Diffusion-weighted imaging and magnetic resonance proton spectroscopy following preterm birth

Hart, Anthony R; Smith, Michael F.; Whitby, Elspeth; Alladi, Sathya; Wilkinson, Stuart; Paley, Martyn N.J.; Griffiths, Paul

doi:10.1016/j.crad.2014.04.001

Cited by 15 publications

(51 citation statements)

References 51 publications

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“…1 H-MRS revealed decreased NAA levels in brain of very premature infants at term equivalent age and later time points [51, 71], consistent with changes observed in a recent animal study [72]. Preterm infants had lower GABA and glutamate in right frontal lobe than term controls and altered neonatal resting-state connectivity, (a measure of neural activity determined by assessing fluctuations in blood oxygen level dependent signal) [73, 74].…”

Section: Metabolic Alterations Associated With Prematuritysupporting

confidence: 62%

“…Bluml et al [30] reported altered metabolic maturation of white matter and disturbed synchronization of white matter and grey matter maturation that could contribute to neurological problems in preterm infants. These recent studies provide strong evidence of alterations in metabolism and connectivity, and asynchronous development in premature brain [30, 51, 71, 73, 76]. To date the metabolic alterations in brain of premature infants are not understood and remain poorly characterized.…”

Section: Metabolic Alterations Associated With Prematuritymentioning

confidence: 99%

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Metabolic Alterations in Developing Brain After Injury: Knowns and Unknowns

2015

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Brain development is a highly orchestrated complex process. The developing brain utilizes many substrates including glucose, ketone bodies, lactate, fatty acids and amino acids for energy, cell division and the biosynthesis of nucleotides, proteins and lipids. Metabolism is crucial to provide energy for all cellular processes required for brain development and function including ATP formation, synaptogenesis, synthesis, release and uptake of neurotransmitters, maintaining ionic gradients and redox status, and myelination. The rapidly growing population of infants and children with neurodevelopmental and cognitive impairments and life-long disability resulting from developmental brain injury is a significant public health concern. Brain injury in infants and children can have devastating effects because the injury is superimposed on the high metabolic demands of the developing brain. Acute injury in the pediatric brain can derail, halt or lead to dysregulation of the complex and highly regulated normal developmental processes. This paper provides a brief review of metabolism in developing brain and alterations found clinically and in animal models of developmental brain injury. The metabolic changes observed in three major categories of injury that can result in life-long cognitive and neurological disabilities, including neonatal hypoxia-ischemia, pediatric traumatic brain injury, and brain injury secondary to prematurity are reviewed.

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Section: Metabolic Alterations Associated With Prematuritysupporting

confidence: 62%

Section: Metabolic Alterations Associated With Prematuritymentioning

confidence: 99%

Metabolic Alterations in Developing Brain After Injury: Knowns and Unknowns

2015

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“…39,50–52 Three studies utilized single-voxel and two evaluated multi-voxel chemical shift imaging to identify biomarkers. Measurements of NAA/Choline in the central white matter and deep nuclear gray matter were the most predictive of NDI.…”

Section: Resultsmentioning

confidence: 99%

Advanced neuroimaging and its role in predicting neurodevelopmental outcomes in very preterm infants

Parikh

2016

Seminars in Perinatology

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Up to 35% of very preterm infants survive with neurodevelopmental impairments (NDI) such as cognitive deficits, cerebral palsy, and attention deficit disorder. Advanced MRI quantitative tools such as brain morphometry, diffusion MRI, magnetic resonance spectroscopy, and functional MRI at term-equivalent age are ideally suited to improve current efforts to predict later development of disabilities. This would facilitate application of targeted early intervention therapies during the first few years of life when neuroplasticity is optimal. A systematic search and review identified 47 published studies of advanced MRI to predict NDI. Diffusion MRI and morphometry studies were the most commonly studied modalities. Despite several limitations, studies clearly showed that brain structural and metabolite biomarkers are promising independent predictors of NDI. Large representative multicenter studies are needed to validate these studies.

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“…Studies in preterm infants have utilised the early application of MRI as an outcome prediction tool for subsequent motor impairment: parenchymal lesions including haemorrhage, periventricular leukomalacia, infarction and reduction of white matter are associated with the development of CP [26]. Abnormalities in diffusion imaging [27][28][29] and MRS [30], also predict poor neurodevelopmental outcome. Abnormal cortical folding in infants born extremely preterm has also been shown to be associated with poor neurodevelopmental outcome at two years, particularly receptive language [31].…”

Section: Brainmentioning

confidence: 99%

The use of antenatal fetal magnetic resonance imaging in the assessment of patients at high risk of preterm birth

Story

Hutter

Zhang

et al. 2018

European Journal of Obstetrics & Gynecology and Reproductiv

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Preterm birth, defined as birth occurring prior to 37 weeks gestation is a common obstetric complication affecting 8% of pregnancies and is associated with significant morbidity and mortality. Infection/inflammation has been implicated in both the aetiology of preterm birth itself and associated neonatal pulmonary and neurological morbidity. Treatment options are currently limited to prolongation of the pregnancy using cervical cerclage, pessaries or progesterone or administration of drugs including steroids to promote lung maturity and neuroprotective agents such as magnesium sulphate, the timing of which are highly critical. Although delivery is expedited in cases of overt infection, decisions regarding timing and mode of delivery in subclinical infection are not clear-cut. This review aims to explore the use of magnetic resonance imaging (MRI) in the antenatal assessment of pregnancies at high risk of preterm birth and its potential to guide management decisions in the future.

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Diffusion-weighted imaging and magnetic resonance proton spectroscopy following preterm birth

Cited by 15 publications

References 51 publications

Metabolic Alterations in Developing Brain After Injury: Knowns and Unknowns

Metabolic Alterations in Developing Brain After Injury: Knowns and Unknowns

Advanced neuroimaging and its role in predicting neurodevelopmental outcomes in very preterm infants

The use of antenatal fetal magnetic resonance imaging in the assessment of patients at high risk of preterm birth

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