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Stolp HB, Solito E. Developmental priming of early cerebrovascular ageing: Implications across a lifetime. Int J Geriatr Psychiatry 2024; 39:e6090. [PMID: 38629845 DOI: 10.1002/gps.6090] [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: 11/16/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Neurological conditions such as Alzheimer's disease and stroke represent a substantial health burden to the world's ageing population. Cerebrovascular dysfunction is a key contributor to these conditions, affecting an individual's risk profile, age of onset, and severity of neurological disease. Recent data shows that early-life events, such as maternal health during pregnancy, birth weight and exposure to environmental toxins can 'prime' the vascular system for later changes. With age, blood vessels can become less flexible and more prone to damage. This can lead to reduced blood flow to the brain, which is associated with cognitive decline and an increased risk of stroke and other cerebrovascular diseases. These in turn increase the risk of vascular dementia and Alzheimer's disease. OBJECTIVES We aim to explore how early life factors influence cerebrovascular health, ageing and disease. METHODS We have reviewed recently published literature from epidemiological studies, clinical cases and basic research which explore mechanisms that contribute to cerebrovascular and blood-brain barrier dysfunction, with a particularly focus on those that assess contribution of early-life events or vascular priming to subsequent injury. RESULTS Perinatal events have been linked to acute cerebrovascular dysfunction and long-term structural reorganisation. Systemic disease throughout the lifetime that produce inflammatory or oxidative stress may further sensitise the cerebrovasculature to disease and contribute to neurodegeneration. CONCLUSIONS By identifying these early-life determinants and understanding their mechanisms, scientists aim to develop strategies for preventing or mitigating cerebrovascular ageing-related issues.
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Affiliation(s)
- Helen B Stolp
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - Egle Solito
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
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Vande Walle C, Keymeulen A, Oostra A, Schiettecatte E, Dhooge I, Smets K, Herregods N. Apparent diffusion coefficient values of the white matter in magnetic resonance imaging of the neonatal brain may help predict outcome in congenital cytomegalovirus infection. Pediatr Radiol 2024; 54:337-346. [PMID: 38182852 PMCID: PMC10830666 DOI: 10.1007/s00247-023-05838-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND White matter change is a well-known abnormality in congenital cytomegalovirus (cCMV) infection, but grading remains challenging and clinical relevance unclear. OBJECTIVE To investigate if quantitative measurement of white matter apparent diffusion coefficient (ADC) values in magnetic resonance imaging (MRI) of the neonatal brain can predict outcome in cCMV. MATERIALS AND METHODS A retrospective, single-center observational study, including patients with cCMV who had a neonatal brain MRI with diffusion-weighted imaging, was performed between 2007 and 2020. Regions of interest were systematically placed in the white matter on the ADC maps. Two pediatric radiologists independently scored additional brain abnormalities. Outcome measures were neonatal hearing and cognitive and motor development. Statistical analysis included simple and penalized elastic net regression. RESULTS Neonatal brain MRI was evaluated in 255 patients (median age 21 days, 25-75 percentiles: 14-28 days, 121 male). Gyral abnormalities were noted in nine patients (3.5%), ventriculomegaly in 24 (9.4%), and subependymal cysts in 58 (22.7%). General white matter ADC was significantly higher in patients with neonatal hearing loss and cognitive and motor impairment (P< 0.05). For neonatal hearing loss, simple logistic regression using only general white matter was the best prediction model, with a receiver operating characteristic area under the curve (AUC)=0.76. For cognitive impairment, interacting elastic net regression, including other brain abnormalities and frontoparietal white matter ADC, performed best, with AUC=0.89. For motor impairment, interacting elastic net regression, including other brain abnormalities and deep anterior frontal white matter performed best, with AUC=0.73. CONCLUSION Neonatal white matter ADC was significantly higher in patients with clinical impairments. Quantitative ADC measurement may be a useful tool for predicting clinical outcome in cCMV.
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Affiliation(s)
- Caroline Vande Walle
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | | | - Anna Oostra
- Center for Developmental Disorders, Ghent, Belgium
| | - Eva Schiettecatte
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Ingeborg Dhooge
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Koenraad Smets
- Department of Neonatology, Ghent University Hospital, Ghent, Belgium
| | - Nele Herregods
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
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3
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Wilson S, Pietsch M, Cordero-Grande L, Christiaens D, Uus A, Karolis VR, Kyriakopoulou V, Colford K, Price AN, Hutter J, Rutherford MA, Hughes EJ, Counsell SJ, Tournier JD, Hajnal JV, Edwards AD, O’Muircheartaigh J, Arichi T. Spatiotemporal tissue maturation of thalamocortical pathways in the human fetal brain. eLife 2023; 12:e83727. [PMID: 37010273 PMCID: PMC10125021 DOI: 10.7554/elife.83727] [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: 09/26/2022] [Accepted: 03/31/2023] [Indexed: 04/04/2023] Open
Abstract
The development of connectivity between the thalamus and maturing cortex is a fundamental process in the second half of human gestation, establishing the neural circuits that are the basis for several important brain functions. In this study, we acquired high-resolution in utero diffusion magnetic resonance imaging (MRI) from 140 fetuses as part of the Developing Human Connectome Project, to examine the emergence of thalamocortical white matter over the second to third trimester. We delineate developing thalamocortical pathways and parcellate the fetal thalamus according to its cortical connectivity using diffusion tractography. We then quantify microstructural tissue components along the tracts in fetal compartments that are critical substrates for white matter maturation, such as the subplate and intermediate zone. We identify patterns of change in the diffusion metrics that reflect critical neurobiological transitions occurring in the second to third trimester, such as the disassembly of radial glial scaffolding and the lamination of the cortical plate. These maturational trajectories of MR signal in transient fetal compartments provide a normative reference to complement histological knowledge, facilitating future studies to establish how developmental disruptions in these regions contribute to pathophysiology.
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Affiliation(s)
- Siân Wilson
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
| | - Maximilian Pietsch
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de MadridMadridSpain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN)MadridSpain
| | - Daan Christiaens
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Department of Electrical Engineering (ESAT/PSI), Katholieke Universiteit LeuvenLeuvenBelgium
| | - Alena Uus
- Department of Biomedical Engineering, School Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas' HospitalLondonUnited Kingdom
| | - Vyacheslav R Karolis
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Vanessa Kyriakopoulou
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Kathleen Colford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Anthony N Price
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Jana Hutter
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Emer J Hughes
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Jacques-Donald Tournier
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
| | - Jonathan O’Muircheartaigh
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
- Department of Forensic and Neurodevelopmental Sciences, King’s College LondonLondonUnited Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation TrustLondonUnited Kingdom
- Department of Bioengineering, Imperial College LondonLondonUnited Kingdom
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4
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Pollatou A, Filippi CA, Aydin E, Vaughn K, Thompson D, Korom M, Dufford AJ, Howell B, Zöllei L, Martino AD, Graham A, Scheinost D, Spann MN. An ode to fetal, infant, and toddler neuroimaging: Chronicling early clinical to research applications with MRI, and an introduction to an academic society connecting the field. Dev Cogn Neurosci 2022; 54:101083. [PMID: 35184026 PMCID: PMC8861425 DOI: 10.1016/j.dcn.2022.101083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/17/2021] [Accepted: 02/04/2022] [Indexed: 12/14/2022] Open
Abstract
Fetal, infant, and toddler neuroimaging is commonly thought of as a development of modern times (last two decades). Yet, this field mobilized shortly after the discovery and implementation of MRI technology. Here, we provide a review of the parallel advancements in the fields of fetal, infant, and toddler neuroimaging, noting the shifts from clinical to research use, and the ongoing challenges in this fast-growing field. We chronicle the pioneering science of fetal, infant, and toddler neuroimaging, highlighting the early studies that set the stage for modern advances in imaging during this developmental period, and the large-scale multi-site efforts which ultimately led to the explosion of interest in the field today. Lastly, we consider the growing pains of the community and the need for an academic society that bridges expertise in developmental neuroscience, clinical science, as well as computational and biomedical engineering, to ensure special consideration of the vulnerable mother-offspring dyad (especially during pregnancy), data quality, and image processing tools that are created, rather than adapted, for the young brain.
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Affiliation(s)
- Angeliki Pollatou
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Courtney A Filippi
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA; Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Ezra Aydin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; Department of Psychology, University of Cambridge, Cambridge, UK
| | - Kelly Vaughn
- Department of Pediatrics, University of Texas Health Sciences Center, Houston, TX, USA
| | - Deanne Thompson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Marta Korom
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Alexander J Dufford
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Brittany Howell
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA, USA; Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA, USA
| | - Lilla Zöllei
- Laboratory for Computational Neuroimaging, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | | | - Alice Graham
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | | | - Dustin Scheinost
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA; Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Marisa N Spann
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
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Hwang M, Tierradentro-García LO, Hussaini SH, Cajigas-Loyola SC, Kaplan SL, Otero HJ, Bellah RD. Ultrasound imaging of preterm brain injury: fundamentals and updates. Pediatr Radiol 2022; 52:817-836. [PMID: 34648071 DOI: 10.1007/s00247-021-05191-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/22/2021] [Accepted: 08/12/2021] [Indexed: 11/25/2022]
Abstract
Neurosonography has become an essential tool for diagnosis and serial monitoring of preterm brain injury. Preterm infants are at significantly higher risk of hypoxic-ischemic injury, intraventricular hemorrhage, periventricular leukomalacia and post-hemorrhagic hydrocephalus. Neonatologists have become increasingly dependent on neurosonography to initiate medical and surgical interventions because it can be used at the bedside. While brain MRI is regarded as the gold standard for detecting preterm brain injury, neurosonography offers distinct advantages such as its cost-effectiveness, diagnostic utility and convenience. Neurosonographic signatures associated with poor long-term outcomes shape decisions regarding supportive care, medical or behavioral interventions, and family members' expectations. Within the last decade substantial progress has been made in neurosonography techniques, prompting an updated review of the topic. In addition to the up-to-date summary of neurosonography, this review discusses the potential roles of emerging neurosonography techniques that offer new functional insights into the brain, such as superb microvessel imaging, elastography, three-dimensional ventricular volume assessment, and contrast-enhanced US.
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Affiliation(s)
- Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Luis O Tierradentro-García
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Syed H Hussaini
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephanie C Cajigas-Loyola
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Summer L Kaplan
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard D Bellah
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Nilsson G, Baburamani AA, Rutherford MA, Zhu C, Mallard C, Hagberg H, Vontell R, Wang X. White matter injury but not germinal matrix hemorrhage induces elevated osteopontin expression in human preterm brains. Acta Neuropathol Commun 2021; 9:166. [PMID: 34654477 PMCID: PMC8518254 DOI: 10.1186/s40478-021-01267-7] [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: 08/06/2021] [Accepted: 09/26/2021] [Indexed: 11/10/2022] Open
Abstract
Osteopontin (OPN) is a matricellular protein that mediates various physiological functions and is implicated in neuroinflammation, myelination, and perinatal brain injury. However, its expression in association with brain injury in preterm infants is unexplored. Here we examined the expression of OPN in postmortem brains of preterm infants and explored how this expression is affected in brain injury. We analyzed brain sections from cases with white matter injury (WMI) and cases with germinal matrix hemorrhage (GMH) and compared them to control cases having no brain injury. WMI cases displayed moderate to severe tissue injury in the periventricular and deep white matter that was accompanied by an increase of microglia with amoeboid morphology. Apart from visible hemorrhage in the germinal matrix, GMH cases displayed diffuse white matter injury in the periventricular and deep white matter. In non-injured preterm brains, OPN was expressed at low levels in microglia, astrocytes, and oligodendrocytes. OPN expression was significantly increased in regions with white matter injury in both WMI cases and GMH cases. The main cellular source of OPN in white matter injury areas was amoeboid microglia, although a significant increase was also observed in astrocytes in WMI cases. OPN was not expressed in the germinal matrix of any case, regardless of whether there was hemorrhage. In conclusion, preterm brain injury induces elevated OPN expression in microglia and astrocytes, and this increase is found in sites closely related to injury in the white matter regions but not with the hemorrhage site in the germinal matrix. Thus, it appears that OPN takes part in the inflammatory process in white matter injury in preterm infants, and these findings facilitate our understanding of OPN's role under both physiological and pathological conditions in the human brain that may lead to greater elucidation of disease mechanisms and potentially better treatment strategies.
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Affiliation(s)
- Gisela Nilsson
- Centre of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden
| | - Ana A Baburamani
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Mary A Rutherford
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Changlian Zhu
- Department of Clinical Neuroscience, Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Henan Key Laboratory of Child Brain Injury and Pediatric Clinical Research Center, Institute of Neuroscience and Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Carina Mallard
- Centre of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden
| | - Henrik Hagberg
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, 40530, Gothenburg, Sweden
| | - Regina Vontell
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
- University of Miami Brain Endowment Bank, Miami, FL, 33136, USA
| | - Xiaoyang Wang
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, 40530, Gothenburg, Sweden.
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7
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Vanes LD, Hadaya L, Kanel D, Falconer S, Ball G, Batalle D, Counsell SJ, Edwards AD, Nosarti C. Associations Between Neonatal Brain Structure, the Home Environment, and Childhood Outcomes Following Very Preterm Birth. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:146-155. [PMID: 34471914 PMCID: PMC8367847 DOI: 10.1016/j.bpsgos.2021.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/16/2021] [Accepted: 05/06/2021] [Indexed: 12/31/2022] Open
Abstract
Background Very preterm birth is associated with an increased risk of childhood psychopathology and cognitive deficits. However, the extent to which these developmental problems associated with preterm birth are amenable to environmental factors or determined by neurobiology at birth remains unclear. Methods We derived neonatal brain structural covariance networks using non-negative matrix factorization in 384 very preterm infants (median gestational age [range], 30.29 [23.57–32.86] weeks) who underwent magnetic resonance imaging at term-equivalent age (median postmenstrual age, 42.57 [37.86–44.86] weeks). Principal component analysis was performed on 32 behavioral and cognitive measures assessed at preschool age (n = 206; median age, 4.65 [4.19–7.17] years) to identify components of childhood psychopathology and cognition. The Cognitively Stimulating Parenting Scale assessed the level of cognitively stimulating experiences available to the child at home. Results Cognitively stimulating parenting was associated with reduced expression of a component reflecting developmental psychopathology and executive dysfunction consistent with the preterm phenotype (inattention-hyperactivity, autism spectrum behaviors, and lower executive function scores). In contrast, a component reflecting better general cognitive abilities was associated with larger neonatal gray matter volume in regions centered on key nodes of the salience network, but not with cognitively stimulating parenting. Conclusions Our results suggest that while neonatal brain structure likely influences cognitive abilities in very preterm children, the severity of behavioral symptoms that are typically observed in these children is sensitive to a cognitively stimulating home environment. Very preterm children may derive meaningful mental health benefits from access to cognitively stimulating experiences during childhood.
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Affiliation(s)
- Lucy D. Vanes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Address correspondence to Lucy D. Vanes, Ph.D.
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dana Kanel
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Gareth Ball
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Dafnis Batalle
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Serena J. Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - A. David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Structural Changes in the Cortico-Ponto-Cerebellar Axis at Birth are Associated with Abnormal Neurological Outcomes in Childhood. Clin Neuroradiol 2021; 31:1005-1020. [PMID: 33944956 DOI: 10.1007/s00062-021-01017-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/04/2021] [Indexed: 10/21/2022]
Abstract
White matter lesions in hypoxic-ischemic encephalopathy (HIE) are considered to be the important substrate of frequent neurological consequences in preterm infants. The aim of the study was to analyze volumes and tractographic parameters of the cortico-ponto-cerebellar axis to assess alterations in the periventricular fiber system and crossroads, corticopontine and corticospinal pathways and prospective transsynaptic changes of the cerebellum.Term infants (control), premature infants without (normotypic) and with perinatal HIE (HIE) underwent brain magnetic resonance imaging at term-equivalent age (TEA) and at 2 years. Cerebrum, cerebellum, brainstem divisions and ventrodorsal compartments volumetric analysis were performed, as well as fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of corticopontine, corticospinal pathways and middle cerebellar peduncles. Amiel-Tison scale at TEA and the Hempel test at 2 years were assessed.Cerebellum, brainstem and its compartments volumes were decreased in normotypic and HIE groups at TEA, while at 2 years volumes were significantly reduced in the HIE group, accompanied by decreased volume and FA and increased ADC of corticopontine and corticospinal pathways. Negative association of the brainstem, cerebellum, mesencephalon, pons, corticopontine volumes and corticospinal pathway FA at TEA with the neurological score at 2 years. Cerebellum and pons volumes presented as potential prognostic indicators of neurological outcomes.Our findings agree that these pathways, as a part of the periventricular fiber system and crossroads, exhibit lesion-induced reaction and vulnerability in HIE. Structural differences between normotypic and HIE group at the 2 years suggest a different developmental structural plasticity.
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Prasad JD, Gunn KC, Davidson JO, Galinsky R, Graham SE, Berry MJ, Bennet L, Gunn AJ, Dean JM. Anti-Inflammatory Therapies for Treatment of Inflammation-Related Preterm Brain Injury. Int J Mol Sci 2021; 22:4008. [PMID: 33924540 PMCID: PMC8069827 DOI: 10.3390/ijms22084008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 12/13/2022] Open
Abstract
Despite the prevalence of preterm brain injury, there are no established neuroprotective strategies to prevent or alleviate mild-to-moderate inflammation-related brain injury. Perinatal infection and inflammation have been shown to trigger acute neuroinflammation, including proinflammatory cytokine release and gliosis, which are associated with acute and chronic disturbances in brain cell survival and maturation. These findings suggest the hypothesis that the inhibition of peripheral immune responses following infection or nonspecific inflammation may be a therapeutic strategy to reduce the associated brain injury and neurobehavioral deficits. This review provides an overview of the neonatal immunity, neuroinflammation, and mechanisms of inflammation-related brain injury in preterm infants and explores the safety and efficacy of anti-inflammatory agents as potentially neurotherapeutics.
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Affiliation(s)
- Jaya D. Prasad
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland 1010, New Zealand; (J.D.P.); (K.C.G.); (J.O.D.); (L.B.); (A.J.G.)
| | - Katherine C. Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland 1010, New Zealand; (J.D.P.); (K.C.G.); (J.O.D.); (L.B.); (A.J.G.)
| | - Joanne O. Davidson
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland 1010, New Zealand; (J.D.P.); (K.C.G.); (J.O.D.); (L.B.); (A.J.G.)
| | - Robert Galinsky
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia;
| | - Scott E. Graham
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Mary J. Berry
- Department of Pediatrics and Health Care, University of Otago, Dunedin 9016, New Zealand;
| | - Laura Bennet
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland 1010, New Zealand; (J.D.P.); (K.C.G.); (J.O.D.); (L.B.); (A.J.G.)
| | - Alistair J. Gunn
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland 1010, New Zealand; (J.D.P.); (K.C.G.); (J.O.D.); (L.B.); (A.J.G.)
| | - Justin M. Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland 1010, New Zealand; (J.D.P.); (K.C.G.); (J.O.D.); (L.B.); (A.J.G.)
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10
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Rath CP, Desai S, Rao SC, Patole S. Diffuse excessive high signal intensity on term equivalent MRI does not predict disability: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 2021; 106:9-16. [PMID: 32451357 DOI: 10.1136/archdischild-2019-318207] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 03/25/2020] [Accepted: 04/22/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate whether diffuse excessive high signal intensity (DEHSI) on term equivalent age MRI (TEA-MRI) predicts disability in preterm infants. DESIGN This is a systematic review and meta-analysis. Medline, EMBASE, Cochrane Library, EMCARE, Google Scholar and MedNar databases were searched in July 2019. Studies comparing developmental outcomes of isolated DEHSI on TEA-MRI versus normal TEA-MRI were included. Two reviewers independently extracted data and assessed the risk of bias. Meta-analysis was undertaken where data were available in a format suitable for pooling. MAIN OUTCOME MEASURES Neurodevelopmental outcomes ≥1 year of corrected age based on validated tools. RESULTS A total of 15 studies (n=1832) were included, of which data from 9 studies were available for meta-analysis. The pooled estimate (n=7) for sensitivity of DEHSI in predicting cognitive/mental disability was 0.58 (95% CI 0.34 to 0.79) and for specificity was 0.46 (95% CI 0.20 to 0.74). The summary area under the receiver operating characteristics (ROC) curve was low at 0.54 (CI 0.50 to 0.58). A pooled diagnostic OR (DOR) of 1 indicated that DEHSI does not discriminate preterm infants with and without mental disability. The pooled estimate (n=8) for sensitivity of DEHSI in predicting cerebral palsy (CP) was 0.57 (95% CI 0.37 to 0.75) and for specificity was 0.41 (95% CI 0.24 to 0.62). The summary area under the ROC curve was low at 0.51 (CI 0.46 to 0.55). A pooled DOR of 1 indicated that DEHSI does not discriminate between preterm infants with and without CP. CONCLUSIONS DEHSI on TEA-MRI did not predict future development of cognitive/mental disabilities or CP. PROSPERO REGISTRATION NUMBER CRD42019130576.
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Affiliation(s)
- Chandra Prakash Rath
- Neonatal Intensive Care Unit, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Saumil Desai
- Neonatal Intensive Care Unit, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Shripada C Rao
- Neonatal Intensive Care Unit, Perth Children's Hospital, Nedlands, Western Australia, Australia .,Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Sanjay Patole
- Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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11
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Della Rosa PA, Canini M, Marchetta E, Cirillo S, Pontesilli S, Scotti R, Natali Sora MG, Poloniato A, Barera G, Falini A, Scifo P, Baldoli C. The effects of the functional interplay between the Default Mode and Executive Control Resting State Networks on cognitive outcome in preterm born infants at 6 months of age. Brain Cogn 2020; 147:105669. [PMID: 33341657 DOI: 10.1016/j.bandc.2020.105669] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 10/22/2022]
Abstract
Preterm birth can affect cognitive functions, such as attention or more generally executive control mechanisms, with severity in impairments proportional to prematurity. The functional cross-talk between the Default Mode (DMN) and Executive Control (ECN) networks mirrors the integrity of cognitive processing and is directly related to brain development. In this study, a cohort of 20 preterm-born infants was investigated using rs-fMRI. First, we addressed biological maturity of the DMN per se and its interplay with the ECN in terms of patterns of increased functional connectivity. Second, we assessed the impact of the degree of prematurity on the DMN-ECN functional interplay development in relation to cognitive outcome at six months. Our results highlighted the emergence of DMN in preterm neonates, with connectivity strength and synchronization between the anterior DMN hub and frontal areas increasing as a function of biological maturity. Further, cognitive scores at 6 months were predicted by mPFC-ECN connectivity strength with degree of prematurity impacting on mPFC-ECN connectivity and triggering differential patterns of functional maturation of the ECN for very early/early and moderate/late preterm neonates. Our findings suggest that the prematurity window allows to observe precursors of functional plasticity that may underlie different developmental trajectories in preterm children.
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Affiliation(s)
| | - Matteo Canini
- Department of Neuroradiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Elisa Marchetta
- Department of Neuroradiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Sara Cirillo
- Department of Neuroradiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Silvia Pontesilli
- Department of Neuroradiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Roberta Scotti
- Department of Neuroradiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Antonella Poloniato
- Unit of Neonatology, Department of Pediatrics, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Graziano Barera
- Unit of Neonatology, Department of Pediatrics, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Scifo
- Department of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Cristina Baldoli
- Department of Neuroradiology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
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12
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Kimpton JA, Batalle D, Barnett ML, Hughes EJ, Chew ATM, Falconer S, Tournier JD, Alexander D, Zhang H, Edwards AD, Counsell SJ. Diffusion magnetic resonance imaging assessment of regional white matter maturation in preterm neonates. Neuroradiology 2020; 63:573-583. [PMID: 33123752 PMCID: PMC7966229 DOI: 10.1007/s00234-020-02584-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/13/2020] [Indexed: 02/03/2023]
Abstract
Purpose Diffusion magnetic resonance imaging (dMRI) studies report altered white matter (WM) development in preterm infants. Neurite orientation dispersion and density imaging (NODDI) metrics provide more realistic estimations of neurite architecture in vivo compared with standard diffusion tensor imaging (DTI) metrics. This study investigated microstructural maturation of WM in preterm neonates scanned between 25 and 45 weeks postmenstrual age (PMA) with normal neurodevelopmental outcomes at 2 years using DTI and NODDI metrics. Methods Thirty-one neonates (n = 17 male) with median (range) gestational age (GA) 32+1 weeks (24+2–36+4) underwent 3 T brain MRI at median (range) post menstrual age (PMA) 35+2 weeks (25+3–43+1). WM tracts (cingulum, fornix, corticospinal tract (CST), inferior longitudinal fasciculus (ILF), optic radiations) were delineated using constrained spherical deconvolution and probabilistic tractography in MRtrix3. DTI and NODDI metrics were extracted for the whole tract and cross-sections along each tract to assess regional development. Results PMA at scan positively correlated with fractional anisotropy (FA) in the CST, fornix and optic radiations and neurite density index (NDI) in the cingulum, CST and fornix and negatively correlated with mean diffusivity (MD) in all tracts. A multilinear regression model demonstrated PMA at scan influenced all diffusion measures, GA and GAxPMA at scan influenced FA, MD and NDI and gender affected NDI. Cross-sectional analyses revealed asynchronous WM maturation within and between WM tracts.). Conclusion We describe normal WM maturation in preterm neonates with normal neurodevelopmental outcomes. NODDI can enhance our understanding of WM maturation compared with standard DTI metrics alone. Supplementary Information The online version of this article (10.1007/s00234-020-02584-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J A Kimpton
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - D Batalle
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.,Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M L Barnett
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - E J Hughes
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - A T M Chew
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - S Falconer
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - J D Tournier
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - D Alexander
- Department of Computer Science and Centre for Medical Imaging Computing, University College London, London, UK
| | - H Zhang
- Department of Computer Science and Centre for Medical Imaging Computing, University College London, London, UK
| | - A D Edwards
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - S J Counsell
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
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13
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Dimitrova R, Pietsch M, Christiaens D, Ciarrusta J, Wolfers T, Batalle D, Hughes E, Hutter J, Cordero-Grande L, Price AN, Chew A, Falconer S, Vecchiato K, Steinweg JK, Carney O, Rutherford MA, Tournier JD, Counsell SJ, Marquand AF, Rueckert D, Hajnal JV, McAlonan G, Edwards AD, O’Muircheartaigh J. Heterogeneity in Brain Microstructural Development Following Preterm Birth. Cereb Cortex 2020; 30:4800-4810. [PMID: 32306044 PMCID: PMC7391275 DOI: 10.1093/cercor/bhaa069] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/24/2020] [Accepted: 02/23/2020] [Indexed: 01/08/2023] Open
Abstract
Preterm-born children are at increased risk of lifelong neurodevelopmental difficulties. Group-wise analyses of magnetic resonance imaging show many differences between preterm- and term-born infants but do not reliably predict neurocognitive prognosis for individual infants. This might be due to the unrecognized heterogeneity of cerebral injury within the preterm group. This study aimed to determine whether atypical brain microstructural development following preterm birth is significantly variable between infants. Using Gaussian process regression, a technique that allows a single-individual inference, we characterized typical variation of brain microstructure using maps of fractional anisotropy and mean diffusivity in a sample of 270 term-born neonates. Then, we compared 82 preterm infants to these normative values to identify brain regions with atypical microstructure and relate observed deviations to degree of prematurity and neurocognition at 18 months. Preterm infants showed strikingly heterogeneous deviations from typical development, with little spatial overlap between infants. Greater and more extensive deviations, captured by a whole brain atypicality index, were associated with more extreme prematurity and predicted poorer cognitive and language abilities at 18 months. Brain microstructural development after preterm birth is highly variable between individual infants. This poorly understood heterogeneity likely relates to both the etiology and prognosis of brain injury.
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Affiliation(s)
- Ralica Dimitrova
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Maximilian Pietsch
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Daan Christiaens
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, 3001, Belgium
| | - Judit Ciarrusta
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Thomas Wolfers
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radbound University, Nijmegen, 6525EN, the Netherlands
- Department of Cognitive Neuroscience, Radbound University Medical Centre, Nijmegen, 6525EN, the Netherlands
| | - Dafnis Batalle
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Emer Hughes
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Jana Hutter
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- Biomedical Image Technologies, ETSI Telecomunicacion, Universidad Politecnica de Madrid and CIBER-BBN, Madrid, 28040, Spain
| | - Anthony N Price
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Andrew Chew
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Shona Falconer
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Katy Vecchiato
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Johannes K Steinweg
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Olivia Carney
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Mary A Rutherford
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - J-Donald Tournier
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Serena J Counsell
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Andre F Marquand
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radbound University, Nijmegen, 6525EN, the Netherlands
- Department of Cognitive Neuroscience, Radbound University Medical Centre, Nijmegen, 6525EN, the Netherlands
| | - Daniel Rueckert
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, SW7 2AZ, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
| | - Grainne McAlonan
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - A David Edwards
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, UK
| | - Jonathan O’Muircheartaigh
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, SE1 7EH, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, SE1 1UL, UK
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14
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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: 49] [Impact Index Per Article: 12.3] [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.
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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.
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15
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Park HA, Hwang JH. The Risk Factors of Periventricular Leukomalacia among Very Low Birth Weight Infants. NEONATAL MEDICINE 2020. [DOI: 10.5385/nm.2020.27.2.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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16
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Sanz Cortes M, Torres P, Yepez M, Guimaraes C, Zarutskie A, Shetty A, Hsiao A, Pyarali M, Davila I, Espinoza J, Shamshirsaz AA, Nassr A, Whitehead W, Lee W, Belfort MA. Comparison of brain microstructure after prenatal spina bifida repair by either laparotomy-assisted fetoscopic or open approach. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 55:87-95. [PMID: 31219638 DOI: 10.1002/uog.20373] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To compare prenatal and postnatal brain microstructure between infants that underwent fetoscopic myelomeningocele (MMC) repair and those that had open-hysterotomy repair. METHODS This was a longitudinal retrospective cohort study of 57 fetuses that met the Management of Myelomeningocele Study (MOMS) trial criteria and underwent prenatal MMC repair, by a fetoscopic (n = 27) or open-hysterotomy (n = 30) approach, at 21.4-25.9 weeks' gestation. Fetoscopic repair was performed under CO2 insufflation, according to our protocol. Diffusion-weighted magnetic resonance imaging (MRI) was performed before surgery in 30 cases (14 fetoscopic and 16 open), at 6 weeks postsurgery in 48 cases (24 fetoscopic and 24 open) and within the first year after birth in 23 infants (five fetoscopic and 18 open). Apparent diffusion coefficient (ADC) values from the basal ganglia, frontal, occipital and parietal lobes, mesencephalon and genu as well as splenium of the corpus callosum were calculated. ADC values at each of the three timepoints (presurgery, 6 weeks postsurgery and postnatally) and the percentage change in the ADC values between the timepoints were compared between the fetoscopic-repair and open-repair groups. ADC values at 6 weeks after surgery in the two prenatally repaired groups were compared with those in a control group of eight healthy fetuses that underwent MRI at a similar gestational age (GA). Comparison of ADC values was performed using the Student's t-test for independent samples (or Mann-Whitney U-test if non-normally distributed) and multivariate general linear model analysis, adjusting for GA or age at MRI and mean ventricular width. RESULTS There were no differences in GA at surgery or GA/postnatal age at MRI between the groups. No significant differences were observed in ADC values in any of the brain areas assessed between the open-repair and fetoscopic-repair groups at 6 weeks after surgery and in the first year after birth. No differences were detected in the ADC values of the studied areas between the control and prenatally repaired groups, except for significantly increased ADC values in the genu of the corpus callosum in the open-hysterotomy and fetoscopic-repair groups. Additionally, there were no differences between the two prenatally repaired groups in the percentage change in ADC values at any of the time intervals analyzed. CONCLUSIONS Fetoscopic MMC repair has no detectable effect on brain microstructure when compared to babies repaired using an open-hysterotomy technique. CO2 insufflation of the uterine cavity during fetoscopy does not seem to have any isolated deleterious effects on fetal brain microstructure. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Sanz Cortes
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - P Torres
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - M Yepez
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - C Guimaraes
- Department of Radiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA
| | - A Zarutskie
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - A Shetty
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - A Hsiao
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - M Pyarali
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - I Davila
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - J Espinoza
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - A A Shamshirsaz
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - A Nassr
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - W Whitehead
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - W Lee
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - M A Belfort
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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17
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Wallois F, Routier L, Bourel-Ponchel E. Impact of prematurity on neurodevelopment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:341-375. [PMID: 32958184 DOI: 10.1016/b978-0-444-64150-2.00026-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The consequences of prematurity on brain functional development are numerous and diverse, and impact all brain functions at different levels. Prematurity occurs between 22 and 36 weeks of gestation. This period is marked by extreme dynamics in the physiologic maturation, structural, and functional processes. These different processes appear sequentially or simultaneously. They are dependent on genetic and/or environmental factors. Disturbance of these processes or of the fine-tuning between them, when caring for premature children, is likely to induce disturbances in the structural and functional development of the immature neural networks. These will appear as impairments in learning skills progress and are likely to have a lasting impact on the development of children born prematurely. The level of severity depends on the initial alteration, whether structural or functional. In this chapter, after having briefly reviewed the neurodevelopmental, structural, and functional processes, we describe, in a nonexhaustive manner, the impact of prematurity on the different brain, motor, sensory, and cognitive functions.
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Affiliation(s)
- Fabrice Wallois
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France.
| | - Laura Routier
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
| | - Emilie Bourel-Ponchel
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
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18
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Stolp HB, Fleiss B, Arai Y, Supramaniam V, Vontell R, Birtles S, Yates AG, Baburamani AA, Thornton C, Rutherford M, Edwards AD, Gressens P. Interneuron Development Is Disrupted in Preterm Brains With Diffuse White Matter Injury: Observations in Mouse and Human. Front Physiol 2019; 10:955. [PMID: 31417418 PMCID: PMC6683859 DOI: 10.3389/fphys.2019.00955] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/09/2019] [Indexed: 12/18/2022] Open
Abstract
Preterm brain injury, occurring in approximately 30% of infants born <32 weeks gestational age, is associated with an increased risk of neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The mechanism of gray matter injury in preterm born children is unclear and likely to be multifactorial; however, inflammation, a high predictor of poor outcome in preterm infants, has been associated with disrupted interneuron maturation in a number of animal models. Interneurons are important for regulating normal brain development, and disruption in interneuron development, and the downstream effects of this, has been implicated in the etiology of neurodevelopmental disorders. Here, we utilize postmortem tissue from human preterm cases with or without diffuse white matter injury (WMI; PMA range: 23+2 to 28+1 for non-WMI group, 26+6 to 30+0 for WMI group, p = 0.002) and a model of inflammation-induced preterm diffuse white matter injury (i.p. IL-1β, b.d., 10 μg/kg/injection in male CD1 mice from P1–5). Data from human preterm infants show deficits in interneuron numbers in the cortex and delayed growth of neuronal arbors at this early stage of development. In the mouse, significant reduction in the number of parvalbumin-positive interneurons was observed from postnatal day (P) 10. This decrease in parvalbumin neuron number was largely rectified by P40, though there was a significantly smaller number of parvalbumin positive cells associated with perineuronal nets in the upper cortical layers. Together, these data suggest that inflammation in the preterm brain may be a contributor to injury of specific interneuron in the cortical gray matter. This may represent a potential target for postnatal therapy to reduce the incidence and/or severity of neurodevelopmental disorders in preterm infants.
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Affiliation(s)
- Helen B Stolp
- Department for Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom.,Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom
| | - Bobbi Fleiss
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom.,Université de Paris, NeuroDiderot, Inserm, Paris, France.,School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Yoko Arai
- Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - Veena Supramaniam
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom
| | - Regina Vontell
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom.,Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Sebastian Birtles
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom
| | - Abi G Yates
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom.,Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Ana A Baburamani
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom
| | - Claire Thornton
- Department for Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom.,Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom
| | - Mary Rutherford
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom
| | - A David Edwards
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom
| | - Pierre Gressens
- Department of Perinatal Imaging & Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Science, King's College London, London, United Kingdom.,Université de Paris, NeuroDiderot, Inserm, Paris, France
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19
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Li H, Parikh NA, Wang J, Merhar S, Chen M, Parikh M, Holland S, He L. Objective and Automated Detection of Diffuse White Matter Abnormality in Preterm Infants Using Deep Convolutional Neural Networks. Front Neurosci 2019; 13:610. [PMID: 31275101 PMCID: PMC6591530 DOI: 10.3389/fnins.2019.00610] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022] Open
Abstract
Diffuse white matter abnormality (DWMA), or diffuse excessive high signal intensity is observed in 50-80% of very preterm infants at term-equivalent age. It is subjectively defined as higher than normal signal intensity in periventricular and subcortical white matter in comparison to normal unmyelinated white matter on T2-weighted MRI images. Despite the well-documented presence of DWMA, it remains debatable whether DWMA represents pathological tissue injury or a transient developmental phenomenon. Manual tracing of DWMA exhibits poor reliability and reproducibility and unduly increases image processing time. Thus, objective and ideally automatic assessment is critical to accurately elucidate the biologic nature of DWMA. We propose a deep learning approach to automatically identify DWMA regions on T2-weighted MRI images. Specifically, we formulated DWMA detection as an image voxel classification task; that is, the voxels on T2-weighted images are treated as samples and exclusively assigned as DWMA or normal white matter voxel classes. To utilize the spatial information of individual voxels, small image patches centered on the given voxels are retrieved. A deep convolutional neural networks (CNN) model was developed to differentiate DWMA and normal voxels. We tested our deep CNN in multiple validation experiments. First, we examined DWMA detection accuracy of our CNN model using computer simulations. This was followed by in vivo assessments in a cohort of very preterm infants (N = 95) using cross-validation and holdout validation. Finally, we tested our approach on an independent preterm cohort (N = 28) to externally validate our model. Our deep CNN model achieved Dice similarity index values ranging from 0.85 to 0.99 for DWMA detection in the aforementioned validation experiments. Our proposed deep CNN model exhibited significantly better performance than other popular machine learning models. We present an objective and automated approach for accurately identifying DWMA that may facilitate the clinical diagnosis of DWMA in very preterm infants.
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Affiliation(s)
- Hailong Li
- The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Nehal A. Parikh
- The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, United States
| | - Jinghua Wang
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Stephanie Merhar
- The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Ming Chen
- The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Electronic Engineering and Computing Systems, University of Cincinnati, Cincinnati, OH, United States
| | - Milan Parikh
- The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Scott Holland
- Medpace Inc., Cincinnati, OH, United States
- Department of Physics, University of Cincinnati, Cincinnati, OH, United States
| | - Lili He
- The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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20
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Nguyen AL, Ding Y, Suffren S, Londono I, Luck D, Lodygensky GA. The brain's kryptonite: Overview of punctate white matter lesions in neonates. Int J Dev Neurosci 2019; 77:77-88. [DOI: 10.1016/j.ijdevneu.2019.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/28/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- Annie L.A. Nguyen
- Sainte‐Justine Hospital Research CenterDepartment of PediatricsUniversity of MontrealMontrealH3T 1C5Canada
- The Canadian Neonatal Brain Platform (CNBP)Canada
| | - Yang Ding
- Sainte‐Justine Hospital Research CenterDepartment of PediatricsUniversity of MontrealMontrealH3T 1C5Canada
- The Canadian Neonatal Brain Platform (CNBP)Canada
| | - Sabrina Suffren
- Sainte‐Justine Hospital Research CenterDepartment of PediatricsUniversity of MontrealMontrealH3T 1C5Canada
- The Canadian Neonatal Brain Platform (CNBP)Canada
| | - Irène Londono
- Sainte‐Justine Hospital Research CenterDepartment of PediatricsUniversity of MontrealMontrealH3T 1C5Canada
- The Canadian Neonatal Brain Platform (CNBP)Canada
| | - David Luck
- Sainte‐Justine Hospital Research CenterDepartment of PediatricsUniversity of MontrealMontrealH3T 1C5Canada
- The Canadian Neonatal Brain Platform (CNBP)Canada
| | - Gregory A. Lodygensky
- Sainte‐Justine Hospital Research CenterDepartment of PediatricsUniversity of MontrealMontrealH3T 1C5Canada
- Department of Pharmacology and PhysiologyUniversity of MontrealMontrealH3T 1J4Canada
- The Canadian Neonatal Brain Platform (CNBP)Canada
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21
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Pregnolato S, Chakkarapani E, Isles AR, Luyt K. Glutamate Transport and Preterm Brain Injury. Front Physiol 2019; 10:417. [PMID: 31068830 PMCID: PMC6491644 DOI: 10.3389/fphys.2019.00417] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/27/2019] [Indexed: 12/19/2022] Open
Abstract
Preterm birth complications are the leading cause of child death worldwide and a top global health priority. Among the survivors, the risk of life-long disabilities is high, including cerebral palsy and impairment of movement, cognition, and behavior. Understanding the molecular mechanisms of preterm brain injuries is at the core of future healthcare improvements. Glutamate excitotoxicity is a key mechanism in preterm brain injury, whereby the accumulation of extracellular glutamate damages the delicate immature oligodendrocytes and neurons, leading to the typical patterns of injury seen in the periventricular white matter. Glutamate excitotoxicity is thought to be induced by an interaction between environmental triggers of injury in the perinatal period, particularly cerebral hypoxia-ischemia and infection/inflammation, and developmental and genetic vulnerabilities. To avoid extracellular build-up of glutamate, the brain relies on rapid uptake by sodium-dependent glutamate transporters. Astrocytic excitatory amino acid transporter 2 (EAAT2) is responsible for up to 95% of glutamate clearance, and several lines of evidence suggest that it is essential for brain functioning. While in the adult EAAT2 is predominantly expressed by astrocytes, EAAT2 is transiently upregulated in the immature oligodendrocytes and selected neuronal populations during mid-late gestation, at the peak time for preterm brain injury. This developmental upregulation may interact with perinatal hypoxia-ischemia and infection/inflammation and contribute to the selective vulnerability of the immature oligodendrocytes and neurons in the preterm brain. Disruption of EAAT2 may involve not only altered expression but also impaired function with reversal of transport direction. Importantly, elevated EAAT2 levels have been found in the reactive astrocytes and macrophages of human infant post-mortem brains with severe white matter injury (cystic periventricular leukomalacia), potentially suggesting an adaptive mechanism against excitotoxicity. Interestingly, EAAT2 is suppressed in animal models of acute hypoxic-ischemic brain injury at term, pointing to an important and complex role in newborn brain injuries. Enhancement of EAAT2 expression and transport function is gathering attention as a potential therapeutic approach for a variety of adult disorders and awaits exploration in the context of the preterm brain injuries.
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Affiliation(s)
- Silvia Pregnolato
- Department of Neonatal Neurology, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Elavazhagan Chakkarapani
- Department of Neonatal Neurology, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anthony R Isles
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Karen Luyt
- Department of Neonatal Neurology, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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22
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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.
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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.
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23
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Nurturing the preterm infant brain: leveraging neuroplasticity to improve neurobehavioral outcomes. Pediatr Res 2019; 85:166-175. [PMID: 30531968 DOI: 10.1038/s41390-018-0203-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022]
Abstract
An intrinsic feature of the developing brain is high susceptibility to environmental influence-known as plasticity. Research indicates cascading disruption to neurological development following preterm (PT) birth; yet, the interactive effects of PT birth and plasticity remain unclear. It is possible that, with regard to neuropsychological outcomes in the PT population, plasticity is a double-edged sword. On one side, high plasticity of rapidly developing neural tissue makes the PT brain more vulnerable to injury resulting from events, including inflammation, hypoxia, and ischemia. On the other side, plasticity may be a mechanism through which positive experience can normalize neurological development for PT children. Much of the available literature on PT neurological development is clinically weighted and focused on diagnostic utility for predicting long-term outcomes. Although diagnostic utility is valuable, research establishing neuroprotective factors is equally beneficial. This review will: (1) detail specific mechanisms through which plasticity is adaptive or maladaptive depending on the experience; (2) integrate research from neuroimaging, intervention, and clinical science fields in a summary of findings suggesting inherent plasticity of the PT brain as a mechanism to improve child outcomes; and (3) summarize how responsive caregiving experiences situate parents as agents of change in normalizing PT infant brain development.
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24
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Kostović I, Sedmak G, Judaš M. Neural histology and neurogenesis of the human fetal and infant brain. Neuroimage 2018; 188:743-773. [PMID: 30594683 DOI: 10.1016/j.neuroimage.2018.12.043] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 01/11/2023] Open
Abstract
The human brain develops slowly and over a long period of time which lasts for almost three decades. This enables good spatio-temporal resolution of histogenetic and neurogenetic events as well as an appropriate and clinically relevant timing of these events. In order to successfully apply in vivo neuroimaging data, in analyzing both the normal brain development and the neurodevelopmental origin of major neurological and mental disorders, it is important to correlate these neuroimaging data with the existing data on morphogenetic, histogenetic and neurogenetic events. Furthermore, when performing such correlation, the genetic, genomic, and molecular biology data on phenotypic specification of developing brain regions, areas and neurons should also be included. In this review, we focus on early developmental periods (form 8 postconceptional weeks to the second postnatal year) and describe the microstructural organization and neural circuitry elements of the fetal and early postnatal human cerebrum.
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Affiliation(s)
- I Kostović
- University of Zagreb School of Medicine, Croatian Institute for Brain Research, Centre of Excellence for Basic, Clinical and Translational Neuroscience, Šalata 12, 10000, Zagreb, Croatia.
| | - G Sedmak
- University of Zagreb School of Medicine, Croatian Institute for Brain Research, Centre of Excellence for Basic, Clinical and Translational Neuroscience, Šalata 12, 10000, Zagreb, Croatia.
| | - M Judaš
- University of Zagreb School of Medicine, Croatian Institute for Brain Research, Centre of Excellence for Basic, Clinical and Translational Neuroscience, Šalata 12, 10000, Zagreb, Croatia.
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25
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Ibrahim J, Mir I, Chalak L. Brain imaging in preterm infants <32 weeks gestation: a clinical review and algorithm for the use of cranial ultrasound and qualitative brain MRI. Pediatr Res 2018; 84:799-806. [PMID: 30315272 DOI: 10.1038/s41390-018-0194-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 02/07/2023]
Abstract
The aim is to review the evidence about the utility of term-equivalent age (TEA) magnetic resonance imaging (MRI) in predicting neurodevelopmental outcomes for preterm neonates. Preterm birth accounts for ~12% of all deliveries in the United States and is the leading cause of neurologic disabilities in children. From the neonatologist perspective, it is critically important to identify preterm infants at risk of subsequent neurodevelopmental disability who may benefit from early intervention services. However "the choose wisely campaign" also emphasizes the need to have ongoing cost/benefit discussions regarding care of preterm newborns to avoid waste that comes from subjecting infants to procedures that do not help. We performed a MEDLINE EMBASE database review from 2000 to 2018 to account for the technical evolution in the cranial ultrasound machines and introduction of MRI imaging in the NICU. Studies were graded based on the strength of their design using the GRADE guidelines and summarized with respect to brain MRI vs. cranial US (1) detection of white matter injury; (2) cerebellar hemorrhage; (3) long-term neurodevelopmental outcomes and impact on parental anxiety. We conclude with a hospital-specific guideline algorithm for performing TEA MRI based on risk evaluations ≤32 weeks.
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Affiliation(s)
- John Ibrahim
- University of Texas Southwestern Medical Center Dallas, Dallas, TX, USA
| | - Imran Mir
- University of Texas Southwestern Medical Center Dallas, Dallas, TX, USA
| | - Lina Chalak
- University of Texas Southwestern Medical Center Dallas, Dallas, TX, USA.
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26
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Chang JL, Bashir M, Santiago C, Farrow K, Fung C, Brown AS, Dettman RW, Dizon MLV. Intrauterine Growth Restriction and Hyperoxia as a Cause of White Matter Injury. Dev Neurosci 2018; 40:344-357. [PMID: 30428455 DOI: 10.1159/000494273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 10/03/2018] [Indexed: 01/17/2023] Open
Abstract
Intrauterine growth restriction (IUGR) is estimated to occur in 5% of pregnancies, with placental insufficiency being the most common cause in developed countries. While it is known that white matter injury occurs in premature infants, the extent of IUGR on white matter injury is less defined in term infants. We used a novel murine model that utilizes a thromboxane A2 (TXA2) analog (U46619), a potent vasoconstrictor, to induce maternal hypertension and mimic human placental insufficiency-induced IUGR to study the white matter. We also investigated the role of hyperoxia as an additional risk factor for white matter injury, as IUGR infants are at increased risk of respiratory comorbidities leading to increased oxygen exposure. We found that TXA2 analog-induced IUGR results in white matter injury as demonstrated by altered myelin structure and changes in the oligodendroglial cell/oligodendrocyte population. In addition, our study demonstrates that hyperoxia exposure independently results in white matter perturbation. To our knowledge, this is the first study to report single and combined effects of IUGR with hyperoxia impacting the white matter and motor function. These results draw attention to the need for close monitoring of motor development in IUGR babies following hospital discharge as well as highlighting the importance of limiting, as clinically feasible, the degree of oxygen overexposure to potentially improve motor outcomes in this population of infants.
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Affiliation(s)
- Jill L Chang
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA,
| | - Mirrah Bashir
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Kathryn Farrow
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Camille Fung
- Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Ashley S Brown
- Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Robert W Dettman
- Stanley Manne Children's Research Institute, Chicago, Illinois, USA
| | - Maria L V Dizon
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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27
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Pecheva D, Kelly C, Kimpton J, Bonthrone A, Batalle D, Zhang H, Counsell SJ. Recent advances in diffusion neuroimaging: applications in the developing preterm brain. F1000Res 2018; 7. [PMID: 30210783 PMCID: PMC6107996 DOI: 10.12688/f1000research.15073.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2018] [Indexed: 12/13/2022] Open
Abstract
Measures obtained from diffusion-weighted imaging provide objective indices of white matter development and injury in the developing preterm brain. To date, diffusion tensor imaging (DTI) has been used widely, highlighting differences in fractional anisotropy (FA) and mean diffusivity (MD) between preterm infants at term and healthy term controls; altered white matter development associated with a number of perinatal risk factors; and correlations between FA values in the white matter in the neonatal period and subsequent neurodevelopmental outcome. Recent developments, including neurite orientation dispersion and density imaging (NODDI) and fixel-based analysis (FBA), enable white matter microstructure to be assessed in detail. Constrained spherical deconvolution (CSD) enables multiple fibre populations in an imaging voxel to be resolved and allows delineation of fibres that traverse regions of fibre-crossings, such as the arcuate fasciculus and cerebellar–cortical pathways. This review summarises DTI findings in the preterm brain and discusses initial findings in this population using CSD, NODDI, and FBA.
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Affiliation(s)
- Diliana Pecheva
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Christopher Kelly
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Jessica Kimpton
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Alexandra Bonthrone
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Dafnis Batalle
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Hui Zhang
- Department of Computer Science & Centre for Medical Image Computing, University College London, London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
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28
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The challenge of cerebral magnetic resonance imaging in neonates: A new method using mathematical morphology for the segmentation of structures including diffuse excessive high signal intensities. Med Image Anal 2018; 48:75-94. [PMID: 29852312 DOI: 10.1016/j.media.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/04/2018] [Accepted: 05/09/2018] [Indexed: 11/20/2022]
Abstract
Preterm birth is a multifactorial condition associated with increased morbidity and mortality. Diffuse excessive high signal intensity (DEHSI) has been recently described on T2-weighted MR sequences in this population and thought to be associated with neuropathologies. To date, no robust and reproducible method to assess the presence of white matter hyperintensities has been developed, perhaps explaining the current controversy over their prognostic value. The aim of this paper is to propose a new semi-automated framework to detect DEHSI on neonatal brain MR images having a particular pattern due to the physiological lack of complete myelination of the white matter. A novel method for semi- automatic segmentation of neonatal brain structures and DEHSI, based on mathematical morphology and on max-tree representations of the images is thus described. It is a mandatory first step to identify and clinically assess homogeneous cohorts of neonates for DEHSI and/or volume of any other segmented structures. Implemented in a user-friendly interface, the method makes it straightforward to select relevant markers of structures to be segmented, and if needed, apply eventually manual corrections. This method responds to the increasing need for providing medical experts with semi-automatic tools for image analysis, and overcomes the limitations of visual analysis alone, prone to subjectivity and variability. Experimental results demonstrate that the method is accurate, with excellent reproducibility and with very few manual corrections needed. Although the method was intended initially for images acquired at 1.5T, which corresponds to the usual clinical practice, preliminary results on images acquired at 3T suggest that the proposed approach can be generalized.
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29
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Young JM, Morgan BR, Whyte HEA, Lee W, Smith ML, Raybaud C, Shroff MM, Sled JG, Taylor MJ. Longitudinal Study of White Matter Development and Outcomes in Children Born Very Preterm. Cereb Cortex 2018; 27:4094-4105. [PMID: 27600850 DOI: 10.1093/cercor/bhw221] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/14/2016] [Indexed: 12/24/2022] Open
Abstract
Identifying trajectories of early white matter development is important for understanding atypical brain development and impaired functional outcomes in children born very preterm (<32 weeks gestational age [GA]). In this study, 161 diffusion images were acquired in children born very preterm (median GA: 29 weeks) shortly following birth (75), term-equivalent (39), 2 years (18), and 4 years of age (29). Diffusion tensors were computed to obtain measures of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), which were aligned and averaged. A paediatric atlas was applied to obtain diffusion metrics within 12 white matter tracts. Developmental trajectories across time points demonstrated age-related changes which plateaued between term-equivalent and 2 years of age in the majority of posterior tracts and between 2 and 4 years of age in anterior tracts. Between preterm and term-equivalent scans, FA rates of change were slower in anterior than posterior tracts. Partial least squares analyses revealed associations between slower MD and RD rates of change within the external and internal capsule with lower intelligence quotients and language scores at 4 years of age. These results uniquely demonstrate early white matter development and its linkage to cognitive functions.
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Affiliation(s)
- Julia M Young
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin R Morgan
- 1Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Hilary E A Whyte
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Neonatology, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Wayne Lee
- 1Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Mary Lou Smith
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
| | - Charles Raybaud
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Manohar M Shroff
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - John G Sled
- Program in Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Margot J Taylor
- 1 Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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Abstract
OBJECTIVES Preterm children demonstrate deficits in executive functions including inhibition, working memory, and cognitive flexibility; however, their goal setting abilities (planning, organization, strategic reasoning) remain unclear. This study compared goal setting abilities between very preterm (VP: <30 weeks/<1250 grams) and term born controls during late childhood. Additionally, early risk factors (neonatal brain abnormalities, medical complications, and sex) were examined in relationship to goal setting outcomes within the VP group. METHODS Participants included 177 VP and 61 full-term born control children aged 13 years. Goal setting was assessed using several measures of planning, organization, and strategic reasoning. Parents also completed the Behavior Rating Inventory of Executive Function. Regression models were performed to compare groups, with secondary analyses adjusting for potential confounders (sex and social risk), and excluding children with major neurosensory impairment and/or IQ<70. Within the VP group, regression models were performed to examine the relationship between brain abnormalities, medical complications, and sex, on goal setting scores. RESULTS The VP group demonstrated a clear pattern of impairment and inefficiency across goal setting measures, consistent with parental report, compared with their full-term born peers. Within the VP group, moderate/severe brain abnormalities on neonatal MRI predicted adverse goal setting outcomes at 13. CONCLUSIONS Goal setting difficulties are a significant area of concern in VP children during late childhood. These difficulties are associated with neonatal brain abnormalities, and are likely to have functional consequences academically, socially and vocationally. (JINS, 2018, 24, 372-381).
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31
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Batalle D, Edwards AD, O'Muircheartaigh J. Annual Research Review: Not just a small adult brain: understanding later neurodevelopment through imaging the neonatal brain. J Child Psychol Psychiatry 2018; 59:350-371. [PMID: 29105061 PMCID: PMC5900873 DOI: 10.1111/jcpp.12838] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND There has been a recent proliferation in neuroimaging research focusing on brain development in the prenatal, neonatal and very early childhood brain. Early brain injury and preterm birth are associated with increased risk of neurodevelopmental disorders, indicating the importance of this early period for later outcome. SCOPE AND METHODOLOGY Although using a wide range of different methodologies and investigating diverse samples, the common aim of many of these studies has been to both track normative development and investigate deviations in this development to predict behavioural, cognitive and neurological function in childhood. Here we review structural and functional neuroimaging studies investigating the developing brain. We focus on practical and technical complexities of studying this early age range and discuss how neuroimaging techniques have been successfully applied to investigate later neurodevelopmental outcome. CONCLUSIONS Neuroimaging markers of later outcome still have surprisingly low predictive power and their specificity to individual neurodevelopmental disorders is still under question. However, the field is still young, and substantial challenges to both acquiring and modeling neonatal data are being met.
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Affiliation(s)
- Dafnis Batalle
- Centre for the Developing BrainSchool of Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
| | - A. David Edwards
- Centre for the Developing BrainSchool of Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
| | - Jonathan O'Muircheartaigh
- Centre for the Developing BrainSchool of Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
- Department of NeuroimagingInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
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32
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The use of antenatal fetal magnetic resonance imaging in the assessment of patients at high risk of preterm birth. Eur J Obstet Gynecol Reprod Biol 2018; 222:134-141. [DOI: 10.1016/j.ejogrb.2018.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/10/2018] [Accepted: 01/15/2018] [Indexed: 12/30/2022]
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The Integrated Stress Response Is Not a Target for Diffuse White Matter Injury in Premature Infants. J Neurosci 2017; 37:11772-11773. [PMID: 29212946 DOI: 10.1523/jneurosci.2763-17.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 10/31/2017] [Accepted: 11/02/2017] [Indexed: 11/21/2022] Open
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Back SA. White matter injury in the preterm infant: pathology and mechanisms. Acta Neuropathol 2017; 134:331-349. [PMID: 28534077 PMCID: PMC5973818 DOI: 10.1007/s00401-017-1718-6] [Citation(s) in RCA: 272] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/27/2017] [Accepted: 04/29/2017] [Indexed: 12/22/2022]
Abstract
The human preterm brain is particularly susceptible to cerebral white matter injury (WMI) that disrupts the normal progression of developmental myelination. Advances in the care of preterm infants have resulted in a sustained reduction in the severity of WMI that has shifted from more severe focal necrotic lesions to milder diffuse WMI. Nevertheless, WMI remains a global health problem and the most common cause of chronic neurological morbidity from cerebral palsy and diverse neurobehavioral disabilities. Diffuse WMI involves maturation-dependent vulnerability of the oligodendrocyte (OL) lineage with selective degeneration of late oligodendrocyte progenitors (preOLs) triggered by oxidative stress and other insults. The magnitude and distribution of diffuse WMI are related to both the timing of appearance and regional distribution of susceptible preOLs. Diffuse WMI disrupts the normal progression of OL lineage maturation and myelination through aberrant mechanisms of regeneration and repair. PreOL degeneration is accompanied by early robust proliferation of OL progenitors that regenerate and augment the preOL pool available to generate myelinating OLs. However, newly generated preOLs fail to differentiate and initiate myelination along their normal developmental trajectory despite the presence of numerous intact-appearing axons. Disrupted preOL maturation is accompanied by diffuse gliosis and disturbances in the composition of the extracellular matrix and is mediated in part by inhibitory factors derived from reactive astrocytes. Signaling pathways implicated in disrupted myelination include those mediated by Notch, WNT-beta catenin, and hyaluronan. Hence, there exists a potentially broad but still poorly defined developmental window for interventions to promote white matter repair and myelination and potentially reverses the widespread disturbances in cerebral gray matter growth that accompanies WMI.
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Affiliation(s)
- Stephen A Back
- Division of Pediatric Neuroscience, Departments of Pediatrics and Neurology, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA.
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35
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Shiow LR, Favrais G, Schirmer L, Schang AL, Cipriani S, Andres C, Wright JN, Nobuta H, Fleiss B, Gressens P, Rowitch DH. Reactive astrocyte COX2-PGE2 production inhibits oligodendrocyte maturation in neonatal white matter injury. Glia 2017; 65:2024-2037. [PMID: 28856805 DOI: 10.1002/glia.23212] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/12/2017] [Accepted: 08/08/2017] [Indexed: 12/19/2022]
Abstract
Inflammation is a major risk factor for neonatal white matter injury (NWMI), which is associated with later development of cerebral palsy. Although recent studies have demonstrated maturation arrest of oligodendrocyte progenitor cells (OPCs) in NWMI, the identity of inflammatory mediators with direct effects on OPCs has been unclear. Here, we investigated downstream effects of pro-inflammatory IL-1β to induce cyclooxygenase-2 (COX2) and prostaglandin E2 (PGE2) production in white matter. First, we assessed COX2 expression in human fetal brain and term neonatal brain affected by hypoxic-ischemic encephalopathy (HIE). In the developing human brain, COX2 was expressed in radial glia, microglia, and endothelial cells. In human term neonatal HIE cases with subcortical WMI, COX2 was strongly induced in reactive astrocytes with "A2" reactivity. Next, we show that OPCs express the EP1 receptor for PGE2, and PGE2 acts directly on OPCs to block maturation in vitro. Pharmacologic blockade with EP1-specific inhibitors (ONO-8711, SC-51089), or genetic deficiency of EP1 attenuated effects of PGE2. In an IL-1β-induced model of NWMI, astrocytes also exhibit "A2" reactivity and induce COX2. Furthermore, in vivo inhibition of COX2 with Nimesulide rescues hypomyelination and behavioral impairment. These findings suggest that neonatal white matter astrocytes can develop "A2" reactivity that contributes to OPC maturation arrest in NWMI through induction of COX2-PGE2 signaling, a pathway that can be targeted for neonatal neuroprotection.
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Affiliation(s)
- Lawrence R Shiow
- Department of Pediatrics and Division of Neonatology.,Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, California
| | - Geraldine Favrais
- INSERM U930, Universite Francois Rabelais, Tours, France.,Neonatal intensive care unit, CHRU de Tours, Universite Francois Rabelais, Tours, France.,PROTECT, INSERM, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France
| | - Lucas Schirmer
- Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, California.,Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Anne-Laure Schang
- PROTECT, INSERM, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France.,PremUP, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France
| | - Sara Cipriani
- PROTECT, INSERM, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France.,PremUP, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France
| | | | - Jaclyn N Wright
- Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, California
| | - Hiroko Nobuta
- Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, California
| | - Bobbi Fleiss
- PROTECT, INSERM, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France.,PremUP, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France.,Department of Perinatal Imaging and Health, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas Hospital, London, United Kingdom
| | - Pierre Gressens
- PROTECT, INSERM, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France.,PremUP, Universite Paris Diderot, Sorbonne Paris Cite, Paris, France.,Department of Perinatal Imaging and Health, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas Hospital, London, United Kingdom
| | - David H Rowitch
- Department of Pediatrics and Division of Neonatology.,Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, California.,Department of Paediatrics, and Wellcome Trust-MRC Stem Cell Institute, Cambridge University, Cambridge, United Kingdom
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36
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Functional neural bases of numerosity judgments in healthy adults born preterm. Brain Cogn 2017; 118:90-99. [PMID: 28802184 DOI: 10.1016/j.bandc.2017.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/25/2017] [Accepted: 07/31/2017] [Indexed: 11/20/2022]
Abstract
High rates of mathematics learning disabilities among individuals born preterm (<37weeksGA) have spurred calls for a greater understanding of the nature of these weaknesses and their neural underpinnings. Groups of healthy, high functioning young adults born preterm and full term (n=20) completed a symbolic and non-symbolic magnitude comparison task while undergoing functional MRI scanning. Collectively, participants showed activation in superior and inferior frontal and parietal regions previously linked to numeric processing when comparing non-symbolic magnitude arrays separated by small numeric distances. Simultaneous deactivation of the default mode network also was evident during these trials. Individuals born preterm showed increased signal change relative to their full term peers in right inferior frontal and parietal regions when comparing the non-symbolic magnitude arrays. Elevated signal change during non-symbolic task blocks was associated with poorer performance on a calculation task administered outside of the scanner. These findings indicate that healthy, high-functioning adults born preterm may recruit fronto-parietal networks more extensively when processing non-symbolic magnitudes, suggesting that approximate number system training may be an inroad for early intervention to prevent mathematics difficulties in this population.
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Salvan P, Tournier JD, Batalle D, Falconer S, Chew A, Kennea N, Aljabar P, Dehaene‐Lambertz G, Arichi T, Edwards AD, Counsell SJ. Language ability in preterm children is associated with arcuate fasciculi microstructure at term. Hum Brain Mapp 2017; 38:3836-3847. [PMID: 28470961 PMCID: PMC5518442 DOI: 10.1002/hbm.23632] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/31/2017] [Accepted: 04/17/2017] [Indexed: 12/22/2022] Open
Abstract
In the mature human brain, the arcuate fasciculus mediates verbal working memory, word learning, and sublexical speech repetition. However, its contribution to early language acquisition remains unclear. In this work, we aimed to evaluate the role of the direct segments of the arcuate fasciculi in the early acquisition of linguistic function. We imaged a cohort of 43 preterm born infants (median age at birth of 30 gestational weeks; median age at scan of 42 postmenstrual weeks) using high b value high-angular resolution diffusion-weighted neuroimaging and assessed their linguistic performance at 2 years of age. Using constrained spherical deconvolution tractography, we virtually dissected the arcuate fasciculi and measured fractional anisotropy (FA) as a metric of white matter development. We found that term equivalent FA of the left and right arcuate fasciculi was significantly associated with individual differences in linguistic and cognitive abilities in early childhood, independent of the degree of prematurity. These findings suggest that differences in arcuate fasciculi microstructure at the time of normal birth have a significant impact on language development and modulate the first stages of language learning. Hum Brain Mapp 38:3836-3847, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Piergiorgio Salvan
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
| | - J. Donald Tournier
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
| | - Dafnis Batalle
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
| | - Shona Falconer
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
| | - Andrew Chew
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
| | - Nigel Kennea
- Neonatal unit, St. George's University Hospital NHSLondonUnited Kingdom
| | - Paul Aljabar
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
| | | | - Tomoki Arichi
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
- Department of BioengineeringImperial College LondonUnited Kingdom
| | - A. David Edwards
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
- Department of BioengineeringImperial College LondonUnited Kingdom
| | - Serena J. Counsell
- Centre for the Developing BrainDivision of Imaging Sciences & Biomedical Engineering, King's College LondonUnited Kingdom
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38
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Hong SJ, Lim KJ, Yoon DY, Choi CS, Yun EJ, Seo YL, Cho YK, Yoon SJ, Moon JY, Baek S, Lim YJ, Lee K. The most-cited articles in pediatric imaging: a bibliometric analysis. Minerva Pediatr 2017; 71:461-469. [PMID: 28752735 DOI: 10.23736/s0026-4946.17.05045-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The number of citations that an article has received reflects its impact on the scientific community. The purpose of our study was to identify and characterize the 51 most-cited articles in pediatric imaging. EVIDENCE ACQUISITION Based on the database of Journal Citation Reports, we selected 350 journals that were considered as potential outlets for pediatric imaging articles. The Web of Science search tools were used to identify the most-cited articles relevant to pediatric imaging within the selected journals. EVIDENCE SYNTHESIS The 51 most-cited articles in pediatric imaging were published between 1952 and 2011, with 1980-1989 and 2000-2009 producing 15 articles, each. The number of citations ranged from 576-124 and the number of annual citations ranged from 49.05-2.56. The majority of articles were published in pediatric and related journals (N.=26), originated in the USA (N.=23), were original articles (N.=45), used MRI as imaging modality (N.=27), and were concerned with the subspecialty of brain (N.=34). University College London School of Medicine (N.=6) and School of Medicine University of California (N.=4) were the leading institutions and Reynolds EO (N.=7) was the most voluminous author. CONCLUSIONS Our study presents a detailed list and an analysis of the most-cited articles in the field of pediatric imaging, which provides an insight into historical developments and allows for recognition of the important advances in this field.
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Affiliation(s)
- Su J Hong
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea.,Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Gywonggi-do, South Korea
| | - Kyoung J Lim
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea -
| | - Dae Y Yoon
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Chul S Choi
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Eun J Yun
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Young L Seo
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Young K Cho
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Soo J Yoon
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Ji Y Moon
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Sora Baek
- Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Yun-Jung Lim
- Department of Radiology, Haeundae Paik Hospital, Inje University, Busan, South Korea
| | - Kwanseop Lee
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, South Korea
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Kotovich D, Guedalia JSB, Hoffmann C, Sze G, Eisenkraft A, Yaniv G. Apparent Diffusion Coefficient Value Changes and Clinical Correlation in 90 Cases of Cytomegalovirus-Infected Fetuses with Unremarkable Fetal MRI Results. AJNR Am J Neuroradiol 2017; 38:1443-1448. [PMID: 28522662 DOI: 10.3174/ajnr.a5222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/06/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cytomegalovirus is the leading intrauterine infection. Fetal MR imaging is an accepted tool for fetal brain evaluation, yet it still lacks the ability to accurately predict the extent of the neurodevelopmental impairment, especially in fetal MR imaging scans with unremarkable findings. Our hypothesis was that intrauterine cytomegalovirus infection causes diffusional changes in fetal brains and that those changes may correlate with the severity of neurodevelopmental deficiencies. MATERIALS AND METHODS A retrospective analysis was performed on 90 fetal MR imaging scans of cytomegalovirus-infected fetuses with unremarkable results and compared with a matched gestational age control group of 68 fetal head MR imaging scans. ADC values were measured and averaged in the frontal, parietal, occipital, and temporal lobes; basal ganglia; thalamus; and pons. For neurocognitive assessment, the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) was used on 58 children in the cytomegalovirus-infected group. RESULTS ADC values were reduced for the cytomegalovirus-infected fetuses in most brain areas studied. The VABS-II showed no trend for the major domains or the composite score of the VABS-II for the cytomegalovirus-infected children compared with the healthy population distribution. Some subdomains showed an association between ADC values and VABS-II scores. CONCLUSIONS Cytomegalovirus infection causes diffuse reduction in ADC values in the fetal brain even in unremarkable fetal MR imaging scans. Cytomegalovirus-infected children with unremarkable fetal MR imaging scans do not deviate from the healthy population in the VABS-II neurocognitive assessment. ADC values were not correlated with VABS-II scores. However, the lack of clinical findings, as seen in most cytomegalovirus-infected fetuses, does not eliminate the possibility of future neurodevelopmental pathology.
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Affiliation(s)
- D Kotovich
- From The Faculty of Medicine (D.K., A.E.), Institute for Research in Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Israel Defense Forces Medical Corps (D.K., A.E.), Chevy Chase, Maryland
| | - J S B Guedalia
- Neuropsychology Unit (J.S.B.G., G.Y.), Shaare Zedek Medical Center, Jerusalem, Israel
| | | | - G Sze
- Department of Radiology and Biomedical Imaging (G.S., G.Y.), Yale School of Medicine, New Haven, Connecticut
| | - A Eisenkraft
- From The Faculty of Medicine (D.K., A.E.), Institute for Research in Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Israel Defense Forces Medical Corps (D.K., A.E.), Chevy Chase, Maryland
| | - G Yaniv
- Neuropsychology Unit (J.S.B.G., G.Y.), Shaare Zedek Medical Center, Jerusalem, Israel
- Dr. Pinchas Bornstein Talpiot Medical Leadership Program (G.Y.), Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
- Department of Radiology and Biomedical Imaging (G.S., G.Y.), Yale School of Medicine, New Haven, Connecticut
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40
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Ou Y, Zöllei L, Retzepi K, Castro V, Bates SV, Pieper S, Andriole KP, Murphy SN, Gollub RL, Grant PE. Using clinically acquired MRI to construct age-specific ADC atlases: Quantifying spatiotemporal ADC changes from birth to 6-year old. Hum Brain Mapp 2017; 38:3052-3068. [PMID: 28371107 PMCID: PMC5426959 DOI: 10.1002/hbm.23573] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/03/2017] [Accepted: 03/07/2017] [Indexed: 12/19/2022] Open
Abstract
Diffusion imaging is critical for detecting acute brain injury. However, normal apparent diffusion coefficient (ADC) maps change rapidly in early childhood, making abnormality detection difficult. In this article, we explored clinical PACS and electronic healthcare records (EHR) to create age-specific ADC atlases for clinical radiology reference. Using the EHR and three rounds of multiexpert reviews, we found ADC maps from 201 children 0-6 years of age scanned between 2006 and 2013 who had brain MRIs with no reported abnormalities and normal clinical evaluations 2+ years later. These images were grouped in 10 age bins, densely sampling the first 1 year of life (5 bins, including neonates and 4 quarters) and representing the 1-6 year age range (an age bin per year). Unbiased group-wise registration was used to construct ADC atlases for 10 age bins. We used the atlases to quantify (a) cross-sectional normative ADC variations; (b) spatiotemporal heterogeneous ADC changes; and (c) spatiotemporal heterogeneous volumetric changes. The quantified age-specific whole-brain and region-wise ADC values were compared to those from age-matched individual subjects in our study and in multiple existing independent studies. The significance of this study is that we have shown that clinically acquired images can be used to construct normative age-specific atlases. These first of their kind age-specific normative ADC atlases quantitatively characterize changes of myelination-related water diffusion in the first 6 years of life. The quantified voxel-wise spatiotemporal ADC variations provide standard references to assist radiologists toward more objective interpretation of abnormalities in clinical images. Our atlases are available at https://www.nitrc.org/projects/mgh_adcatlases. Hum Brain Mapp 38:3052-3068, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Yangming Ou
- Psychiatric Neuroimaging, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Quantitative Tumor Imaging at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Fetal‐Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Lilla Zöllei
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
| | - Kallirroi Retzepi
- Psychiatric Neuroimaging, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
| | - Victor Castro
- Research Computing, Partners Healthcare, 1 Constitution CenterCharlestownMassachusetts
- Laboratory of Computer ScienceMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Sara V. Bates
- Division of Newborn Medicine, Department of PediatricsMassachusetts General Hospital for Children, Harvard Medical SchoolBostonMassachusetts
| | | | - Katherine P. Andriole
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Shawn N. Murphy
- Research Computing, Partners Healthcare, 1 Constitution CenterCharlestownMassachusetts
- Laboratory of Computer ScienceMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Randy L. Gollub
- Psychiatric Neuroimaging, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
| | - Patricia Ellen Grant
- Fetal‐Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical SchoolBostonMassachusetts
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Alexander DC, Zikic D, Ghosh A, Tanno R, Wottschel V, Zhang J, Kaden E, Dyrby TB, Sotiropoulos SN, Zhang H, Criminisi A. Image quality transfer and applications in diffusion MRI. Neuroimage 2017; 152:283-298. [DOI: 10.1016/j.neuroimage.2017.02.089] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/22/2017] [Accepted: 02/28/2017] [Indexed: 01/03/2023] Open
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Krsnik Ž, Majić V, Vasung L, Huang H, Kostović I. Growth of Thalamocortical Fibers to the Somatosensory Cortex in the Human Fetal Brain. Front Neurosci 2017; 11:233. [PMID: 28496398 PMCID: PMC5406414 DOI: 10.3389/fnins.2017.00233] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 04/07/2017] [Indexed: 01/17/2023] Open
Abstract
Thalamocortical (TH-C) fiber growth begins during the embryonic period and is completed by the third trimester of gestation in humans. Here we determined the timing and trajectories of somatosensory TH-C fibers in the developing human brain. We analyzed the periods of TH-C fiber outgrowth, path-finding, "waiting" in the subplate (SP), target selection, and ingrowth in the cortical plate (CP) using histological sections from post-mortem fetal brain [from 7 to 34 postconceptional weeks (PCW)] that were processed with acetylcholinesterase (AChE) histochemistry and immunohistochemical methods. Images were compared with post mortem diffusion tensor imaging (DTI)-based fiber tractography (code No NO1-HD-4-3368). The results showed TH-C axon outgrowth occurs as early as 7.5 PCW in the ventrolateral part of the thalamic anlage. Between 8 and 9.5 PCW, TH-C axons form massive bundles that traverse the diencephalic-telencephalic boundary. From 9.5 to 11 PCW, thalamocortical axons pass the periventricular area at the pallial-subpallial boundary and enter intermediate zone in radiating fashion. Between 12 and 14 PCW, the TH-C axons, aligned along the fibers from the basal forebrain, continue to grow for a short distance within the deep intermediate zone and enter the deep CP, parallel with SP expansion. Between 14 and 18 PCW, the TH-C interdigitate with callosal fibers, running shortly in the sagittal stratum and spreading through the deep SP ("waiting" phase). From 19 to 22 PCW, TH-C axons accumulate in the superficial SP below the somatosensory cortical area; this occurs 2 weeks earlier than in the frontal and occipital cortices. Between 23 and 24 PCW, AChE-reactive TH-C axons penetrate the CP concomitantly with its initial lamination. Between 25 and 34 PCW, AChE reactivity of the CP exhibits an uneven pattern suggestive of vertical banding, showing a basic 6-layer pattern. In conclusion, human thalamocortical axons show prolonged growth (4 months), and somatosensory fibers precede the ingrowth of fibers destined for frontal and occipital areas. The major features of growing TH-C somatosensory fiber trajectories are fan-like radiation, short runs in the sagittal strata, and interdigitation with the callosal system. These results support our hypothesis that TH-C axons are early factors in SP and CP morphogenesis and synaptogenesis and may regulate cortical somatosensory system maturation.
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Affiliation(s)
- Željka Krsnik
- Department of Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of ZagrebZagreb, Croatia
| | - Visnja Majić
- Department of Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of ZagrebZagreb, Croatia
| | - Lana Vasung
- Harvard Medical School, Boston Children's HospitalBoston, MA, USA
| | - Hao Huang
- Laboratory of Neural MRI and Brain Connectivity, School of Medicine and Children's Hospital of Philadelphia, University of Pennsylvania PerelmanPhiladelphia, PA, USA
| | - Ivica Kostović
- Department of Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of ZagrebZagreb, Croatia
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Denison FC, Macnaught G, Semple SIK, Terris G, Walker J, Anblagan D, Serag A, Reynolds RM, Boardman JP. Brain Development in Fetuses of Mothers with Diabetes: A Case-Control MR Imaging Study. AJNR Am J Neuroradiol 2017; 38:1037-1044. [PMID: 28302607 DOI: 10.3174/ajnr.a5118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/20/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Offspring exposed to maternal diabetes are at increased risk of neurocognitive impairment, but its origins are unknown. With MR imaging, we investigated the feasibility of comprehensive assessment of brain metabolism (1H-MRS), microstructure (DWI), and macrostructure (structural MRI) in third-trimester fetuses in women with diabetes and determined normal ranges for the MR imaging parameters measured. MATERIALS AND METHODS Women with singleton pregnancies with diabetes (n = 26) and healthy controls (n = 26) were recruited prospectively for MR imaging studies between 34 and 38 weeks' gestation. RESULTS Data suitable for postprocessing were obtained from 79%, 71%, and 46% of women for 1H-MRS, DWI, and structural MRI, respectively. There was no difference in the NAA/Cho and NAA/Cr ratios (mean [SD]) in the fetal brain in women with diabetes compared with controls (1.74 [0.79] versus 1.79 [0.64], P = .81; and 0.78 [0.28] versus 0.94 [0.36], P = .12, respectively), but the Cho/Cr ratio was marginally lower (0.46 [0.11] versus 0.53 [0.10], P = .04). There was no difference in mean [SD] anterior white, posterior white, and deep gray matter ADC between patients and controls (1.16 [0.12] versus 1.16 [0.08], P = .96; 1.54 [0.16] versus 1.59 [0.20], P = .56; and 1.49 [0.23] versus 1.52 [0.23], P = .89, respectively) or volume of the cerebrum (243.0 mL [22.7 mL] versus 253.8 mL [31.6 mL], P = .38). CONCLUSIONS Acquiring multimodal MR imaging of the fetal brain at 3T from pregnant women with diabetes is feasible. Further study of fetal brain metabolism in maternal diabetes is warranted.
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Affiliation(s)
- F C Denison
- From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK
| | - G Macnaught
- Clinical Research Imaging Centre (G.M., S.I.K.S.)
| | - S I K Semple
- Clinical Research Imaging Centre (G.M., S.I.K.S.).,University/British Heart Foundation Centre for Cardiovascular Science (S.I.K.S., R.M.R.)
| | - G Terris
- Simpson Centre for Reproductive Health (G.T., J.W.), Royal Infirmary, Edinburgh, UK
| | - J Walker
- Simpson Centre for Reproductive Health (G.T., J.W.), Royal Infirmary, Edinburgh, UK
| | - D Anblagan
- From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK.,Centre for Clinical Brain Sciences (D.A., J.P.B.), University of Edinburgh, Edinburgh, UK
| | - A Serag
- From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK
| | - R M Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science (S.I.K.S., R.M.R.)
| | - J P Boardman
- From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK.,Centre for Clinical Brain Sciences (D.A., J.P.B.), University of Edinburgh, Edinburgh, UK
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Carbajal-Valenzuela CC, Santiago-Rodríguez E, Quirarte GL, Harmony T. Development of Emotional Face Processing in Premature and Full-Term Infants. Clin EEG Neurosci 2017; 48:88-95. [PMID: 27170673 DOI: 10.1177/1550059416647904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The rate of premature births has increased in the past 2 decades. Ten percent of premature birth survivors develop motor impairment, but almost half exhibit later sensorial, cognitive, and emotional disabilities attributed to white matter injury and decreased volume of neuronal structures. The aim of this study was to test the hypothesis that premature and full-term infants differ in their development of emotional face processing. A comparative longitudinal study was conducted in premature and full-term infants at 4 and 8 months of age. The absolute power of the electroencephalogram was analyzed in both groups during 5 conditions of an emotional face processing task: positive, negative, neutral faces, non-face, and rest. Differences between the conditions of the task at 4 months were limited to rest versus non-rest comparisons in both groups. Eight-month-old term infants had increases ( P ≤ .05) in absolute power in the left occipital region at the frequency of 10.1 Hz and in the right occipital region at 3.5, 12.8, and 16.0 Hz when shown a positive face in comparison with a neutral face. They also showed increases in absolute power in the left occipital region at 1.9 Hz and in the right occipital region at 2.3 and 3.5 Hz with positive compared to non-face stimuli. In contrast, positive, negative, and neutral faces elicited the same responses in premature infants. In conclusion, our study provides electrophysiological evidence that emotional face processing develops differently in premature than in full-term infants, suggesting that premature birth alters mechanisms of brain development, such as the myelination process, and consequently affects complex cognitive functions.
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Affiliation(s)
- Cintli Carolina Carbajal-Valenzuela
- 1 Unidad de Investigación en Neurodesarrollo "Dr Augusto Fernández Guardiola" Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Juriquilla, Querétaro, México
| | - Efraín Santiago-Rodríguez
- 1 Unidad de Investigación en Neurodesarrollo "Dr Augusto Fernández Guardiola" Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Juriquilla, Querétaro, México
| | - Gina L Quirarte
- 2 Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Juriquilla, Querétaro, Mexico
| | - Thalía Harmony
- 1 Unidad de Investigación en Neurodesarrollo "Dr Augusto Fernández Guardiola" Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Juriquilla, Querétaro, México
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Cui J, Tymofiyeva O, Desikan R, Flynn T, Kim H, Gano D, Hess CP, Ferriero DM, Barkovich AJ, Xu D. Microstructure of the Default Mode Network in Preterm Infants. AJNR Am J Neuroradiol 2016; 38:343-348. [PMID: 28059709 DOI: 10.3174/ajnr.a4997] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 09/06/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Diffusion and fMRI has been providing insights to brain development in addition to anatomic imaging. This study aimed to evaluate the microstructure of white matter tracts underlying the default mode network in premature infants by using resting-state functional MR imaging in conjunction with diffusion tensor imaging-based tractography. MATERIALS AND METHODS A cohort of 44 preterm infants underwent structural T1-weighted imaging, resting-state fMRI, and DTI at 3T, including 21 infants with brain injuries and 23 infants with normal-appearing structural imaging as controls. Neurodevelopment was evaluated with the Bayley Scales of Infant Development at 12 months' adjusted age. Probabilistic independent component analysis was applied to resting-state fMRI data to explore resting-state networks. The localized clusters of the default mode network were used as seeding for probabilistic tractography. The DTI metrics (fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity) of the reconstructed primary tracts within the default mode network-cingula were measured. RESULTS Results revealed decreased fractional anisotropy (0.20 ± 0.03) and elevated radial diffusivity values (1.24 ± 0.16) of the cingula in the preterm infants with brain injuries compared with controls (fractional anisotropy, 0.25 ± 0.03; P < .001; radial diffusivity, 1.06 ± 0.16; P = .001). The Bayley Scales of Infant Development cognitive scores were significantly associated with cingulate fractional anisotropy (P = .004) and radial diffusivity (P = .021); this association suggests that the microstructural properties of interconnecting axonal pathways within the default mode network are of critical importance in the early neurocognitive development of infants. CONCLUSIONS This study of combined resting-state fMRI and DTI at rest suggests that such studies may allow the investigation of key functional brain circuits in premature infants, which could function not only as diagnostic tools but also as biomarkers for long-term neurodevelopmental outcomes.
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Affiliation(s)
- J Cui
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
| | - O Tymofiyeva
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
| | - R Desikan
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
| | - T Flynn
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
| | - H Kim
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
| | - D Gano
- Pediatrics and Neurology (D.G., D.M.F.), University of California, San Francisco, San Francisco, California
| | - C P Hess
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
| | - D M Ferriero
- Pediatrics and Neurology (D.G., D.M.F.), University of California, San Francisco, San Francisco, California
| | - A J Barkovich
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
| | - D Xu
- From the Departments of Radiology and Biomedical Imaging (J.C., O.T., R.D., T.F., H.K., C.P.H., A.J.B., D.X.)
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PREMM: preterm early massage by the mother: protocol of a randomised controlled trial of massage therapy in very preterm infants. BMC Pediatr 2016; 16:146. [PMID: 27568006 PMCID: PMC5002318 DOI: 10.1186/s12887-016-0678-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/16/2016] [Indexed: 12/13/2022] Open
Abstract
Background Preterm infants follow an altered neurodevelopmental trajectory compared to their term born peers as a result of the influence of early birth, and the altered environment. Infant massage in the preterm infant has shown positive effects on weight gain and reduced length of hospital stay. There is however, limited current evidence of improved neurodevelopment or improved attachment, maternal mood or anxiety. The aim of this study is to investigate the effects of infant massage performed by the mother in very preterm (VPT) infants. Effects on the infant will be assessed at the electrophysiological, neuroradiological and clinical levels. Effects on maternal mood, anxiety and mother-infant attachment will also be measured. Methods/Design A randomised controlled trial to investigate the effect of massage therapy in VPT infants. Sixty VPT infants, born at 28 to 32 weeks and 6 days gestational age, who are stable, off supplemental oxygen therapy and have normal cranial ultrasounds will be recruited and randomised to an intervention (infant massage) group or a control (standard care) group. Ten healthy term born infants will be recruited as a reference comparison group. The intervention group will receive standardised massage therapy administered by the mother from recruitment, until term equivalent age (TEA). The control group will receive care as usual (CAU). Infants and their mothers will be assessed at baseline, TEA, 12 months and 24 months corrected age (CA), with a battery of clinical, neuroimaging and electrophysiological measures, as well as structured questionnaires, psychoanalytic observations and neurodevelopmental assessments. Discussion Optimising preterm infant neurodevelopment is a key aim of neonatal research, which could substantially improve long-term outcomes and reduce the socio-economic impact of VPT birth. This study has the potential to give insights into the mother-baby relationship and any positive effects of infant massage on neurodevelopment. An early intervention such as massage that is relatively easy to administer and could alter the trajectory of preterm infant brain development, holds potential to improve neurodevelopmental outcomes in this vulnerable population. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12612000335897. Date registered: 22/3/2012.
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Morel B, Virzi A, Geraud T, Adamsbaum C, Bloch I. A challenging issue: Detection of white matter hyperintensities in neonatal brain MRI. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:93-96. [PMID: 28268289 DOI: 10.1109/embc.2016.7590648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The progress of magnetic resonance imaging (MRI) allows for a precise exploration of the brain of premature infants at term equivalent age. The so-called DEHSI (diffuse excessive high signal intensity) of the white matter of premature brains remains a challenging issue in terms of definition, and thus of interpretation. We propose a semi-automatic detection and quantification method of white matter hyperintensities in MRI relying on morphological operators and max-tree representations, which constitutes a powerful tool to help radiologists to improve their interpretation. Results show better reproducibility and robustness than interactive segmentation.
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Domizio S, Barbante E, Puglielli C, Clementini E, Domizio R, Sabatino GMD, Albanese A, Colosimo C, Sabatino G. Excessively High Magnetic Resonance Signal in Preterm Infants and Neuropsychobehavioural Follow-up at 2 Years. Int J Immunopathol Pharmacol 2016; 18:365-75. [PMID: 15888258 DOI: 10.1177/039463200501800218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The diffuse excessive high-signal intensity (DEHSI) findings in the T2 weighted scans of white matter (WM), besides the corresponding low signal in the T1 weighted images, are usually more evident around the periventricular regions. It is not clear whether the DEHSI should be considered as a diffuse WM injury rather than a sign of delayed maturation of the WM. Eighty nine preterm infants at the full-term equivalent age (FEA) were studied using conventional Magnetic Resonance (MR) imaging of the brain. Based on the MR findings, the infants studied were divided into three groups: the control group presenting normal WM, the DEHSI group and the group with other WM lesions. Ten newborns were not included in the statistical analysis because they presented evidence of precedent germinal matrix hemorrhage (GMH-IVH) which cannot be considered as WM lesions. Seventy nine infants were enrolled in a program of neuropsychobehavioural study follow-up until 24 months of age. Each infant was evaluated for those variables which mostly affect the occurrence of neuropsychomotor disability. In the DEHSI infant group, significantly lower mean pH and mean base excess (BE) values were found in comparison to controls, while the mean birth weight (BW) was significantly higher. No significant difference was observed between the mean 1st minute Apgar Score, mean birth gestational age (GA) and assisted ventilation mean duration of controls and DEHSI groups. Finally, no significant difference between the parameters studied was found by comparing the WM lesion infants group to the DEHSI infants one. Our observations, together with follow-up studies, even up to school age, confirm that DEHSI has a clinical significance and cannot be considered as a simple indicator of delayed WM maturation.
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Affiliation(s)
- S Domizio
- Neonatal Intensive Care Unit, University G. D'Annunzio, Chieti, Italy
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Martinez-Biarge M, Groenendaal F, Kersbergen KJ, Benders MJNL, Foti F, Cowan FM, de Vries LS. MRI Based Preterm White Matter Injury Classification: The Importance of Sequential Imaging in Determining Severity of Injury. PLoS One 2016; 11:e0156245. [PMID: 27257863 PMCID: PMC4892507 DOI: 10.1371/journal.pone.0156245] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 05/11/2016] [Indexed: 11/18/2022] Open
Abstract
Background The evolution of non-hemorrhagic white matter injury (WMI) based on sequential magnetic resonance imaging (MRI) has not been well studied. Our aim was to describe sequential MRI findings in preterm infants with non-hemorrhagic WMI and to develop an MRI classification system for preterm WMI based on these findings. Methods Eighty-two preterm infants (gestation ≤35 weeks) were retrospectively included. WMI was diagnosed and classified based on sequential cranial ultrasound (cUS) and confirmed on MRI. Results 138 MRIs were obtained at three time-points: early (<2 weeks; n = 32), mid (2–6 weeks; n = 30) and term equivalent age (TEA; n = 76). 63 infants (77%) had 2 MRIs during the neonatal period. WMI was non-cystic in 35 and cystic in 47 infants. In infants with cystic-WMI early MRI showed extensive restricted diffusion abnormalities, cysts were already present in 3 infants; mid MRI showed focal or extensive cysts, without acute diffusion changes. A significant reduction in the size and/or extent of the cysts was observed in 32% of the infants between early/mid and TEA MRI. In 4/9 infants previously seen focal cysts were no longer identified at TEA. All infants with cystic WMI showed ≥2 additional findings at TEA: significant reduction in WM volume, mild-moderate irregular ventriculomegaly, several areas of increased signal intensity on T1-weighted-images, abnormal myelination of the PLIC, small thalami. Conclusion In infants with extensive WM cysts at 2–6 weeks, cysts may be reduced in number or may even no longer be seen at TEA. A single MRI at TEA, without taking sequential cUS data and pre-TEA MRI findings into account, may underestimate the extent of WMI; based on these results we propose a new MRI classification for preterm non-hemorrhagic WMI.
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Affiliation(s)
| | - Floris Groenendaal
- Department of Neonatology, Wilhelmina Children’s Hospital, UMCU, Utrecht, the Netherlands
| | - Karina J. Kersbergen
- Department of Neonatology, Wilhelmina Children’s Hospital, UMCU, Utrecht, the Netherlands
| | - Manon J. N. L. Benders
- Department of Neonatology, Wilhelmina Children’s Hospital, UMCU, Utrecht, the Netherlands
| | - Francesca Foti
- Department of Paediatrics, Imperial College London, London, United Kingdom
| | - Frances M. Cowan
- Department of Paediatrics, Imperial College London, London, United Kingdom
| | - Linda S. de Vries
- Department of Neonatology, Wilhelmina Children’s Hospital, UMCU, Utrecht, the Netherlands
- * E-mail:
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Differentiating T2 hyperintensity in neonatal white matter by two-compartment model of diffusional kurtosis imaging. Sci Rep 2016; 6:24473. [PMID: 27075248 PMCID: PMC4830988 DOI: 10.1038/srep24473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 03/30/2016] [Indexed: 12/18/2022] Open
Abstract
In conventional neonatal MRI, the T2 hyperintensity (T2h) in cerebral white matter (WM) at term-equivalent age due to immaturity or impairment is still difficult to identify. To clarify such issue, this study used the metrics derived from a two-compartment WM model of diffusional kurtosis imaging (WM-DKI), including intra-axonal, extra-axonal axial and radial diffusivities (Da, De,// and De,⊥), to compare WM differences between the simple T2h and normal control for both preterm and full-term neonates, and between simple T2h and complex T2h with hypoxic-ischemic encephalopathy (HIE). Results indicated that compared with control, the simple T2h showed significantly increased De,// and De,⊥, but no significant change in Da in multiple premyelination regions, indicative of expanding extra-axonal diffusion microenvironment; while myelinated regions showed no changes. However, compared with simple T2h, the complex T2h with HIE had decreased Da, increased De,⊥ in both premyelination and myelinated regions, indicative of both intra- and extra-axonal diffusion alterations. While diffusion tensor imaging (DTI) failed to distinguish simple T2h from complex T2h with HIE. In conclusion, superior to DTI-metrics, WM-DKI metrics showed more specificity for WM microstructural changes to distinguish simple T2h from complex T2h with HIE.
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