1
|
Mao W, Chen Y, He Z, Wang Z, Xiao Z, Sun Y, He L, Zhou J, Guo W, Ma C, Zhao L, Kendrick KM, Zhou B, Becker B, Liu T, Zhang T, Jiang X. Brain Structural Connectivity Guided Vision Transformers for Identification of Functional Connectivity Characteristics in Preterm Neonates. IEEE J Biomed Health Inform 2024; 28:2223-2234. [PMID: 38285570 DOI: 10.1109/jbhi.2024.3355020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Preterm birth is the leading cause of death in children under five years old, and is associated with a wide sequence of complications in both short and long term. In view of rapid neurodevelopment during the neonatal period, preterm neonates may exhibit considerable functional alterations compared to term ones. However, the identified functional alterations in previous studies merely achieve moderate classification performance, while more accurate functional characteristics with satisfying discrimination ability for better diagnosis and therapeutic treatment is underexplored. To address this problem, we propose a novel brain structural connectivity (SC) guided Vision Transformer (SCG-ViT) to identify functional connectivity (FC) differences among three neonatal groups: preterm, preterm with early postnatal experience, and term. Particularly, inspired by the neuroscience-derived information, a novel patch token of SC/FC matrix is defined, and the SC matrix is then adopted as an effective mask into the ViT model to screen out input FC patch embeddings with weaker SC, and to focus on stronger ones for better classification and identification of FC differences among the three groups. The experimental results on multi-modal MRI data of 437 neonatal brains from publicly released Developing Human Connectome Project (dHCP) demonstrate that SCG-ViT achieves superior classification ability compared to baseline models, and successfully identifies holistically different FC patterns among the three groups. Moreover, these different FCs are significantly correlated with the differential gene expressions of the three groups. In summary, SCG-ViT provides a powerfully brain-guided pipeline of adopting large-scale and data-intensive deep learning models for medical imaging-based diagnosis.
Collapse
|
2
|
Pinto CR, Duarte JV, Marques C, Vicente IN, Paiva C, Éloi J, Pereira DJ, Correia BR, Castelo-Branco M, Oliveira G. The role of early functional neuroimaging in predicting neurodevelopmental outcomes in neonatal encephalopathy. Eur J Pediatr 2023; 182:1191-1200. [PMID: 36607412 PMCID: PMC10023620 DOI: 10.1007/s00431-022-04778-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023]
Abstract
Reliably assessing the early neurodevelopmental outcomes in infants with neonatal encephalopathy (NE) is of utmost importance to advise parents and implement early and personalized interventions. We aimed to evaluate the accuracy of neuroimaging modalities, including functional magnetic resonance imaging (fMRI) in predicting neurodevelopmental outcomes in NE. Eighteen newborns with NE due to presumed perinatal asphyxia (PA) were included in the study, 16 of whom underwent therapeutic hypothermia. Structural magnetic resonance imaging (MRI), and fMRI during passive visual, auditory, and sensorimotor stimulation were acquired between the 10th and 14th day of age. Clinical follow-up protocol included visual and auditory evoked potentials and a detailed neurodevelopmental evaluation at 12 and 18 months of age. Infants were divided according to sensory and neurodevelopmental outcome: severe, moderate disability, or normal. Structural MRI findings were the best predictor of severe disability with an AUC close to 1.0. There were no good predictors to discriminate between moderate disability versus normal outcome. Nevertheless, structural MRI measures showed a significant correlation with the scores of neurodevelopmental assessments. During sensorimotor stimulation, the fMRI signal in the right hemisphere had an AUC of 0.9 to predict absence of cerebral palsy (CP). fMRI measures during auditory and visual stimulation did not predict sensorineural hearing loss or cerebral visual impairment. CONCLUSION In addition to structural MRI, fMRI with sensorimotor stimulation may open the gate to improve the knowledge of neurodevelopmental/motor prognosis if proven in a larger cohort of newborns with NE. WHAT IS KNOWN • Establishing an early, accurate neurodevelopmental prognosis in neonatal encephalopathy remains challenging. • Although structural MRI has a central role in neonatal encephalopathy, advanced MRI modalities are gradually being explored to optimize neurodevelopmental outcome knowledge. WHAT IS NEW • Newborns who later developed cerebral palsy had a trend towards lower fMRI measures in the right sensorimotor area during sensorimotor stimulation. • These preliminary fMRI results may improve future early delineation of motor prognosis in neonatal encephalopathy.
Collapse
Affiliation(s)
- Carla R Pinto
- Pediatric Intensive Care Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Avenida Afonso Romão, Coimbra, 3000-602, Portugal.
- University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.
| | - João V Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Carla Marques
- Child Developmental Center, Research and Clinical Training Center, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Inês N Vicente
- Child Developmental Center, Research and Clinical Training Center, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Catarina Paiva
- Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - João Éloi
- Otorhinolaryngology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Daniela J Pereira
- Neuroradiology Unit, Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bárbara R Correia
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Quantitative Methods, Information and Management Systems Department, Coimbra Business School, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Guiomar Oliveira
- University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Child Developmental Center, Research and Clinical Training Center, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| |
Collapse
|
3
|
Petanjek Z, Banovac I, Sedmak D, Hladnik A. Dendritic Spines: Synaptogenesis and Synaptic Pruning for the Developmental Organization of Brain Circuits. ADVANCES IN NEUROBIOLOGY 2023; 34:143-221. [PMID: 37962796 DOI: 10.1007/978-3-031-36159-3_4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Synaptic overproduction and elimination is a regular developmental event in the mammalian brain. In the cerebral cortex, synaptic overproduction is almost exclusively correlated with glutamatergic synapses located on dendritic spines. Therefore, analysis of changes in spine density on different parts of the dendritic tree in identified classes of principal neurons could provide insight into developmental reorganization of specific microcircuits.The activity-dependent stabilization and selective elimination of the initially overproduced synapses is a major mechanism for generating diversity of neural connections beyond their genetic determination. The largest number of overproduced synapses was found in the monkey and human cerebral cortex. The highest (exceeding adult values by two- to threefold) and most protracted overproduction (up to third decade of life) was described for associative layer IIIC pyramidal neurons in the human dorsolateral prefrontal cortex.Therefore, the highest proportion and extraordinarily extended phase of synaptic spine overproduction is a hallmark of neural circuitry in human higher-order associative areas. This indicates that microcircuits processing the most complex human cognitive functions have the highest level of developmental plasticity. This finding is the backbone for understanding the effect of environmental impact on the development of the most complex, human-specific cognitive and emotional capacities, and on the late onset of human-specific neuropsychiatric disorders, such as autism and schizophrenia.
Collapse
Affiliation(s)
- Zdravko Petanjek
- Department of Anatomy and Clinical Anatomy, School of Medicine, University of Zagreb, Zagreb, Croatia.
- Department of Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia.
- Center of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Ivan Banovac
- Department of Anatomy and Clinical Anatomy, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
- Center of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Dora Sedmak
- Department of Anatomy and Clinical Anatomy, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
- Center of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Hladnik
- Department of Anatomy and Clinical Anatomy, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
- Center of Excellence for Basic, Clinical and Translational Neuroscience, School of Medicine, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
4
|
Ciarrusta J, Christiaens D, Fitzgibbon SP, Dimitrova R, Hutter J, Hughes E, Duff E, Price AN, Cordero-Grande L, Tournier JD, Rueckert D, Hajnal JV, Arichi T, McAlonan G, Edwards AD, Batalle D. The developing brain structural and functional connectome fingerprint. Dev Cogn Neurosci 2022; 55:101117. [PMID: 35662682 PMCID: PMC9344310 DOI: 10.1016/j.dcn.2022.101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/14/2022] [Accepted: 05/17/2022] [Indexed: 11/03/2022] Open
Abstract
In the mature brain, structural and functional 'fingerprints' of brain connectivity can be used to identify the uniqueness of an individual. However, whether the characteristics that make a given brain distinguishable from others already exist at birth remains unknown. Here, we used neuroimaging data from the developing Human Connectome Project (dHCP) of preterm born neonates who were scanned twice during the perinatal period to assess the developing brain fingerprint. We found that 62% of the participants could be identified based on the congruence of the later structural connectome to the initial connectivity matrix derived from the earlier timepoint. In contrast, similarity between functional connectomes of the same subject at different time points was low. Only 10% of the participants showed greater self-similarity in comparison to self-to-other-similarity for the functional connectome. These results suggest that structural connectivity is more stable in early life and can represent a potential connectome fingerprint of the individual: a relatively stable structural connectome appears to support a changing functional connectome at a time when neonates must rapidly acquire new skills to adapt to their new environment.
Collapse
Affiliation(s)
- Judit Ciarrusta
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom; Center for Brain and Cognition (CBC), Universitat Pompeu Fabra, Barcelona, Spain
| | - Daan Christiaens
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom; Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Sean P Fitzgibbon
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Ralica Dimitrova
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Jana Hutter
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Emer Hughes
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Eugene Duff
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK; Paediatric Neuroimaging Group, Department of Paediatrics, University of Oxford, UK
| | - Anthony N Price
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom; Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, Spain
| | - J-Donald Tournier
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Daniel Rueckert
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, United Kingdom; Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom; Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom; Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - Grainne McAlonan
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom
| | - A David Edwards
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom
| | - Dafnis Batalle
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| |
Collapse
|
5
|
Ciarrusta J, Dimitrova R, McAlonan G. Early maturation of the social brain: How brain development provides a platform for the acquisition of social-cognitive competence. PROGRESS IN BRAIN RESEARCH 2020; 254:49-70. [PMID: 32859293 DOI: 10.1016/bs.pbr.2020.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Across the last century psychology has provided a lot of insight about social-cognitive competence. Recognizing facial expressions, joint attention, discrimination of cues and experiencing empathy are just a few examples of the social skills humans acquire from birth to adolescence. However, how very early brain maturation provides a platform to support the attainment of highly complex social behavior later in development remains poorly understood. Magnetic Resonance Imaging provides a safe means to investigate the typical and atypical maturation of regions of the brain responsible for social cognition in as early as the perinatal period. Here, we first review some technical challenges and advances of using functional magnetic resonance imaging on developing infants to then describe current knowledge on the development of diverse systems associated with social function. We will then explain how these characteristics might differ in infants with genetic or environmental risk factors, who are vulnerable to atypical neurodevelopment. Finally, given the rapid early development of systems necessary for social skills, we propose a new framework to investigate sensitive time windows of development when neural substrates might be more vulnerable to impairment due to a genetic or environmental insult.
Collapse
Affiliation(s)
- Judit Ciarrusta
- Centre for the Developing Brain, School Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom; Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ralica Dimitrova
- Centre for the Developing Brain, School Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom; Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Grainne McAlonan
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom.
| |
Collapse
|
6
|
Kostović I. The enigmatic fetal subplate compartment forms an early tangential cortical nexus and provides the framework for construction of cortical connectivity. Prog Neurobiol 2020; 194:101883. [PMID: 32659318 DOI: 10.1016/j.pneurobio.2020.101883] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 12/19/2022]
Abstract
The most prominent transient compartment of the primate fetal cortex is the deep, cell-sparse, synapse-containing subplate compartment (SPC). The developmental role of the SPC and its extraordinary size in humans remain enigmatic. This paper evaluates evidence on the development and connectivity of the SPC and discusses its role in the pathogenesis of neurodevelopmental disorders. A synthesis of data shows that the subplate becomes a prominent compartment by its expansion from the deep cortical plate (CP), appearing well-delineated on MR scans and forming a tangential nexus across the hemisphere, consisting of an extracellular matrix, randomly distributed postmigratory neurons, multiple branches of thalamic and long corticocortical axons. The SPC generates early spontaneous non-synaptic and synaptic activity and mediates cortical response upon thalamic stimulation. The subplate nexus provides large-scale interareal connectivity possibly underlying fMR resting-state activity, before corticocortical pathways are established. In late fetal phase, when synapses appear within the CP, transient the SPC coexists with permanent circuitry. The histogenetic role of the SPC is to provide interactive milieu and capacity for guidance, sorting, "waiting" and target selection of thalamocortical and corticocortical pathways. The new evolutionary role of the SPC and its remnant white matter neurons is linked to the increasing number of associative pathways in the human neocortex. These roles attributed to the SPC are regulated using a spatiotemporal gene expression during critical periods, when pathogenic factors may disturb vulnerable circuitry of the SPC, causing neurodevelopmental cognitive circuitry disorders.
Collapse
Affiliation(s)
- Ivica Kostović
- Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, Salata 12, 10000 Zagreb, Croatia.
| |
Collapse
|
7
|
Vasung L, Abaci Turk E, Ferradal SL, Sutin J, Stout JN, Ahtam B, Lin PY, Grant PE. Exploring early human brain development with structural and physiological neuroimaging. Neuroimage 2019; 187:226-254. [PMID: 30041061 PMCID: PMC6537870 DOI: 10.1016/j.neuroimage.2018.07.041] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 12/11/2022] Open
Abstract
Early brain development, from the embryonic period to infancy, is characterized by rapid structural and functional changes. These changes can be studied using structural and physiological neuroimaging methods. In order to optimally acquire and accurately interpret this data, concepts from adult neuroimaging cannot be directly transferred. Instead, one must have a basic understanding of fetal and neonatal structural and physiological brain development, and the important modulators of this process. Here, we first review the major developmental milestones of transient cerebral structures and structural connectivity (axonal connectivity) followed by a summary of the contributions from ex vivo and in vivo MRI. Next, we discuss the basic biology of neuronal circuitry development (synaptic connectivity, i.e. ensemble of direct chemical and electrical connections between neurons), physiology of neurovascular coupling, baseline metabolic needs of the fetus and the infant, and functional connectivity (defined as statistical dependence of low-frequency spontaneous fluctuations seen with functional magnetic resonance imaging (fMRI)). The complementary roles of magnetic resonance imaging (MRI), electroencephalography (EEG), magnetoencephalography (MEG), and near-infrared spectroscopy (NIRS) are discussed. We include a section on modulators of brain development where we focus on the placenta and emerging placental MRI approaches. In each section we discuss key technical limitations of the imaging modalities and some of the limitations arising due to the biology of the system. Although neuroimaging approaches have contributed significantly to our understanding of early brain development, there is much yet to be done and a dire need for technical innovations and scientific discoveries to realize the future potential of early fetal and infant interventions to avert long term disease.
Collapse
Affiliation(s)
- Lana Vasung
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Esra Abaci Turk
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Silvina L Ferradal
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Jason Sutin
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Jeffrey N Stout
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Banu Ahtam
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Pei-Yi Lin
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - P Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| |
Collapse
|
8
|
Smyser CD, Wheelock MD, Limbrick DD, Neil JJ. Neonatal brain injury and aberrant connectivity. Neuroimage 2019; 185:609-623. [PMID: 30059733 PMCID: PMC6289815 DOI: 10.1016/j.neuroimage.2018.07.057] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 06/21/2018] [Accepted: 07/24/2018] [Indexed: 12/12/2022] Open
Abstract
Brain injury sustained during the neonatal period may disrupt development of critical structural and functional connectivity networks leading to subsequent neurodevelopmental impairment in affected children. These networks can be characterized using structural (via diffusion MRI) and functional (via resting state-functional MRI) neuroimaging techniques. Advances in neuroimaging have led to expanded application of these approaches to study term- and prematurely-born infants, providing improved understanding of cerebral development and the deleterious effects of early brain injury. Across both modalities, neuroimaging data are conducive to analyses ranging from characterization of individual white matter tracts and/or resting state networks through advanced 'connectome-style' approaches capable of identifying highly connected network hubs and investigating metrics of network topology such as modularity and small-worldness. We begin this review by summarizing the literature detailing structural and functional connectivity findings in healthy term and preterm infants without brain injury during the postnatal period, including discussion of early connectome development. We then detail common forms of brain injury in term- and prematurely-born infants. In this context, we next review the emerging body of literature detailing studies employing diffusion MRI, resting state-functional MRI and other complementary neuroimaging modalities to characterize structural and functional connectivity development in infants with brain injury. We conclude by reviewing technical challenges associated with neonatal neuroimaging, highlighting those most relevant to studying infants with brain injury and emphasizing the need for further targeted study in this high-risk population.
Collapse
Affiliation(s)
- Christopher D Smyser
- Departments of Neurology, Pediatrics and Radiology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO, 63110, USA.
| | - Muriah D Wheelock
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO, 63110, USA.
| | - David D Limbrick
- Departments of Neurosurgery and Pediatrics, Washington University School of Medicine, One Children's Place, Suite S20, St. Louis, MO, 63110, USA.
| | - Jeffrey J Neil
- Department of Pediatric Neurology, Boston Children's Hospital, 300 Longwood Avenue, BCH3443, Boston, MA, 02115, USA.
| |
Collapse
|
9
|
Counsell SJ, Arichi T, Arulkumaran S, Rutherford MA. Fetal and neonatal neuroimaging. HANDBOOK OF CLINICAL NEUROLOGY 2019; 162:67-103. [PMID: 31324329 DOI: 10.1016/b978-0-444-64029-1.00004-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Magnetic resonance imaging (MRI) can provide detail of the soft tissues of the fetal and neonatal brain that cannot be obtained by any other imaging modality. Conventional T1 and T2 weighted sequences provide anatomic detail of the normally developing brain and can demonstrate lesions, including those associated with preterm birth, hypoxic ischemic encephalopathy, perinatal arterial stroke, infections, and congenital malformations. Specialized imaging techniques can be used to assess cerebral vasculature (magnetic resonance angiography and venography), cerebral metabolism (magnetic resonance spectroscopy), cerebral perfusion (arterial spin labeling), and function (functional MRI). A wealth of quantitative tools, most of which were originally developed for the adult brain, can be applied to study the developing brain in utero and postnatally including measures of tissue microstructure obtained from diffusion MRI, morphometric studies to measure whole brain and regional tissue volumes, and automated approaches to study cortical folding. In this chapter, we aim to describe different imaging approaches for the fetal and neonatal brain, and to discuss their use in a range of clinical applications.
Collapse
Affiliation(s)
- Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Sophie Arulkumaran
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| |
Collapse
|
10
|
Wilke M, Groeschel S, Lorenzen A, Rona S, Schuhmann MU, Ernemann U, Krägeloh‐Mann I. Clinical application of advanced MR methods in children: points to consider. Ann Clin Transl Neurol 2018; 5:1434-1455. [PMID: 30480038 PMCID: PMC6243383 DOI: 10.1002/acn3.658] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 12/11/2022] Open
Abstract
The application of both functional MRI and diffusion MR tractography prior to a neurosurgical operation is well established in adults, but less so in children, for several reasons. For this review, we have identified several aspects (task design, subject preparation, actual scanning session, data processing, interpretation of results, and decision-making) where pediatric peculiarities should be taken into account. Further, we not only systematically identify common issues, but also provide solutions, based on our experience as well as a review of the pertinent literature. The aim is to provide the clinician as well as the imaging scientist with information that helps to plan, conduct, and interpret such a clinically-indicated exam in a way that maximizes benefit for, and minimizes the burden on the individual child.
Collapse
Affiliation(s)
- Marko Wilke
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
- Children's Hospital and Department of NeuroradiologyExperimental Pediatric NeuroimagingTuebingenGermany
| | - Samuel Groeschel
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
- Children's Hospital and Department of NeuroradiologyExperimental Pediatric NeuroimagingTuebingenGermany
| | - Anna Lorenzen
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
- Children's Hospital and Department of NeuroradiologyExperimental Pediatric NeuroimagingTuebingenGermany
| | - Sabine Rona
- Department of NeurosurgeryUniversity HospitalTuebingenGermany
| | | | - Ulrike Ernemann
- Department of Diagnostic and Interventional NeuroradiologyUniversity HospitalUniversity of TübingenTuebingenGermany
| | - Ingeborg Krägeloh‐Mann
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
| |
Collapse
|
11
|
Arichi T, Whitehead K, Barone G, Pressler R, Padormo F, Edwards AD, Fabrizi L. Localization of spontaneous bursting neuronal activity in the preterm human brain with simultaneous EEG-fMRI. eLife 2017; 6. [PMID: 28893378 PMCID: PMC5595428 DOI: 10.7554/elife.27814] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 08/03/2017] [Indexed: 12/21/2022] Open
Abstract
Electroencephalographic recordings from the developing human brain are characterized by spontaneous neuronal bursts, the most common of which is the delta brush. Although similar events in animal models are known to occur in areas of immature cortex and drive their development, their origin in humans has not yet been identified. Here, we use simultaneous EEG-fMRI to localise the source of delta brush events in 10 preterm infants aged 32–36 postmenstrual weeks. The most frequent patterns were left and right posterior-temporal delta brushes which were associated in the left hemisphere with ipsilateral BOLD activation in the insula only; and in the right hemisphere in both the insular and temporal cortices. This direct measure of neural and hemodynamic activity shows that the insula, one of the most densely connected hubs in the developing cortex, is a major source of the transient bursting events that are critical for brain maturation.
Collapse
Affiliation(s)
- Tomoki Arichi
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.,Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Kimberley Whitehead
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Giovanni Barone
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.,Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy
| | - Ronit Pressler
- Clinical Neurosciences, UCL-Institute of Child Health, London, United Kingdom
| | - Francesco Padormo
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.,Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, United States
| | - A David Edwards
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.,Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Lorenzo Fabrizi
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| |
Collapse
|
12
|
Merhar SL, Gozdas E, Tkach JA, Harpster KL, Schwartz TL, Yuan W, Kline-Fath BM, Leach JL, Altaye M, Holland SK. Functional and structural connectivity of the visual system in infants with perinatal brain injury. Pediatr Res 2016; 80:43-8. [PMID: 26991261 DOI: 10.1038/pr.2016.49] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/23/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Infants with perinatal brain injury are at risk of later visual problems. Advanced neuroimaging techniques show promise to detect functional and structural alterations of the visual system. We hypothesized that infants with perinatal brain injury would have less brain activation during a visual functional magnetic resonance imaging (fMRI) task and reduced task-based functional connectivity and structural connectivity as compared with healthy controls. METHODS Ten infants with perinatal brain injury and 20 control infants underwent visual fMRI and diffusion tensor imaging (DTI) during natural sleep with no sedation. Activation maps, functional connectivity maps, and structural connectivity were analyzed and compared between the two groups. RESULTS Most infants in both groups had negative activation in the visual cortex during the fMRI task. Infants with brain injury showed reduced activation in the occipital cortex, weaker connectivity between visual areas and other areas of the brain during the visual task, and reduced fractional anisotropy in white matter tracts projecting to visual regions, as compared with control infants. CONCLUSION Infants with brain injury sustained in the perinatal period showed evidence of decreased brain activity and functional connectivity during a visual task and altered structural connectivity as compared with healthy term neonates.
Collapse
Affiliation(s)
- Stephanie L Merhar
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Elveda Gozdas
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jean A Tkach
- Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Karen L Harpster
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Terry L Schwartz
- Division of Ophthalmology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Beth M Kline-Fath
- Department of Radiology and Medical imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - James L Leach
- Department of Radiology and Medical imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Scott K Holland
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| |
Collapse
|
13
|
Biagi L, Crespi SA, Tosetti M, Morrone MC. BOLD Response Selective to Flow-Motion in Very Young Infants. PLoS Biol 2015; 13:e1002260. [PMID: 26418729 PMCID: PMC4587790 DOI: 10.1371/journal.pbio.1002260] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 08/21/2015] [Indexed: 11/20/2022] Open
Abstract
In adults, motion perception is mediated by an extensive network of occipital, parietal, temporal, and insular cortical areas. Little is known about the neural substrate of visual motion in infants, although behavioural studies suggest that motion perception is rudimentary at birth and matures steadily over the first few years. Here, by measuring Blood Oxygenated Level Dependent (BOLD) responses to flow versus random-motion stimuli, we demonstrate that the major cortical areas serving motion processing in adults are operative by 7 wk of age. Resting-state correlations demonstrate adult-like functional connectivity between the motion-selective associative areas, but not between primary cortex and temporo-occipital and posterior-insular cortices. Taken together, the results suggest that the development of motion perception may be limited by slow maturation of the subcortical input and of the cortico-cortical connections. In addition they support the existence of independent input to primary (V1) and temporo-occipital (V5/MT+) cortices very early in life. Although 7-wk-old infants do not perceive motion with fine sensitivity, this study shows that their brains have a well-established network of associative cortical areas selective to visual flow-motion. While it is known that the visual brain is immature at birth, there is little firm information about the developmental timeline of the visual system in humans. Despite this, it is commonly assumed that the cortex matures slowly, with primary visual areas developing first, followed by higher associative regions. Here we use fMRI in very young infants to show that this isn’t the case. Adults are highly sensitive to moving objects, and to the spurious flow projected on their retinas while they move in the environment. Flow perception is mediated by an extensive network of areas involving primary and associative visual areas, but also vestibular associative cortices that mediate the perception of body motion (vection). Our data demonstrate that this complex network of higher associative areas is established and well developed by 7 wk of age, including the vestibular associative cortex. Interestingly, the maturation of the primary visual cortex lags behind the higher associative cortex; this suggests the existence of independent cortical inputs to the primary and the associative cortex at this stage of development, explaining why infants do not yet perceive motion with the same sensitivity as adults.
Collapse
Affiliation(s)
- Laura Biagi
- IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - Sofia Allegra Crespi
- Department of Psychology, Vita-Salute San Raffaele University, Milan, Italy; CERMAC and Neuroradiology Unit, San Raffaele Hospital, Milan, Italy
| | | | - Maria Concetta Morrone
- IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy; Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| |
Collapse
|
14
|
Cusack R, Wild C, Linke AC, Arichi T, Lee DSC, Han VK. Optimizing stimulation and analysis protocols for neonatal fMRI. PLoS One 2015; 10:e0120202. [PMID: 26266954 PMCID: PMC4534447 DOI: 10.1371/journal.pone.0120202] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 11/06/2014] [Indexed: 12/22/2022] Open
Abstract
The development of brain function in young infants is poorly understood. The core challenge is that infants have a limited behavioral repertoire through which brain function can be expressed. Neuroimaging with fMRI has great potential as a way of characterizing typical development, and detecting abnormal development early. But, a number of methodological challenges must first be tackled to improve the robustness and sensitivity of neonatal fMRI. A critical one of these, addressed here, is that the hemodynamic response function (HRF) in pre-term and term neonates differs from that in adults, which has a number of implications for fMRI. We created a realistic model of noise in fMRI data, using resting-state fMRI data from infants and adults, and then conducted simulations to assess the effect of HRF of the power of different stimulation protocols and analysis assumptions (HRF modeling). We found that neonatal fMRI is most powerful if block-durations are kept at the lower range of those typically used in adults (full on/off cycle duration 25-30s). Furthermore, we show that it is important to use the age-appropriate HRF during analysis, as mismatches can lead to reduced power or even inverted signal. Where the appropriate HRF is not known (for example due to potential developmental delay), a flexible basis set performs well, and allows accurate post-hoc estimation of the HRF.
Collapse
Affiliation(s)
- Rhodri Cusack
- Brain and Mind Institute, Western University, London, Canada
- Children’s Health Research Institute, London, Canada
- * E-mail:
| | - Conor Wild
- Brain and Mind Institute, Western University, London, Canada
| | - Annika C. Linke
- Brain and Mind Institute, Western University, London, Canada
| | - Tomoki Arichi
- Department of Perinatal Imaging and Health, King’s College London, London, United Kingdom
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | | | - Victor K. Han
- Children’s Health Research Institute, London, Canada
| |
Collapse
|
15
|
Developmental synergy between thalamic structure and interhemispheric connectivity in the visual system of preterm infants. NEUROIMAGE-CLINICAL 2015; 8:462-72. [PMID: 26106571 PMCID: PMC4474422 DOI: 10.1016/j.nicl.2015.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 11/22/2022]
Abstract
Thalamic structural co-variation with cortical regions has been demonstrated in preterm infants, but its relationship to cortical function and severity of non-cystic white matter injury (non-cystic WMI) is unclear. The relationship between thalamic morphology and both cortical network synchronization and cortical structural connectivity has not been established. We tested the hypothesis that in preterm neonates, thalamic volume would correlate with primary cortical visual function and microstructural integrity of cortico-cortical visual association pathways. A total of 80 term-equivalent preterm and 44 term-born infants underwent high-resolution structural imaging coupled with visual functional magnetic resonance imaging or diffusion tensor imaging. There was a strong correlation between thalamic volume and primary visual cortical activation in preterms with non-cystic WMI (r = 0.81, p-value = 0.001). Thalamic volume also correlated strongly with interhemispheric cortico-cortical connectivity (splenium) in preterm neonates with a relatively higher severity of non-cystic WMI (p-value < 0.001). In contrast, there was lower correlation between thalamic volume and intrahemispheric cortico-cortical connectivity, including the inferior longitudinal fasciculus and inferior frontal orbital fasciculus. This study shows distinct temporal overlap in the disruption of thalamo-cortical and interhemispheric cortico-cortical connectivity in preterm infants suggesting developmental synergy between thalamic morphology and the emergence of cortical networks in the last trimester.
Collapse
|
16
|
Vasylechko S, Malamateniou C, Nunes RG, Fox M, Allsop J, Rutherford M, Rueckert D, Hajnal JV. T2* relaxometry of fetal brain at 1.5 Tesla using a motion tolerant method. Magn Reson Med 2015; 73:1795-802. [PMID: 25046845 DOI: 10.1002/mrm.25299] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 03/29/2014] [Accepted: 05/01/2014] [Indexed: 11/11/2022]
Abstract
PURPOSE The aim of this study was to determine T2* values for the fetal brain in utero and to compare them with previously reported values in preterm and term neonates. Knowledge of T2* may be useful for assessing brain development, brain abnormalities, and for optimizing functional imaging studies. METHODS Maternal respiration and unpredictable fetal motion mean that conventional multishot acquisition techniques used in adult T2* relaxometry studies are not practical. Single shot multiecho echo planar imaging was used as a rapid method for measuring fetal T2* by effectively freezing intra-slice motion. RESULTS T2* determined from a sample of 24 subjects correlated negatively with gestational age with mean values of 220 ms (±45) for frontal white matter, 159 ms (±32) for thalamic gray matter, and 236 ms (±45) for occipital white matter. CONCLUSION Fetal T2* values are higher than those previously reported for preterm neonates and decline with a consistent trend across gestational age. The data suggest that longer than usual echo times or direct T2* measurement should be considered when performing fetal fMRI to reach optimal BOLD sensitivity.
Collapse
Affiliation(s)
- Serge Vasylechko
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Abstract
Advances in methodology have led to expanded application of resting-state functional MRI (rs-fMRI) to the study of term and prematurely born infants during the first years of life, providing fresh insight into the earliest forms of functional cerebral development. In this review, we detail our evolving understanding of the use of rs-fMRI for studying neonates. We initially focus on the biological processes of cortical development related to resting-state network development. We then review technical issues principally affecting neonatal investigations, including the effects of subject motion during acquisition and image distortions related to magnetic susceptibility effects. We next summarize the literature in which rs-fMRI is used to study normal brain development during the early postnatal period, the effects of prematurity, and the effects of cerebral injury. Finally, we review potential future directions for the field, such as the use of complementary imaging modalities and advanced analysis techniques.
Collapse
Affiliation(s)
- Christopher D. Smyser
- Division of Pediatric Neurology, Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Jeffrey J. Neil
- Department of Neurology, Boston Children’s Hospital, Boston, MA,Corresponding author. Jeff Neil, MD, PhD, Neurology, Boston Children's Hospital, 333 Longwood Avenue, LO 450, Boston, MA 02115, phone (617) 355-6388, fax (617) 730-0284,
| |
Collapse
|
18
|
Giovedì 2 Ottobre. Neuroradiol J 2014. [DOI: 10.1177/197140091402700505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
19
|
Allievi AG, Arichi T, Gordon AL, Burdet E. Technology-aided assessment of sensorimotor function in early infancy. Front Neurol 2014; 5:197. [PMID: 25324827 PMCID: PMC4181230 DOI: 10.3389/fneur.2014.00197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/17/2014] [Indexed: 01/31/2023] Open
Abstract
There is a pressing need for new techniques capable of providing accurate information about sensorimotor function during the first 2 years of childhood. Here, we review current clinical methods and challenges for assessing motor function in early infancy, and discuss the potential benefits of applying technology-assisted methods. We also describe how the use of these tools with neuroimaging, and in particular functional magnetic resonance imaging (fMRI), can shed new light on the intra-cerebral processes underlying neurodevelopmental impairment. This knowledge is of particular relevance in the early infant brain, which has an increased capacity for compensatory neural plasticity. Such tools could bring a wealth of knowledge about the underlying pathophysiological processes of diseases such as cerebral palsy; act as biomarkers to monitor the effects of possible therapeutic interventions; and provide clinicians with much needed early diagnostic information.
Collapse
Affiliation(s)
- Alessandro G Allievi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
| | - Tomoki Arichi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK ; Department of Perinatal Imaging and Health, King's College London , London , UK
| | - Anne L Gordon
- Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust , London , UK ; Institute of Psychiatry, Psychology and Neuroscience, Kings College London , London , UK
| | - Etienne Burdet
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
| |
Collapse
|
20
|
Allievi AG, Arichi T, Gordon AL, Burdet E. Technology-aided assessment of sensorimotor function in early infancy. Front Neurol 2014; 5:197. [PMID: 25324827 DOI: 10.3389/fneur.2014.00197/abstract] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/17/2014] [Indexed: 05/23/2023] Open
Abstract
There is a pressing need for new techniques capable of providing accurate information about sensorimotor function during the first 2 years of childhood. Here, we review current clinical methods and challenges for assessing motor function in early infancy, and discuss the potential benefits of applying technology-assisted methods. We also describe how the use of these tools with neuroimaging, and in particular functional magnetic resonance imaging (fMRI), can shed new light on the intra-cerebral processes underlying neurodevelopmental impairment. This knowledge is of particular relevance in the early infant brain, which has an increased capacity for compensatory neural plasticity. Such tools could bring a wealth of knowledge about the underlying pathophysiological processes of diseases such as cerebral palsy; act as biomarkers to monitor the effects of possible therapeutic interventions; and provide clinicians with much needed early diagnostic information.
Collapse
Affiliation(s)
- Alessandro G Allievi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
| | - Tomoki Arichi
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK ; Department of Perinatal Imaging and Health, King's College London , London , UK
| | - Anne L Gordon
- Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust , London , UK ; Institute of Psychiatry, Psychology and Neuroscience, Kings College London , London , UK
| | - Etienne Burdet
- Human Robotics Group, Department of Bioengineering, Imperial College London , London , UK
| |
Collapse
|
21
|
Abstract
Over the past 20 years, the field of cognitive neuroscience has relied heavily on hemodynamic measures of blood oxygenation in local regions of the brain to make inferences about underlying cognitive processes. These same functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy (fNIRS) techniques have recently been adapted for use with human infants. We review the advantages and disadvantages of these two neuroimaging methods for studies of infant cognition, with a particular emphasis on their technical limitations and the linking hypotheses that are used to draw conclusions from correlational data. In addition to summarizing key findings in several domains of infant cognition, we highlight the prospects of improving the quality of fNIRS data from infants to address in a more sophisticated way how cognitive development is mediated by changes in underlying neural mechanisms.
Collapse
Affiliation(s)
- Richard N Aslin
- Brain and Cognitive Sciences, University of Rochester, Rochester, New York 14627; ,
| | | | | |
Collapse
|
22
|
Tusor N, Arichi T, Counsell SJ, Edwards AD. Brain development in preterm infants assessed using advanced MRI techniques. Clin Perinatol 2014; 41:25-45. [PMID: 24524445 DOI: 10.1016/j.clp.2013.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Infants who are born preterm have a high incidence of neurocognitive and neurobehavioral abnormalities, which may be associated with impaired brain development. Advanced magnetic resonance imaging (MRI) approaches, such as diffusion MRI (d-MRI) and functional MRI (fMRI), provide objective and reproducible measures of brain development. Indices derived from d-MRI can be used to provide quantitative measures of preterm brain injury. Although fMRI of the neonatal brain is currently a research tool, future studies combining d-MRI and fMRI have the potential to assess the structural and functional properties of the developing brain and its response to injury.
Collapse
Affiliation(s)
- Nora Tusor
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK
| | - Tomoki Arichi
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK; Department of Bioengineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - Serena J Counsell
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK
| | - A David Edwards
- Centre for the Developing Brain, Department of Perinatal Imaging, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK; Department of Bioengineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
| |
Collapse
|
23
|
Taylor MJ. Structure and function: how to connect? Neuroradiology 2013; 55 Suppl 2:55-64. [PMID: 23929311 DOI: 10.1007/s00234-013-1246-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 07/11/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The majority, but not all, of very preterm-born infants have difficulties with a variety of cognitive functions as children. It is critical to be able to predict as early as possible those who will have difficulties, to be able to direct appropriate interventions. METHODS We are conducting multimodal structural and functional MRI studies in very preterm-born infants and following them with behavioural and neuroimaging assessments until 4 years of age. We are also completing structural and more complex functional imaging in school-aged very preterm-born children. RESULTS A number of MRI measures between preterm and term age correlate with outcome at 2 years of age. Functional and structural differences are also seen at school age; examples from these various studies are presented. CONCLUSION Structural and functional studies in preterm-born versus term-born infants and children, particularly if completed longitudinally, provide important information on the evolution of brain-behaviour correlates and can help predict outcome in this high-risk population.
Collapse
Affiliation(s)
- Margot J Taylor
- Diagnostic Imaging, Neurosciences and Mental Health Programme, Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada.
| |
Collapse
|
24
|
Lee W, Morgan BR, Shroff MM, Sled JG, Taylor MJ. The development of regional functional connectivity in preterm infants into early childhood. Neuroradiology 2013; 55 Suppl 2:105-11. [PMID: 23881450 DOI: 10.1007/s00234-013-1232-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Resting state networks are proposed to reflect the neuronal connectivity that underlies cognitive processes. Consequently, abnormal behaviour of these networks due to disease or altered development may predict poor cognitive outcome. To understand how very preterm birth may affect the development of resting state connectivity, we followed a cohort of very preterm-born infants from birth through to 4 years of age using resting state functional MRI. METHODS From a larger longitudinal cohort of infants born very preterm (<32 weeks gestational age), 36 at birth, 30 at term, 21 two-year and 22 four-year resting state fMRI datasets were acquired. Using seed-based connectivity analyses with seeds in the anterior cingulate cortex, posterior cingulate cortex, left and right motor-hand regions and left and right temporal lobes, we investigated local and inter-region connectivity as a function of group and age. RESULTS We found strong local connectivity during the preterm period, which matured into inter-hemispheric and preliminary default-mode network correlations by 4 years of age. This development is comparable to the resting state networks found in term-born infants of equivalent age. CONCLUSION The results of this study suggest that differences in developmental trajectory between preterm-born and term-born infants are small and, if present, would require a large sample from both populations to be detected.
Collapse
Affiliation(s)
- Wayne Lee
- Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada.
| | | | | | | | | |
Collapse
|
25
|
Chau V, Taylor MJ, Miller SP. Visual function in preterm infants: visualizing the brain to improve prognosis. Doc Ophthalmol 2013; 127:41-55. [PMID: 23761036 DOI: 10.1007/s10633-013-9397-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/05/2013] [Indexed: 11/28/2022]
Abstract
Considerable development of the visual system occurs in the third trimester of life, a time when very preterm-born infants are in a neonatal intensive care unit (NICU). Their very early birth during a period of rapid and marked neurodevelopment and their clinical course makes them a very high-risk population. A range of different events impacts brain development and the visual system, leading to significant long-term visual dysfunction. Improved neuroimaging techniques provide an important window on the early brain and visual system development of these vulnerable infants. Greater understanding of the etiology of visual impairment subsequent to preterm birth and the timing of critical processes will allow early recognition and the earlier implementations of interventions. In the longer term, this will help clinicians optimize NICU practice to reduce the incidence of visual dysfunction in these children.
Collapse
Affiliation(s)
- Vann Chau
- Department of Pediatrics (Neurology), University of British Columbia, Vancouver, Canada
| | | | | |
Collapse
|
26
|
Duerden EG, Taylor MJ, Miller SP. Brain development in infants born preterm: looking beyond injury. Semin Pediatr Neurol 2013; 20:65-74. [PMID: 23948681 DOI: 10.1016/j.spen.2013.06.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Infants born very preterm are high risk for acquired brain injury and disturbances in brain maturation. Although survival rates for preterm infants have increased in the last decades owing to improved neonatal intensive care, motor disabilities including cerebral palsy persist, and impairments in cognitive, language, social, and executive functions have not decreased. Evidence from neuroimaging studies exploring brain structure, function, and metabolism has indicated abnormalities in the brain development trajectory of very preterm-born infants that persist through to adulthood. In this chapter, we review neuroimaging approaches for the identification of brain injury in the preterm neonate. Advances in medical imaging and availability of specialized equipment necessary to scan infants have facilitated the feasibility of conducting longitudinal studies to provide greater understanding of early brain injury and atypical brain development and their effects on neurodevelopmental outcome. Improved understanding of the risk factors for acquired brain injury and associated factors that affect brain development in this population is setting the stage for improving the brain health of children born preterm.
Collapse
Affiliation(s)
- Emma G Duerden
- Neurosciences & Mental Health, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.
| | | | | |
Collapse
|
27
|
Affiliation(s)
- Tomoki Arichi
- Centre for the Developing Brain, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, UK
| |
Collapse
|