Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants

Autor: Susan R. Hintz, Katelyn Cahill-Rowley, Jessica Rose, Ximena Stecher Guzman, David K. Stevenson, Naama Barnea-Goraly, Rachel Vassar
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Male
Pediatrics
Internal capsule
Corpus callosum
ALIC
anterior limb of the internal capsule
Gastroenterology
lcsh:RC346-429
0302 clinical medicine
Infant
Very Low Birth Weight
FA
fractional anisotropy
medicine.diagnostic_test
Gestational age
Brain
Retinopathy of prematurity
Magnetic Resonance Imaging
Brain development
3. Good health
Diffusion tensor imaging
Neurology
Necrotizing enterocolitis
lcsh:R858-859.7
Female
medicine.symptom
Psychology
IC
internal capsule
Infant
Premature
MRI
medicine.medical_specialty
Cognitive Neuroscience
CC
corpus callosum
lcsh:Computer applications to medicine. Medical informatics
Article
03 medical and health sciences
030225 pediatrics
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
lcsh:Neurology. Diseases of the nervous system
MD
mean diffusivity
PMA
post-menstrual age
Infant
Newborn
Infant
Preterm infants
Magnetic resonance imaging
medicine.disease
Low birth weight
Cross-Sectional Studies
Bronchopulmonary dysplasia
Risk factors
VLBW
very-low-birth-weight
PLIC
posterior limb of the internal capsule
GloP
globus pallidus
White matter microstructure
Neurology (clinical)
DTI
diffusion tensor imaging
GA
gestational age
030217 neurology & neurosurgery
Zdroj: NeuroImage: Clinical, Vol 5, Iss C, Pp 169-177 (2014)
NeuroImage : Clinical
ISSN: 2213-1582
Popis: Structural brain abnormalities identified at near-term age have been recognized as potential predictors of neurodevelopment in children born preterm. The aim of this study was to examine the relationship between neonatal physiological risk factors and early brain structure in very-low-birth-weight (VLBW) preterm infants using structural MRI and diffusion tensor imaging (DTI) at near-term age. Structural brain MRI, diffusion-weighted scans, and neonatal physiological risk factors were analyzed in a cross-sectional sample of 102 VLBW preterm infants (BW ≤ 1500 g, gestational age (GA) ≤ 32 weeks), who were admitted to the Lucile Packard Children's Hospital, Stanford NICU and recruited to participate prior to routine near-term brain MRI conducted at 36.6 ± 1.8 weeks postmenstrual age (PMA) from 2010 to 2011; 66/102 also underwent a diffusion-weighted scan. Brain abnormalities were assessed qualitatively on structural MRI, and white matter (WM) microstructure was analyzed quantitatively on DTI in six subcortical regions defined by DiffeoMap neonatal brain atlas. Specific regions of interest included the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, the thalamus, and the globus pallidus. Regional fractional anisotropy (FA) and mean diffusivity (MD) were calculated using DTI data and examined in relation to neonatal physiological risk factors including gestational age (GA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis, as well as serum levels of C-reactive protein (CRP), glucose, albumin, and total bilirubin. Brain abnormalities were observed on structural MRI in 38/102 infants including 35% of females and 40% of males. Infants with brain abnormalities observed on MRI had higher incidence of BPD (42% vs. 25%) and sepsis (21% vs. 6%) and higher mean and peak serum CRP levels, respectively, (0.64 vs. 0.34 mg/dL, p = .008; 1.57 vs. 0.67 mg/dL, p= .006) compared to those without. The number of signal abnormalities observed on structural MRI correlated to mean and peak CRP (rho = .316, p = .002; rho = .318, p= .002). The number of signal abnormalities observed on MRI correlated with thalamus MD (left: r= .382, p= .002; right: r= .400, p= .001), controlling for PMA-at-scan. Thalamus WM microstructure demonstrated the strongest associations with neonatal risk factors. Higher thalamus MD on the left and right, respectively, was associated with lower GA (r = −.322, p = .009; r= −.381, p= .002), lower mean albumin (r = −.276, p= .029; r= −.385, p= .002), and lower mean bilirubin (r = −.293, p= .020; r= −.337 p= .007). Results suggest that at near-term age, thalamus WM microstructure may be particularly vulnerable to certain neonatal risk factors. Interactions between albumin, bilirubin, phototherapy, and brain development warrant further investigation. Identification of physiological risk factors associated with selective vulnerability of certain brain regions at near-term age may clarify the etiology of neurodevelopmental impairment and inform neuroprotective treatment for VLBW preterm infants.
Highlights • Biomarkers of inflammation in preterm infants correlated with brain abnormalities detected on near-term structural MRI. • Biomarkers of inflammation in preterm infants correlated with near-term WM microstructure assessed on DTI. • Signal abnormalities observed on near-term structural MRI correlated with increased thalamus MD.
Databáze: OpenAIRE
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