infants (birth weight <1500 g or gestational age ≤32 weeks) obtained cerebral MRI at term-equivalent period, which was assessed by using established composite scores for the white and gray matter; cognitive outcomes at 9 years old were assessed in 60 subjects by using Wechsler Intelligence Scale for Children, Third Edition. RESULTS Mildly low scores on the different IQ indices (<85) were observed in 23.3% (verbal IQ), 41.7% (performance IQ), and 30.0% (full-scale IQ) of the cohort, whereas moderately low scores (<70) were noted in 3.3% (verbal IQ), 11.7% (performance IQ), and 11.7% (full-scale IQ); cerebral palsy was diagnosed in 10.0%, whereas special assistance at school was required in 56.7%. Abnormal white matter appearances predicted mildly low verbal, performance, and full-scale IQs; moderately low performance and full-scale IQs; cerebral palsy; and the requirement for special assistance at school. Abnormal white matter appearances predicted mild cognitive impairment even after the adjustment for known clinical risk factors. In contrast, abnormal gray matter appearances did not predict any of the outcome measures. CONCLUSIONS In a cohort of very preterm born infants, abnormal white matter appearance on term MRI showed consistent associations with cognitive impairments at 9 years old, further supporting the benefit of obtaining term MRI for very preterm born infants.
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Affiliation(s)
- Sachiko Iwata
- Centre for Developmental & Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011 Japan
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Differential brain development with low and high IQ in attention-deficit/hyperactivity disorder. PLoS One 2012; 7:e35770. [PMID: 22536435 PMCID: PMC3335015 DOI: 10.1371/journal.pone.0035770] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 03/26/2012] [Indexed: 01/20/2023] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) and intelligence (IQ) are both heritable phenotypes. Overlapping genetic effects have been suggested to influence both, with neuroimaging work suggesting similar overlap in terms of morphometric properties of the brain. Together, this evidence suggests that the brain changes characteristic of ADHD may vary as a function of IQ. This study investigated this hypothesis in a sample of 108 children with ADHD and 106 typically developing controls, who participated in a cross-sectional anatomical MRI study. A subgroup of 64 children also participated in a diffusion tensor imaging scan. Brain volumes, local cortical thickness and average cerebral white matter microstructure were analyzed in relation to diagnostic group and IQ. Dimensional analyses investigated possible group differences in the relationship between anatomical measures and IQ. Second, the groups were split into above and below median IQ subgroups to investigate possible differences in the trajectories of cortical development. Dimensionally, cerebral gray matter volume and cerebral white matter microstructure were positively associated with IQ for controls, but not for ADHD. In the analyses of the below and above median IQ subgroups, we found no differences from controls in cerebral gray matter volume in ADHD with below-median IQ, but a delay of cortical development in a number of regions, including prefrontal areas. Conversely, in ADHD with above-median IQ, there were significant reductions from controls in cerebral gray matter volume, but no local differences in the trajectories of cortical development. In conclusion, the basic relationship between IQ and neuroanatomy appears to be altered in ADHD. Our results suggest that there may be multiple brain phenotypes associated with ADHD, where ADHD combined with above median IQ is characterized by small, more global reductions in brain volume that are stable over development, whereas ADHD with below median IQ is associated more with a delay of cortical development.
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Northam GB, Liégeois F, Chong WK, Baker K, Tournier JD, Wyatt JS, Baldeweg T, Morgan A. Speech and oromotor outcome in adolescents born preterm: relationship to motor tract integrity. J Pediatr 2012; 160:402-408.e1. [PMID: 22000302 PMCID: PMC3657185 DOI: 10.1016/j.jpeds.2011.08.055] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 05/31/2011] [Accepted: 08/25/2011] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess speech abilities in adolescents born preterm and investigate whether there is an association between specific speech deficits and brain abnormalities. STUDY DESIGN Fifty adolescents born prematurely (<33 weeks' gestation) with a spectrum of brain injuries were recruited (mean age, 16 years). Speech examination included tests of speech-sound processing and production and speech and oromotor control. Conventional magnetic resonance imaging and diffusion-weighted imaging was acquired in all adolescents born preterm and 30 term-born control subjects. Radiological ratings of brain injury were recorded and the integrity of the primary motor projections was measured (corticospinal tract and speech-motor corticobulbar tract [CST/CBT]). RESULTS There were no clinical diagnoses of developmental dysarthria, dyspraxia, or a speech-sound disorder, but difficulties in speech and oromotor control were common. A regression analysis revealed that presence of a neurologic impairment, and diffusion-weighted imaging abnormalities in the left CST/CBT were significant independent predictors of poor speech and oromotor outcome. These left-lateralized abnormalities were most evident at the level of the posterior limb of the internal capsule. CONCLUSION Difficulties in speech and oromotor control are common in adolescents born preterm, and adolescents with injury to the CST/CBT pathways in the left-hemisphere may be most at risk.
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Key Words
- cbt, corticobulbar tract
- cst, corticospinal tract
- cus, cranial ultrasound scanning
- dwi, diffusion-weighted imaging
- fa, fractional anisotropy
- foc, focal oromotor control
- fsiq, full-scale iq
- hpi, hemorrhagic parenchymal infarction
- ivh, intraventricular hemorrhage
- mri, magnetic resonance imaging
- plic, posterior limb of the internal capsule
- vmpac, verbal motor production assessment for children
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Affiliation(s)
- Gemma B. Northam
- UCL Institute of Child Health, London, United Kingdom,Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom,Reprint requests: Gemma B. Northam, MSc, Developmental Cognitive Neuroscience Unit, UCL Institute of Child Health, London, WC1N 1EH, United Kingdom.
| | - Frédérique Liégeois
- UCL Institute of Child Health, London, United Kingdom,Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Wui K. Chong
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Kate Baker
- UCL Institute of Child Health, London, United Kingdom
| | | | - John S. Wyatt
- UCL Institute for Women’s Health, London, United Kingdom
| | - Torsten Baldeweg
- UCL Institute of Child Health, London, United Kingdom,Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Angela Morgan
- Murdoch Childrens Research Institute, Melbourne, Australia,Royal Children’s Hospital, Melbourne, Australia
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Knickmeyer RC, Kang C, Woolson S, Smith JK, Hamer RM, Lin W, Gerig G, Styner M, Gilmore JH. Twin-singleton differences in neonatal brain structure. Twin Res Hum Genet 2012; 14:268-76. [PMID: 21623657 DOI: 10.1375/twin.14.3.268] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Twin studies suggest that global and regional brain volumes are highly heritable. However, estimates of heritability vary across development. Given that all twin studies are open to the potential criticism of non-generalizability due to differences in intrauterine environment between twins and singletons, these age effects may reflect the influence of perinatal environmental factors, which are unique to twins and which may be especially evident early in life. To address this question, we compared brain volumes and the relationship of brain volumes to gestational age in 136 singletons (67 male, 69 female) and 154 twins (75 male, 79 female; 82 DZ, 72 MZ) who had received high resolution MRI scans of the brain in the first month of life. Intracranial volume, total white matter, and ventricle volumes did not differ between twins and singletons. However, cerebrospinal fluid and frontal white matter volume was greater in twins compared to singletons. While gray matter volumes at MRI did not differ between groups, the slope of the relationship between total and cortical gray matter and gestational age at the MRI scan was steeper in MZ twins compared to DZ twins. Post-hoc analyses suggested that gray matter development is delayed in MZ twins in utero and that they experience 'catch-up' growth in the first month of life. These differences should be taken into account when interpreting and designing studies in the early postnatal period.
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Affiliation(s)
- Rebecca C Knickmeyer
- Department of Psychiatry, University of North Carolina, United States of America.
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Moon IJ, Kim EY, Park GY, Jang MS, Kim JH, Lee J, Chung WH, Cho YS, Hong SH. The Clinical Significance of Preoperative Brain Magnetic Resonance Imaging in Pediatric Cochlear Implant Recipients. ACTA ACUST UNITED AC 2012; 17:373-80. [DOI: 10.1159/000341818] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 07/09/2012] [Indexed: 11/19/2022]
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Neurocognitive development in preterm infants: Insights from different approaches. Neurosci Biobehav Rev 2012; 36:536-55. [DOI: 10.1016/j.neubiorev.2011.08.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 08/23/2011] [Accepted: 08/29/2011] [Indexed: 11/22/2022]
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Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome. Pediatr Radiol 2012; 42 Suppl 1:S33-61. [PMID: 22395719 PMCID: PMC4517479 DOI: 10.1007/s00247-011-2239-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 08/08/2011] [Accepted: 08/08/2011] [Indexed: 01/24/2023]
Abstract
For typically developing infants, the last trimester of fetal development extending into the first post-natal months is a period of rapid brain development. Infants who are born premature face significant risk of brain injury (e.g., intraventricular or germinal matrix hemorrhage and periventricular leukomalacia) from complications in the perinatal period and also potential long-term neurodevelopmental disabilities because these early injuries can interrupt normal brain maturation. Neuroimaging has played an important role in the diagnosis and management of the preterm infant. Both cranial US and conventional MRI techniques are useful in diagnostic and prognostic evaluation of preterm brain development and injury. Cranial US is highly sensitive for intraventricular hemorrhage (IVH) and provides prognostic information regarding cerebral palsy. Data are limited regarding the utility of MRI as a routine screening instrument for brain injury for all preterm infants. However, MRI might provide diagnostic or prognostic information regarding PVL and other types of preterm brain injury in the setting of specific clinical indications and risk factors. Further development of advanced MR techniques like volumetric MR imaging, diffusion tensor imaging, metabolic imaging (MR spectroscopy) and functional connectivity are necessary to provide additional insight into the molecular, cellular and systems processes that underlie brain development and outcome in the preterm infant. The adult concept of the "connectome" is also relevant in understanding brain networks that underlie the preterm brain. Knowledge of the preterm connectome will provide a framework for understanding preterm brain function and dysfunction, and potentially even a roadmap for brain plasticity. By combining conventional imaging techniques with more advanced techniques, neuroimaging findings will likely be used not only as diagnostic and prognostic tools, but also as biomarkers for long-term neurodevelopmental outcomes, instruments to assess the efficacy of neuroprotective agents and maneuvers in the NICU, and as screening instruments to appropriately select infants for longitudinal developmental interventions.
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de Bruïne FT, van den Berg-Huysmans AA, Leijser LM, Rijken M, Steggerda SJ, van der Grond J, van Wezel-Meijler G. Clinical Implications of MR Imaging Findings in the White Matter in Very Preterm Infants: A 2-year Follow-up Study. Radiology 2011; 261:899-906. [PMID: 22031710 DOI: 10.1148/radiol.11110797] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Francisca T de Bruïne
- Department of Radiology and Pediatrics, Subdivision of Neonatology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, the Netherlands
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Allin MPG, Kontis D, Walshe M, Wyatt J, Barker GJ, Kanaan RAA, McGuire P, Rifkin L, Murray RM, Nosarti C. White matter and cognition in adults who were born preterm. PLoS One 2011; 6:e24525. [PMID: 22022357 PMCID: PMC3192037 DOI: 10.1371/journal.pone.0024525] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 08/12/2011] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Individuals born very preterm (before 33 weeks of gestation, VPT) are at risk of damage to developing white matter, which may affect later cognition and behaviour. METHODS We used diffusion tensor MRI (DT-MRI) to assess white matter microstructure (fractional anisotropy; FA) in 80 VPT and 41 term-born individuals (mean age 19.1 years, range 17-22, and 18.5 years, range 17-22 years, respectively). VPT individuals were part of a 1982-1984 birth cohort which had been followed up since birth; term individuals were recruited by local press advertisement. General intellectual function, executive function and memory were assessed. RESULTS The VPT group had reduced FA in four clusters, and increased FA in four clusters relative to the Term group, involving several association tracts of both hemispheres. Clusters of increased FA were associated with more severe neonatal brain injury in the VPT group. Clusters of reduced FA were associated with lower birth weight and perinatal hypoxia, and with reduced adult cognitive performance in the VPT group only. CONCLUSIONS Alterations of white matter microstructure persist into adulthood in VPT individuals and are associated with cognitive function.
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Affiliation(s)
- Matthew P G Allin
- King's Health Partners, King's College London, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom.
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Hart A, Whitby E, Wilkinson S, Alladi S, Paley M, Smith M. Neuro-developmental outcome at 18 months in premature infants with diffuse excessive high signal intensity on MR imaging of the brain. Pediatr Radiol 2011; 41:1284-92. [PMID: 21681616 DOI: 10.1007/s00247-011-2155-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 01/01/2011] [Accepted: 03/28/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Diffuse excessive high signal intensity (DEHSI) may represent damage to the white matter in preterm infants, but may be best studied alongside quantitative markers. Limited published data exists on its neuro-developmental implications. OBJECTIVE The purpose of this study was to assess whether preterm children with DEHSI at term-corrected age have abnormal neuro-developmental outcome. MATERIALS AND METHODS This was a prospective observational study of 67 preterm infants with MRI of the brain around term-equivalent age, including diffusion-weighted imaging (DWI). Images were reported as being normal, overtly abnormal or to show DEHSI. A single observer placed six regions of interest in the periventricular white matter and calculated the apparent diffusion coefficients (ADC). DEHSI was defined as (1) high signal on T2-weighted images alone, (2) high signal with raised ADC values or (3) raised ADC values independent of visual appearances. The neuro-development was assessed around 18 months' corrected age using the Bayley Scales of Infant and Toddler Development (3rd Edition). Standard t tests compared outcome scores between imaging groups. RESULTS No statistically significant difference in neuro-developmental outcome scores was seen between participants with normal MRI and DEHSI, regardless of which definition was used. CONCLUSION Preterm children with DEHSI have similar neuro-developmental outcome to those with normal brain MRI, even if the definition includes objective markers alongside visual appearances.
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Affiliation(s)
- Anthony Hart
- Department of Neonatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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Abstract
AIM To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon. METHOD One hundred and six very preterm children (63 males, 43 females; gestational age 24.0-31.6 wk; birthweight 480-2275 g) were assessed for cognition and motor outcome at 6 to 12 years. We assessed total, verbal, and performance IQ using the Wechsler Intelligence Scale for Children, and motor outcome using the Movement Assessment Battery for Children (Movement ABC). RESULTS The IQs and Movement ABC z-scores were normally distributed, but shifted to the left. Mean total IQ (SD) was 91 (12), performance IQ 89 (13), and verbal IQ 93 (15), being 0.60, 0.73, and 0.47 SD lower than the norm respectively. Movement ABC z-scores were -1.27 SD lower (SD 1.01). IQ and Movement ABC z-scores did not correlate with brain lesions or gestational age. INTERPRETATION The distribution curve for cognition and motor outcome at school age is shifted to the left in preterm children, with an effect size of 0.60 SD for IQ (nine IQ points) and 1.27 SD for motor outcome. These findings are restricted to the current group. Developmental disruptions, affecting cerebral white matter, cortex, cerebellum, and thalamus might be involved, although the exact pathogenetic mechanism is unclear.
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Affiliation(s)
- Arend F Bos
- Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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50
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Doesburg SM, Ribary U, Herdman AT, Moiseev A, Cheung T, Miller SP, Poskitt KJ, Weinberg H, Whitfield MF, Synnes A, Grunau RE. Magnetoencephalography reveals slowing of resting peak oscillatory frequency in children born very preterm. Pediatr Res 2011; 70:171-5. [PMID: 21544009 PMCID: PMC3150785 DOI: 10.1203/pdr.0b013e3182225a9e] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Resting cortical activity is characterized by a distinct spectral peak in the alpha frequency range. Slowing of this oscillatory peak toward the upper theta-band has been associated with a variety of neurological and neuropsychiatric conditions and has been attributed to altered thalamocortical dynamics. Children born very preterm exhibit altered development of thalamocortical systems. To test the hypothesis that peak oscillatory frequency is slowed in children born very preterm, we recorded resting magnetoencephalography (MEG) from school age children born very preterm (≤ 32 wk gestation) without major intellectual or neurological impairment and age-matched full-term controls. Very preterm children exhibit a slowing of peak frequency toward the theta-band over bilateral frontal cortex, together with reduced alpha-band power over bilateral frontal and temporal cortex, suggesting that mildly dysrhythmic thalamocortical interactions may contribute to altered spontaneous cortical activity in children born very preterm.
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Affiliation(s)
- Sam M Doesburg
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto M5G 1X8, Canada.
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