Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption

Van, Philippe Vo; Alison, Marianne; Morel, Baptiste; Beck, J.; Bednarek, Nathalie; Hertz‐Pannier, Lucie; Loron, Gauthier

doi:10.3390/children9030356

Cited by 10 publications

(3 citation statements)

References 104 publications

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“…Furthermore, the juvenile age preterm and term-born cohort of animals allowed us to uncover deficits that persisted up until the equivalence of late childhood age and highlight when neurodevelopmental trajectories may have been dysregulated. This is consistent with other clinical findings of long-term developmental damages in preterm infants, such as white matter abnormalities, and validates the use of the guinea pig as a model of preterm birth (van Beek et al, 2021;Vo Van et al, 2022). One of the key findings of this study was that preterm males have significantly reduced expression of all five of the dopamine receptor subunits in the frontal cortex.…”

Section: Discussionsupporting

confidence: 90%

Ongoing effects of preterm birth on the dopaminergic and noradrenergic pathways in the frontal cortex and hippocampus of guinea pigs

Moloney,

Palliser,

Dyson

et al. 2024

Developmental Neurobiology

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Children born preterm have an increased likelihood of developing neurobehavioral disorders such as attention‐deficit hyperactivity disorder (ADHD) and anxiety. These disorders have a sex bias, with males having a higher incidence of ADHD, whereas anxiety disorder tends to be more prevalent in females. Both disorders are underpinned by imbalances to key neurotransmitter systems, with dopamine and noradrenaline in particular having major roles in attention regulation and stress modulation. Preterm birth disturbances to neurodevelopment may affect this neurotransmission in a sexually dimorphic manner. Time‐mated guinea pig dams were allocated to deliver by preterm induction of labor (gestational age 62 [GA62]) or spontaneously at term (GA69). The resultant offspring were randomized to endpoints as neonates (24 h after term‐equivalence age) or juveniles (corrected postnatal day 40, childhood equivalence). Relative mRNA expressions of key dopamine and noradrenaline pathway genes were examined in the frontal cortex and hippocampus and quantified with real‐time PCR. Myelin basic protein and neuronal nuclei immunostaining were performed to characterize the impact of preterm birth. Within the frontal cortex, there were persisting reductions in the expression of dopaminergic pathway components that occurred in preterm males only. Conversely, preterm‐born females had increased expression of key noradrenergic receptors and a reduction of the noradrenergic transporter within the hippocampus. This study demonstrated that preterm birth results in major changes in dopaminergic and noradrenergic receptor, transporter, and synthesis enzyme gene expression in a sex‐ and region‐based manner that may contribute to the sex differences in susceptibility to neurobehavioral disorders. These findings highlight the need for the development of sex‐based treatments for improving these conditions.

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Section: Discussionsupporting

confidence: 90%

Ongoing effects of preterm birth on the dopaminergic and noradrenergic pathways in the frontal cortex and hippocampus of guinea pigs

Moloney,

Palliser,

Dyson

et al. 2024

Developmental Neurobiology

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“…Evaluating brain growth in the preterm population is of critical interest. Premature birth disrupts brain growth independently of the development of WM lesions or IVH ( 15 , 16 ). Many 3D segmentation brain MRI studies demonstrated decreased cerebral volume across many structures in infants born preterm ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

Assessment of brain two-dimensional metrics in infants born preterm at term equivalent age: Correlation of ultrasound scans with magnetic resonance imaging

et al. 2022

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ContextDeveloping brain imaging is a critical subject for infants born preterm. Impaired brain growth is correlated with poor neurological outcomes, regardless of overt brain lesions, such as hemorrhage or leukomalacia. As magnetic resonance imaging (MRI) remains a research tool for assessing regional brain volumes, two-dimensional metrics (2D metrics) provide a reliable estimation of brain structures. In neonatal intensive care, cerebral ultrasound (cUS) is routinely performed to assess brain integrity. This prospective work has compared US and MRI accuracy for the measurement of 2D brain metrics and identification of overt injuries.MethodsMRI and cUS were performed at term equivalent age (TEA) in infants born before 32 weeks of gestation (GW). Demographical data and results of serial cUS (Neonatal Intensive Care Unit [NICU]-US) performed during hospitalization were gathered from medical charts. Blinded, experienced senior doctors reviewed the scans for both standard analysis and standardized, 2D measurements. The correlation of 2D metrics and inter-/intraobserver agreements were evaluated using Pearson’s coefficient, Bland-Altman plots, and intraclass coefficient (ICC), respectively.ResultsIn total, 102 infants born preterm were included. The performance of “TEA-cUS and NICU-cUS” when compared to “TEA-MRI and NICU-cUS” was identical for the detection of high-grade hemorrhages and close for low-grade ones. However, TEA-MRI only detected nodular lesions of the white matter (WM). No infant presented a cerebellar infarct on imaging. Intra- and inter-observer agreements were excellent for all 2D metrics except for the corpus callosum width (CCW) and anteroposterior vermis diameter. MRI and cUS showed good to excellent correlation for brain and bones biparietal diameters, corpus callosum length (CCL), transcerebellar diameters (TCDs), and lateral ventricle diameters. Measures of CCW and vermis dimensions were poorly correlated.Conclusion and perspectiveThe cUS is a reliable tool to assess selected 2D measurements in the developing brain. Repetition of these metrics by serial cUS during NICU stay would allow the completion of growth charts for several brain structures. Further studies will assess whether these charts are relevant markers of neurological outcome.

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“…The neuronal networks identified are referred to as "resting-state networks" (RSN). 42 Herzmann et al described the rs-fMRI findings in VP infants and compared the intracerebellar and cortico-cerebellar connections between VP infants without major intracranial pathology on earlier USG/MRI at term-equivalent age, with term controls. 43 Corticocerebellar functional connectivity was well-established by term age.…”

Section: Functional Mrimentioning

confidence: 99%

Imaging of the Preterm Cerebellum

Upadhyay,

Gupta,

Rao

et al. 2023

Newborn

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Cerebellar injury is being increasingly recognized as a significant complication of preterm birth. A critical phase of cerebellar growth occurs during the third trimester characterized by cellular migration, proliferation, and arborization. This vulnerable developmental phase increases the risk of impaired cerebellar development, especially in preterm infants, given their exposure to adverse extrauterine environments. Cerebellar malformations and disruptions are the types of cerebellar insults encountered. A "malformation" is defined as a non-progressive, congenital morphologic anomaly of a single organ or body part following altered primary development. A "disruption" is defined as a non-progressive, congenital morphologic anomaly following the breakdown of a body structure that had the normal potential for development. Advances in neonatal neuroimaging with increased use of mastoidal and suboccipital views focusing on the posterior fossa by cranial ultrasound (cUS) and high-resolution anatomical and functional magnetic resonance imaging (MRI) have improved the sensitive and specific identification of posterior fossa abnormalities, in particular of cerebellar injury in preterm neonates. This article discusses the various modalities of neuroimaging of the cerebellum with advantages and disadvantages. Ultrasonography (USG) is the most easily available and feasible bedside modality of imaging, though it has the disadvantage of not detecting subtle abnormalities like punctate hemorrhages. Conventional T1 and T2 weighted MRI can detect most of the cerebellar malformations and disruptions in preterm infants. But the logistics of MRI at most institutions make it less feasible during the first few weeks of life for extremely preterm neonates. The role of advanced MRI modalities such as functional MRI, diffusion tensor imaging (DTI), and magnetic resonance (MR) spectroscopy in cerebellar disruptions and malformations are also discussed in some detail.

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Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption

Cited by 10 publications

References 104 publications

Ongoing effects of preterm birth on the dopaminergic and noradrenergic pathways in the frontal cortex and hippocampus of guinea pigs

Ongoing effects of preterm birth on the dopaminergic and noradrenergic pathways in the frontal cortex and hippocampus of guinea pigs

Assessment of brain two-dimensional metrics in infants born preterm at term equivalent age: Correlation of ultrasound scans with magnetic resonance imaging

Imaging of the Preterm Cerebellum

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