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Kruth SS, Willers C, Persad E, Sjöström ES, Lagerström SR, Rakow A. Probiotic supplementation and risk of necrotizing enterocolitis and mortality among extremely preterm infants-the Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial: study protocol for a multicenter, double-blinded, placebo-controlled, and registry-based randomized controlled trial. Trials 2024; 25:259. [PMID: 38610034 PMCID: PMC11015611 DOI: 10.1186/s13063-024-08088-8] [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: 07/06/2023] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Extremely preterm infants, defined as those born before 28 weeks' gestational age, are a very vulnerable patient group at high risk for adverse outcomes, such as necrotizing enterocolitis and death. Necrotizing enterocolitis is an inflammatory gastrointestinal disease with high incidence in this cohort and has severe implications on morbidity and mortality. Previous randomized controlled trials have shown reduced incidence of necrotizing enterocolitis among older preterm infants following probiotic supplementation. However, these trials were underpowered for extremely preterm infants, rendering evidence for probiotic supplementation in this population insufficient to date. METHODS The Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial is a multicenter, double-blinded, placebo-controlled and registry-based randomized controlled trial conducted among extremely preterm infants (n = 1620) born at six tertiary neonatal units in Sweden and four units in Denmark. Enrolled infants will be allocated to receive either probiotic supplementation with ProPrems® (Bifidobacterium infantis, Bifidobacterium lactis, and Streptococcus thermophilus) diluted in 3 mL breastmilk or placebo (0.5 g maltodextrin powder) diluted in 3 mL breastmilk per day until gestational week 34. The primary composite outcome is incidence of necrotizing enterocolitis and/or mortality. Secondary outcomes include incidence of late-onset sepsis, length of hospitalization, use of antibiotics, feeding tolerance, growth, and body composition at age of full-term and 3 months corrected age after hospital discharge. DISCUSSION Current recommendations for probiotic supplementation in Sweden and Denmark do not include extremely preterm infants due to lack of evidence in this population. However, this young subgroup is notably the most at risk for experiencing adverse outcomes. This trial aims to investigate the effects of probiotic supplementation on necrotizing enterocolitis, death, and other relevant outcomes to provide sufficiently powered, high-quality evidence to inform probiotic supplementation guidelines in this population. The results could have implications for clinical practice both in Sweden and Denmark and worldwide. TRIAL REGISTRATION ( Clinicaltrials.gov ): NCT05604846.
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Affiliation(s)
- Sofia Söderquist Kruth
- Women's Health and Allied Health Professional Theme, Karolinska University Hospital, Solna, 17176, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Carl Willers
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14152, Huddinge, Sweden
| | - Emma Persad
- Department of Women's and Children's Health, Karolinska Institutet, 17177, Stockholm, Sweden
| | | | - Susanne Rautiainen Lagerström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- K2 Medicin, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Rakow
- Department of Women's and Children's Health, Karolinska Institutet, 17177, Stockholm, Sweden.
- Department of Neonatology, Karolinska University Hospital, Solna, 17176, Stockholm, Sweden.
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Chen X, Chen Y, Yan K, Chen H, Qin Q, Yang L, Liu B, Cheng G, Cao Y, Wu B, Dong X, Qiao Z, Zhou W. Genetic background of idiopathic neurodevelopmental delay patients with significant brain deviation volume. Chin Med J (Engl) 2023; 136:807-814. [PMID: 36806579 PMCID: PMC10150856 DOI: 10.1097/cm9.0000000000002297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Significant brain volume deviation is an essential phenotype in children with neurodevelopmental delay (NDD), but its genetic basis has not been fully characterized. This study attempted to analyze the genetic factors associated with significant whole-brain deviation volume (WBDV). METHODS We established a reference curve based on 4222 subjects ranging in age from the first postnatal day to 18 years. We recruited only NDD patients without acquired etiologies or positive genetic results. Cranial magnetic resonance imaging (MRI) and clinical exome sequencing (2742 genes) data were acquired. A genetic burden test was performed, and the results were compared between patients with and without significant WBDV. Literature review analyses and BrainSpan analysis based on the human brain developmental transcriptome were performed to detect the potential role of genetic risk factors in human brain development. RESULTS We recruited a total of 253 NDD patients. Among them, 26 had significantly decreased WBDV (<-2 standard deviations [SDs]), and 14 had significantly increased WBDV (>+2 SDs). NDD patients with significant WBDV had higher rates of motor development delay (49.8% [106/213] vs . 75.0% [30/40], P = 0.003) than patients without significant WBDV. Genetic burden analyses found 30 genes with an increased allele frequency of rare variants in patients with significant WBDV. Analyses of the literature further demonstrated that these genes were not randomly identified: burden genes were more related to the brain development than background genes ( P = 1.656e -9 ). In seven human brain regions related to motor development, we observed burden genes had higher expression before 37-week gestational age than postnatal stages. Functional analyses found that burden genes were enriched in embryonic brain development, with positive regulation of synaptic growth at the neuromuscular junction, positive regulation of deoxyribonucleic acid templated transcription, and response to hormone, and these genes were shown to be expressed in neural progenitors. Based on single cell sequencing analyses, we found TUBB2B gene had elevated expression levels in neural progenitor cells, interneuron, and excitatory neuron and SOX15 had high expression in interneuron and excitatory neuron. CONCLUSION Idiopathic NDD patients with significant brain volume changes detected by MRI had an increased prevalence of motor development delay, which could be explained by the genetic differences characterized herein.
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Affiliation(s)
- Xiang Chen
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Yuxi Chen
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China
| | - Kai Yan
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Huiyao Chen
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China
| | - Qian Qin
- Shanghai Key Laboratory of Birth Defects, The Translational Medicine Center of Children Development and Disease of Fudan University, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Lin Yang
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Bo Liu
- Shanghai Key Laboratory of Birth Defects, The Translational Medicine Center of Children Development and Disease of Fudan University, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Guoqiang Cheng
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Bingbing Wu
- Shanghai Key Laboratory of Birth Defects, The Translational Medicine Center of Children Development and Disease of Fudan University, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Xinran Dong
- Shanghai Key Laboratory of Birth Defects, The Translational Medicine Center of Children Development and Disease of Fudan University, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Zhongwei Qiao
- Department of Radiology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
- Shanghai Key Laboratory of Birth Defects, The Translational Medicine Center of Children Development and Disease of Fudan University, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai 200433, China
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Beunders VAA, Roelants JA, Suurland J, Dudink J, Govaert P, Swarte RMC, Kouwenberg-Raets MMA, Reiss IKM, Joosten KFM, Vermeulen MJ. Early Ultrasonic Monitoring of Brain Growth and Later Neurodevelopmental Outcome in Very Preterm Infants. AJNR Am J Neuroradiol 2022; 43:639-644. [PMID: 35332022 PMCID: PMC8993199 DOI: 10.3174/ajnr.a7456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/10/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In infants born very preterm, monitoring of early brain growth could contribute to prediction of later neurodevelopment. Therefore, our aim was to investigate associations between 2 early cranial ultrasound markers (corpus callosum-fastigium and corpus callosum length) and neurodevelopmental outcome and the added value of both markers in the prediction of neurodevelopmental outcome based on neonatal risk factors and head circumference in very preterm infants. MATERIALS AND METHODS This prospective observational study included 225 infants born at <30 weeks' gestational age, of whom 153 were without any brain injury on cranial ultrasound. Corpus callosum-fastigium and corpus callosum length and head circumference were measured at birth, 29 weeks' gestational age, transfer from the neonatal intensive care unit to a level II hospital, and 2 months' corrected age. We analyzed associations of brain markers and their growth with cognitive, motor, language, and behavioral outcome at 2 years' corrected age. RESULTS In infants without brain injury, greater corpus callosum-fastigium length at 2 months was associated with better cognitive outcome. Corpus callosum length at 2 months was positively associated with cognitive, motor, and language outcome. Faster growth of the corpus callosum length between birth and 2 months was associated with better cognitive and motor function. Prediction of neurodevelopmental outcome based on neonatal risk factors with or without head circumference was significantly improved by adding corpus callosum length. CONCLUSIONS Both corpus callosum-fastigium and corpus callosum length on cranial ultrasound are associated with neurodevelopmental outcome of very preterm infants without brain injury at 2 years, but only corpus callosum length shows the added clinical utility in predicting neurodevelopmental outcome.
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Affiliation(s)
- V A A Beunders
- From the Department of Pediatrics (V.A.A.B., J.A.R., P.G., R.M.C.S., I.K.M.R., M.J.V.)
| | - J A Roelants
- From the Department of Pediatrics (V.A.A.B., J.A.R., P.G., R.M.C.S., I.K.M.R., M.J.V.)
| | - J Suurland
- Division of Neonatology, Department of Child and Adolescent Psychiatry/Psychology (J.S.)
| | - J Dudink
- Department of Neonatology (J.D.), Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center (J.D.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - P Govaert
- From the Department of Pediatrics (V.A.A.B., J.A.R., P.G., R.M.C.S., I.K.M.R., M.J.V.)
| | - R M C Swarte
- From the Department of Pediatrics (V.A.A.B., J.A.R., P.G., R.M.C.S., I.K.M.R., M.J.V.)
| | - M M A Kouwenberg-Raets
- Department of Pediatrics (M.M.A.K-.R.), Division of Neonatology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - I K M Reiss
- From the Department of Pediatrics (V.A.A.B., J.A.R., P.G., R.M.C.S., I.K.M.R., M.J.V.)
| | - K F M Joosten
- Department of Pediatrics (K.F.M.J.), Intensive Care Unit, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M J Vermeulen
- From the Department of Pediatrics (V.A.A.B., J.A.R., P.G., R.M.C.S., I.K.M.R., M.J.V.)
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Vermeulen MJ, Burkhardt W, Fritze A, Roelants J, Mense L, Willemsen S, Rüdiger M. Reference Charts for Neonatal Cranial Volume Based on 3D Laser Scanning to Monitor Head Growth. Front Pediatr 2021; 9:654112. [PMID: 34123964 PMCID: PMC8192695 DOI: 10.3389/fped.2021.654112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Postnatal brain growth is an important predictor of neurodevelopmental outcome in preterm infants. A new reliable proxy for brain volume is cranial volume, which can be measured routinely by 3-D laser scanning. The aim of this study was to develop reference charts for normal cranial volume in newborn infants at different gestational ages starting from late preterm for both sexes. Methods: Cross-sectional cohort study in a German university hospital, including singleton, clinically stable, neonates born after 34 weeks of gestation. Cranial volume was measured in the first week of life by a validated 3-D laser scanner. Cranial volume data was modeled to calculate percentile values by gestational age and birth weight and to develop cranial volume reference charts for girls and boys separately. Results: Of the 1,703 included infants, 846 (50%) were female. Birth weights ranged from 1,370 to 4,830 grams (median 3,370). Median cranial volume ranged from 320 [interquartile range (IQR) 294-347] ml at 34 weeks to 469 [IQR 442-496] ml at 42 weeks and was higher in boys than in girls. Conclusions: This study presents the first reference charts of cranial volume which can be used in clinical practice to monitor brain growth between 34 and 42 weeks gestation in infants.
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Affiliation(s)
- Marijn Jorien Vermeulen
- Division of Neonatology, Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Wolfram Burkhardt
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany
| | - Anne Fritze
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany
| | - Jorine Roelants
- Division of Neonatology, Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Lars Mense
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany
| | - Sten Willemsen
- Division of Biostatistics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mario Rüdiger
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany.,Saxonian Center for Feto-Neonatal Health, Technische Universität Dresden, Dresden, Germany
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Tu L, Porras AR, Enquobahrie A, Buck B S GC, Tsering M S D, Horvath S, Keating R, Oh AK, Rogers GF, George Linguraru M. Automated Measurement of Intracranial Volume Using Three-Dimensional Photography. Plast Reconstr Surg 2020; 146:314e-323e. [PMID: 32459727 DOI: 10.1097/prs.0000000000007066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current methods to analyze three-dimensional photography do not quantify intracranial volume, an important metric of development. This study presents the first noninvasive, radiation-free, accurate, and reproducible method to quantify intracranial volume from three-dimensional photography. METHODS In this retrospective study, cranial bones and head skin were automatically segmented from computed tomographic images of 575 subjects without cranial abnormality (average age, 5 ± 5 years; range, 0 to 16 years). The intracranial volume and the head volume were measured at the cranial vault region, and their relation was modeled by polynomial regression, also accounting for age and sex. Then, the regression model was used to estimate the intracranial volume of 30 independent pediatric patients from their head volume measured using three-dimensional photography. Evaluation was performed by comparing the estimated intracranial volume with the true intracranial volume of these patients computed from paired computed tomographic images; two growth models were used to compensate for the time gap between computed tomographic and three-dimensional photography. RESULTS The regression model estimated the intracranial volume of the normative population from the head volume calculated from computed tomographic images with an average error of 3.81 ± 3.15 percent (p = 0.93) and a correlation (R) of 0.96. The authors obtained an average error of 4.07 ± 3.01 percent (p = 0.57) in estimating the intracranial volume of the patients from three-dimensional photography using the regression model. CONCLUSION Three-dimensional photography with image analysis provides measurement of intracranial volume with clinically acceptable accuracy, thus offering a noninvasive, precise, and reproducible method to evaluate normal and abnormal brain development in young children. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, V.
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Affiliation(s)
- Liyun Tu
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Antonio R Porras
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Andinet Enquobahrie
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Graham C Buck B S
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Deki Tsering M S
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Samantha Horvath
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Robert Keating
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Albert K Oh
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Gary F Rogers
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Marius George Linguraru
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
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Santander P, Quast A, Hubbert J, Horn S, Meyer-Marcotty P, Küster H, Dieks JK. Three-dimensional head shape acquisition in preterm infants - Translating an orthodontic imaging procedure into neonatal care. Early Hum Dev 2019; 140:104908. [PMID: 31670175 DOI: 10.1016/j.earlhumdev.2019.104908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Head shape and head volume of preterm infants give important information on short- and long-term development. Three-dimensional (3D) assessment of a preterm infant's head would therefore provide more information than currently used two-dimensional methods. AIMS To evaluate a contactless 3D imaging system to assess head shape and volume in preterm infants. METHODS A protocol for 3D imaging and reconstruction of an infant's head with a portable stereophotogrammetric camera system was developed. It was validated on a manikin by comparison to an established stationary stereophotogrammetric device. Feasibility for clinical routine and 3D data analysis were assessed in six preterm infants. RESULTS Ten 3D reconstructions from a manikin were done with ten images each taken from different angles. The accuracy of the 3D reconstruction was measured at the overlapping areas between two images. Comparing the portable to the stationary system, a high concordance was found for the 3D manikin head-reconstructions (mean difference 0.21 ± 0.03 mm). In preterm infants, digital evaluation of the head was proven to be feasible for head circumference (HC), cranial index and asymmetry indices. There was good concordance between manual and digital measurement of the HC (95% CI -0.85 to 0.38 mm). CONCLUSIONS The portable camera system allowed fast and contactless 3D image capture of a preterm infant's head without any risk or interference with neonatal care. Together with a new software, this technique would allow more precise evaluation of head growth even in very preterm infants and thereby may improve their care and long-term outcome.
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Affiliation(s)
- P Santander
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
| | - A Quast
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
| | - J Hubbert
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - S Horn
- Department of Pediatric Cardiology, Neonatology and Intensive Care Medicine, University Medical Center, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
| | - P Meyer-Marcotty
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
| | - H Küster
- Department of Pediatric Cardiology, Neonatology and Intensive Care Medicine, University Medical Center, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
| | - J K Dieks
- Department of Pediatric Cardiology, Neonatology and Intensive Care Medicine, University Medical Center, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
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Zöllei L, Jaimes C, Saliba E, Grant PE, Yendiki A. TRActs constrained by UnderLying INfant anatomy (TRACULInA): An automated probabilistic tractography tool with anatomical priors for use in the newborn brain. Neuroimage 2019; 199:1-17. [PMID: 31132451 PMCID: PMC6688923 DOI: 10.1016/j.neuroimage.2019.05.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 05/14/2019] [Accepted: 05/18/2019] [Indexed: 10/26/2022] Open
Abstract
The ongoing myelination of white-matter fiber bundles plays a significant role in brain development. However, reliable and consistent identification of these bundles from infant brain MRIs is often challenging due to inherently low diffusion anisotropy, as well as motion and other artifacts. In this paper we introduce a new tool for automated probabilistic tractography specifically designed for newborn infants. Our tool incorporates prior information about the anatomical neighborhood of white-matter pathways from a training data set. In our experiments, we evaluate this tool on data from both full-term and prematurely born infants and demonstrate that it can reconstruct known white-matter tracts in both groups robustly, even in the presence of differences between the training set and study subjects. Additionally, we evaluate it on a publicly available large data set of healthy term infants (UNC Early Brain Development Program). This paves the way for performing a host of sophisticated analyses in newborns that we have previously implemented for the adult brain, such as pointwise analysis along tracts and longitudinal analysis, in both health and disease.
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Affiliation(s)
- Lilla Zöllei
- Massachusetts General Hospital, Boston, United States.
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