1
|
Kromm GH, Patankar H, Nagalotimath S, Wong H, Austin T. Socioemotional and Psychological Outcomes of Hypoxic-Ischemic Encephalopathy: A Systematic Review. Pediatrics 2024; 153:e2023063399. [PMID: 38440801 PMCID: PMC10979301 DOI: 10.1542/peds.2023-063399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Therapeutic hypothermia has reduced the risk of death or major disability following perinatal hypoxic-ischemic encephalopathy (HIE); however, many children who experience perinatal HIE still go on to develop personal and behavioral challenges, which can be difficult for caregivers and a public health burden for society. Our objective with this review is to systematically identify and synthesize studies that evaluate associations between perinatal HIE and socioemotional or psychological outcomes. METHODS We screened all search-returned journal articles from Cochrane Library, Embase, Medline, PsycINFO, Scopus, and Web of Science from data inception through February 1, 2023. Keywords related to HIE (eg, neonatal encephalopathy, neonatal brain injury) and outcomes (eg, social*, emotion*, behav* problem, psycholog*, psychiatr*) were searched with a predefined search string. We included all observational human studies reporting socioemotional or psychological sequelae of term HIE. Study data were recorded on standardized sheets, and the Newcastle-Ottawa Scale was adapted to assess study quality. RESULTS We included 43 studies documenting 3244 HIE participants and 2132 comparison participants. We found statistically significant associations between HIE and social and emotional, behavioral, and psychological and psychiatric deficits throughout infancy, childhood, and adolescence (19 studies). The authors of the included studies also report nonsignificant findings (11 studies) and outcomes without statistical comparison (25 studies). CONCLUSIONS Perinatal HIE may be a risk factor for a range of socioemotional and psychological challenges in the short- and long-term. Routine screening, early intervention, and follow-up support may be particularly beneficial to this population.
Collapse
Affiliation(s)
| | | | | | - Hilary Wong
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
- NICU, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Topun Austin
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
- NICU, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| |
Collapse
|
2
|
Zhao T, Alder NN, Starkweather AR, Chen MH, Matson AP, Xu W, Balsbaugh JL, Cong X. Associations of Mitochondrial Function, Stress, and Neurodevelopmental Outcomes in Early Life: A Systematic Review. Dev Neurosci 2022; 44:438-454. [PMID: 35995037 PMCID: PMC9928905 DOI: 10.1159/000526491] [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: 03/04/2022] [Accepted: 07/18/2022] [Indexed: 11/19/2022] Open
Abstract
Early life stress is commonly experienced by infants, especially preterm infants, and may impact their neurodevelopmental outcomes in their early and later lives. Mitochondrial function/dysfunction may play an important role underlying the linkage of prenatal and postnatal stress and neurodevelopmental outcomes in infants. This review aimed to provide insights on the relationship between early life stress and neurodevelopment and the mechanisms of mitochondrial function/dysfunction that contribute to the neuropathology of stress. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to develop this systematic review. PubMed, Scopus, PsycINFO, and Biosis databases were searched for primary research articles published between 2010 and 2021 that examined the relationships among mitochondrial function/dysfunction, infant stress, and neurodevelopment. Thirty studies were identified. There is evidence to support that mitochondrial function/dysfunction mediates the relationship between prenatal and postnatal stress and neurodevelopmental outcomes in infants. Maternal transgenerational transmission of mitochondrial bioenergetic patterns influenced prenatal stress induced neurodevelopmental outcomes and behavioral changes in infants. Multiple functionally relevant mitochondrial proteins, genes, and polymorphisms were associated with stress exposure. This is the first review of the role that mitochondrial function/dysfunction plays in the association between stress and neurodevelopmental outcomes in full-term and preterm infants. Although multiple limitations were found based on the lack of data on the influence of biological sex, and due to invasive sampling, and lack of longitudinal data, many genes and proteins associated with mitochondrial function/dysfunction were found to influence neurodevelopmental outcomes in the early life of infants.
Collapse
Affiliation(s)
- Tingting Zhao
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA,
| | - Nathan N Alder
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut, USA
| | | | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Adam P Matson
- Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Wanli Xu
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| | - Jeremy L Balsbaugh
- Proteomics and Metabolomics Facility, University of Connecticut, Storrs, Connecticut, USA
| | - Xiaomei Cong
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| |
Collapse
|
3
|
Rabow Z, Morningstar T, Showalter M, Heil H, Thongphanh K, Fan S, Chan J, Martínez-Cerdeño V, Berman R, Zagzag D, Nudler E, Fiehn O, Lechpammer M. Exposure to DMSO during infancy alters neurochemistry, social interactions, and brain morphology in long-evans rats. Brain Behav 2021; 11:e02146. [PMID: 33838015 PMCID: PMC8119844 DOI: 10.1002/brb3.2146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Dimethyl sulfoxide (DMSO) is a widely used solvent to dissolve hydrophobic substances for clinical uses and experimental in vivo purposes. While usually regarded safe, our prior studies suggest changes to behavior following DMSO exposure. We therefore evaluated the effects of a five-day, short-term exposure to DMSO on postnatal infant rats (P6-10). METHODS DMSO was intraperitoneally injected for five days at 0.2, 2.0, and 4.0 ml/kg body mass. One cohort of animals was sacrificed 24 hr after DMSO exposure to analyze the neurometabolic changes in four brain regions (cortex, hippocampus, basal ganglia, and cerebellum) by hydrophilic interaction liquid chromatography. A second cohort of animals was used to analyze chronic alterations to behavior and pathological changes to glia and neuronal cells later in life (P21-P40). RESULTS 164 metabolites, including key regulatory molecules (retinoic acid, orotic acid, adrenic acid, and hypotaurine), were found significantly altered by DMSO exposure in at least one of the brain regions at P11 (p < .05). Behavioral tests showed significant hypoactive behavior and decreased social habits to the 2.0 and 4.0 ml DMSO/kg groups (p < .01). Significant increases in number of microglia and astrocytes at P40 were observed in the 4.0 ml DMSO/kg group (at p < .015.) CONCLUSIONS: Despite short-term exposure at low, putatively nontoxic concentrations, DMSO led to changes in behavior and social preferences, chronic alterations in glial cells, and changes in essential regulatory brain metabolites. The chronic neurological effects of DMSO exposure reported here raise concerns about its neurotoxicity and consequent safety in human medical applications and clinical trials.
Collapse
Affiliation(s)
- Zachary Rabow
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA.,NIH West Coast Metabolomics Center, University of California Davis, Davis, CA, USA
| | - Taryn Morningstar
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA
| | - Megan Showalter
- NIH West Coast Metabolomics Center, University of California Davis, Davis, CA, USA
| | - Hailey Heil
- NIH West Coast Metabolomics Center, University of California Davis, Davis, CA, USA
| | - Krista Thongphanh
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA
| | - Sili Fan
- NIH West Coast Metabolomics Center, University of California Davis, Davis, CA, USA
| | - Joanne Chan
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA
| | - Verónica Martínez-Cerdeño
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA.,MIND Institute, University of California Davis, Sacramento, CA, USA.,Institute for Pediatric Regenerative Medicine and Shriners Hospital for Children of Northern California, Sacramento, CA, USA
| | - Robert Berman
- MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Neurological Surgery, University of California Davis, Sacramento, CA, USA
| | - David Zagzag
- Departments of Pathology and Neurosurgery, Division of Neuropathology, NYU Langone Medical Center, New York, NY, USA
| | - Evgeny Nudler
- Howard Hughes Medical Institute, New York University School of Medicine, New York, NY, USA.,Department of Biochemistry & Molecular Pharmacology, New York University School of Medicine, New York, NY, USA
| | - Oliver Fiehn
- NIH West Coast Metabolomics Center, University of California Davis, Davis, CA, USA
| | - Mirna Lechpammer
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA.,MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Biochemistry & Molecular Pharmacology, New York University School of Medicine, New York, NY, USA.,Pathology, Foundation Medicine, Inc., Cambridge, MA, USA
| |
Collapse
|
4
|
Xue Y, Dongmei Li, Yige Zhang, Hang Gao, Li H. Angelica polysaccharide moderates hypoxia-evoked apoptosis and autophagy in rat neural stem cells by downregulation of BNIP3. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:2492-2499. [PMID: 31208217 DOI: 10.1080/21691401.2019.1623228] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Yongzhen Xue
- Department of Children’s Healthcare, East Medical District of Linyi People’s Hospital, Linyi, China
| | - Dongmei Li
- Department of Internal Medicine, Shandong Provincial Coal Linyi Hot Springs Sanatorium Hospital, Linyi, China
| | - Yige Zhang
- Classe Six of Clinical Five-Year System, Medical Department of Qingdao University, Qingdao, China
| | - Hang Gao
- Class eight of Clinical Medicine, Basic Medical College of Jining Medical University, Jining, China
| | - Hui Li
- Department of Children’s Rehabilitation, Linyi Women’s and Children’s Hospital, Linyi, China
| |
Collapse
|
5
|
Modabbernia A, Velthorst E, Reichenberg A. Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses. Mol Autism 2017; 8:13. [PMID: 28331572 PMCID: PMC5356236 DOI: 10.1186/s13229-017-0121-4] [Citation(s) in RCA: 420] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 02/12/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND According to recent evidence, up to 40-50% of variance in autism spectrum disorder (ASD) liability might be determined by environmental factors. In the present paper, we conducted a review of systematic reviews and meta-analyses of environmental risk factors for ASD. We assessed each review for quality of evidence and provided a brief overview of putative mechanisms of environmental risk factors for ASD. FINDINGS Current evidence suggests that several environmental factors including vaccination, maternal smoking, thimerosal exposure, and most likely assisted reproductive technologies are unrelated to risk of ASD. On the contrary, advanced parental age is associated with higher risk of ASD. Birth complications that are associated with trauma or ischemia and hypoxia have also shown strong links to ASD, whereas other pregnancy-related factors such as maternal obesity, maternal diabetes, and caesarian section have shown a less strong (but significant) association with risk of ASD. The reviews on nutritional elements have been inconclusive about the detrimental effects of deficiency in folic acid and omega 3, but vitamin D seems to be deficient in patients with ASD. The studies on toxic elements have been largely limited by their design, but there is enough evidence for the association between some heavy metals (most important inorganic mercury and lead) and ASD that warrants further investigation. Mechanisms of the association between environmental factors and ASD are debated but might include non-causative association (including confounding), gene-related effect, oxidative stress, inflammation, hypoxia/ischemia, endocrine disruption, neurotransmitter alterations, and interference with signaling pathways. CONCLUSIONS Compared to genetic studies of ASD, studies of environmental risk factors are in their infancy and have significant methodological limitations. Future studies of ASD risk factors would benefit from a developmental psychopathology approach, prospective design, precise exposure measurement, reliable timing of exposure in relation to critical developmental periods and should take into account the dynamic interplay between gene and environment by using genetically informed designs.
Collapse
Affiliation(s)
- Amirhossein Modabbernia
- Department of Psychiatry and Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Eva Velthorst
- Department of Psychiatry and Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Abraham Reichenberg
- Department of Psychiatry and Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
- Friedman Brain Institute, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|
6
|
Cai Q, Wang T, Yang WJ, Fen X. Protective mechanisms of microRNA-27a against oxygen-glucose deprivation-induced injuries in hippocampal neurons. Neural Regen Res 2016; 11:1285-92. [PMID: 27651777 PMCID: PMC5020828 DOI: 10.4103/1673-5374.189194] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Hypoxic injuries during fetal distress have been shown to cause reduced expression of microRNA-27a (miR-27a), which regulates sensitivity of cortical neurons to apoptosis. We hypothesized that miR-27a overexpression attenuates hypoxia- and ischemia-induced neuronal apoptosis by regulating FOXO1, an important transcription factor for regulating the oxidative stress response. miR-27a mimic was transfected into hippocampal neurons to overexpress miR-27a. Results showed increased hippocampal neuronal viability and decreased caspase-3 expression. The luciferase reporter gene system demonstrated that miR-27a directly binded to FOXO1 3'UTR in hippocampal neurons and inhibited FOXO1 expression, suggesting that FOXO1 was the target gene for miR-27a. These findings confirm that miR-27a protects hippocampal neurons against oxygen-glucose deprivation-induced injuries. The mechanism might be mediated by modulation of FOXO1 and apoptosis-related gene caspase-3 expression.
Collapse
Affiliation(s)
- Qun Cai
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Ting Wang
- Department of Emergency, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Wen-Jie Yang
- Medical College of Nantong University, Nantong, Jiangsu Province, China
| | - Xing Fen
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China
| |
Collapse
|
7
|
Lechpammer M, Tran YP, Wintermark P, Martínez-Cerdeño V, Krishnan VV, Ahmed W, Berman RF, Jensen FE, Nudler E, Zagzag D. Upregulation of cystathionine β-synthase and p70S6K/S6 in neonatal hypoxic ischemic brain injury. Brain Pathol 2016; 27:449-458. [PMID: 27465493 DOI: 10.1111/bpa.12421] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/12/2016] [Indexed: 12/20/2022] Open
Abstract
Encephalopathy of prematurity (EOP) is a complex form of cerebral injury that occurs in the setting of hypoxia-ischemia (HI) in premature infants. Using a rat model of EOP, we investigated whether neonatal HI of the brain may alter the expression of cystathionine β-synthase (CBS) and the components of the mammalian target of rapamycin (mTOR) signaling. We performed unilateral carotid ligation and induced HI (UCL/HI) in Long-Evans rats at P6 and found increased CBS expression in white matter (i.e. corpus callosum, cingulum bundle and external capsule) as early as 24 h (P7) postprocedure. CBS remained elevated through P21, and, to a lesser extent, at P40. The mTOR downstream target 70 kDa ribosomal protein S6 kinase (p70S6K and phospho-p70S6K) and 40S ribosomal protein S6 (S6 and phospho-S6) were also overexpressed at the same time points in the UCL/HI rats compared to healthy controls. Overexpression of mTOR components was not observed in rats treated with the mTOR inhibitor everolimus. Behavioral assays performed on young rats (postnatal day 35-37) following UCL/HI at P6 indicated impaired preference for social novelty, a behavior relevant to autism spectrum disorder, and hyperactivity. Everolimus restored behavioral patterns to those observed in healthy controls. A gait analysis has shown that motor deficits in the hind paws of UCL/HI rats were also significantly reduced by everolimus. Our results suggest that neonatal HI brain injury may inflict long-term damage by upregulation of CBS and mTOR signaling. We propose this cascade as a possible new molecular target for EOP-a still untreatable cause of autism, hyperactivity and cerebral palsy.
Collapse
Affiliation(s)
- Mirna Lechpammer
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, CA
| | - Yen P Tran
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, CA
| | - Pia Wintermark
- Department of Pediatrics, Division of Newborn Medicine, Montréal Children's Hospital, McGill University, Montréal, QC, Canada
| | - Veronica Martínez-Cerdeño
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, CA.,MIND Institute, University of California Davis, Sacramento, CA.,Institute for Pediatric Regenerative Medicine and Shriners Hospital for Children of Northern California, Sacramento, CA
| | - Viswanathan V Krishnan
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, CA
| | - Waseem Ahmed
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, CA
| | - Robert F Berman
- MIND Institute, University of California Davis, Sacramento, CA.,Department of Neurological Surgery, University of California Davis, Sacramento, CA
| | - Frances E Jensen
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - Evgeny Nudler
- Howard Hughes Medical Institute and Department of Biochemistry, New York University School of Medicine, New York, NY
| | - David Zagzag
- Departments of Pathology and Neurosurgery, Division of Neuropathology, Microvascular and Molecular Neuro-Oncology Laboratory, Perlmutter Cancer Center, New York University Langone Medical Center, New York, NY
| |
Collapse
|