Movement disorders due to bilirubin toxicity

Rose, Jessica; Vassar, Rachel

doi:10.1016/j.siny.2014.11.002

Cited by 49 publications

(48 citation statements)

References 34 publications

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“…Our study showed that the changes of MK between NBE and control newborns were greater in the globus pallidus than in the putamen and thalamus, which may illustrate that the greatest internal environment change of globus pallidus, probably due to its location in the circuit of the basal ganglia. The internal globus pallidus contains output neurons of the basal ganglia, which project through the motor thalamus and back to the motor cortex (2).…”

Section: Discussionmentioning

confidence: 99%

“…Neonatal bilirubin encephalopathy (NBE) is a relatively rare neurological syndrome caused by the deposition of unconjugated bilirubin in brain cells; the damage inflicted on the brain by bilirubin is not always reversible (1,2). The condition has recently become more prevalent because of the relaxed standards for rapid and aggressive intervention, early hospital discharge, and increased practice of breastfeeding (2,3). The mechanisms of NBE neurotoxicity are unclear but generally considered to be related to the deposition of unconjugated bilirubin in the central nervous system (3,4).…”

Section: Introductionmentioning

confidence: 99%

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Demonstrating Microstructural Environment of the Brain in Neonatal Bilirubin Encephalopathy with Diffusion Kurtosis Imaging

Zhang

Wang

et al. 2017

Iran J Radiol

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Background: Magnetic resonance spectroscopy (MRS) of infants with bilirubin encephalopathy shows abnormal changes in the metabolite concentrations in various parts of the brain. Diffusional kurtosis imaging (DKI) is an extension of diffusion tensor imaging (DTI), which includes non-Gaussian diffusion effects, thereby allowing more comprehensive characterization of microstructural changes in pathological analysis. Objectives:Our study retrospectively analyzed DKI data to determine whether the DKI profiles of newborns with bilirubin encephalopathy can evaluate microstructural changes and illustrate related mechanisms. This study also verified whether DKI parametrics can serve as an in vivo marker for neonatal bilirubin encephalopathy. Patients and Methods:A total of 17 patients with neonatal bilirubin encephalopathy and 21 healthy, age-matched control newborns were included in this study. Conventional MRI and DKI were performed for all patients and controls. The mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), fractional anisotropy (FA), and mean diffusion (MD) were obtained from the voxels of interest (VOIs) within the bilateral globus pallidus, putamen, and thalamus. Results:Compared with the control group, the MK, AK, RK, and FA in all VOIs were significantly decreased in neonatal bilirubin encephalopathy, whereas MD increased. Among the kurtosis tensor parameters, RK had the largest change between groups (reduced 15.2% in globus pallidus, 8.8% in putamen and 9.0% in thalamus, respectively). Between neonatal bilirubin encephalopathy and control newborns, the values of MK, AK, RK, and MD more markedly varied in the globus pallidus than in the putamen and thalamus. However, FA more obviously changed in the thalamus than in the globus pallidus and putamen.Conclusions: DKI detects significant microstructural changes, which are consistent with known patterns of neurological damage in neonatal bilirubin encephalopathy. DKI parametrics can comprehensively evaluate microstructural changes and may serve as an in vivo marker for neonatal bilirubin encephalopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Demonstrating Microstructural Environment of the Brain in Neonatal Bilirubin Encephalopathy with Diffusion Kurtosis Imaging

Zhang

Wang

et al. 2017

Iran J Radiol

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“…Total bilirubin is composed of conjugated and unconjugated bilirubin [8]. Unconjugated bilirubin is a potent neurotoxin, which, by crossing the blood-brain barrier, may injure neural cells.…”

Section: Introductionmentioning

confidence: 99%

The effects of hyperbilirubinaemia on synaptic plasticity in the dentate gyrus region of the rat hippocampus in vivo

Yang

Wang

et al. 2020

aoms

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Introduction: The aim of our study is to investigate the effect of hyperbilirubinaemia on synaptic plasticity in the dentate gyrus (DG) region of the rat hippocampus. Material and methods: Seven-day-old healthy Sprague Dawley (SD) rats were randomly divided into a control group and an experiment group (n = 20 in each group). The input/output (I/O) functions, paired-pulse reactions (PPR), excitatory postsynaptic potential (EPSP), and population spike (PS) amplitude were measured in the DG area of both groups of rats in response to stimulation applied to the lateral perforant path. Results: Compared with that in the control rats, the current-voltage curves of both EPSP slope and PS amplitude in the experimental rats were significantly depressed. The average peak facilitation was 187 ±16% in the control and 164 ±18% in the experiment group (F = 21.054, p < 0.01). The facilitation period duration of PS was 155 ms in the experimental rats, which was less than that of the controls (235 ms). In the control group, the long-term potentiation (LTP) amplitudes were 140 ±3.5% and 242 ±6%, when estimated from the EPSP slope and PS amplitude, respectively, which were significantly depressed to 124 ±3.4% (EPSP slope, F = 70.489, p < 0.01) and 138 ±8.6% (PS amplitude, F = 253.46, p < 0.01), respectively, in the experiment group. Conclusions: These findings suggest that hyperbilirubinaemia could induce impairment of synaptic plasticity in the rat DG area in vivo, including I/O function, paired-pulse ratio (PPR), and LTP, which may be closely related to cognitive impairment.

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“…However, neonatal exposure to high levels of bilirubin continues to cause CP. New categories of bilirubin-induced neurological dysfunction, either independent or characterised by subtle bilirubin encephalopathy following moderate hyperbilirubinemia, have been implicated in long-term motor function [13].…”

Section: Introductionmentioning

confidence: 99%

“….053 AR* -attributable risk, the effect of a risk factor on the exposed group % (10) 53 (21) 48 (19) 52 2118 772 2932 (13) 13 516 (6) 269 (78) 54 (16) 57 (16) 35 (10) 33 1014 (4) 92 (27) 31 911 35 (1) . Flowchart showing inclusion in the study population…”

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confidence: 99%

Risk factors for cerebral palsy in Moldova

Bufteac

Jahnsen

Spinei

et al. 2020

Preprint

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Abstract BackgroundThis is the first study assessing risk factors for cerebral palsy (CP) among children born in Moldova.MethodsWe identified 351 children with CP born during 2009 and 2010 in state hospitals, maternity wards, orphanages and rehabilitation centres in Moldova. Detailed information on 417 children without CP (of the total number of 81,277 children) served as a reference group. Logistic regression analyses were applied to calculate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) in addition to attributable risk (AR).ResultsAmong children with CP (40.5% girls), 26% had unilateral, 54% bilateral, 13% dyskinetic, and 5% ataxic CP, with 2% unclassified. Almost three quarters of children with CP were from rural areas and 101 (29%) were prematurely born.Significant risk factors for CP included low Apgar score at five minutes (OR 6.187, 95% CI 2.059–18.59), hyperbilirubinemia (OR 6.3, 95% CI 4.1–9.6), breech delivery (OR 3.5, 95% CI 2–6.01), assisted vaginal delivery (OR 47, 95% CI 11–194), birth out of maternity (OR 6.591, 95% CI 1.904–22.81), low education level (OR 3.889, 95% CI 2.8–5.248), alcohol consumption (OR 1.903, 95% CI 1.269–2.885) and hypertension (OR 2.264, 95% CI 1.5–5.417).For singletons born at term, significant risk factors were low Apgar score (OR 2.115, 95% CI 1.22–3.808), hyperbilirubinemia (OR 5.854, 95% CI 3.648–9.393), breech delivery (OR 6.48, 95% CI 3.1–13.7), fundal pressure (OR 3.268, 95% CI 1.398–7.642), maternal hypertension (OR 2.248, 95% CI 1.55–3.997) and alcohol consumption (OR 2.105, 95% CI 1.315–3.369).Hyperbilirubinemia, Apgar score (0–3), birth out of maternity and breech delivery had the highest AR for CP both in the total and term singleton groups. Chronic diseases among mothers also had a high AR for CP.ConclusionsA combination of factors related to the child, the delivery and the mother were risk factors for CP among children born in Moldova, many of them possibly avoidable. The results may indicate a need for better maternal and perinatal childcare. A national CP register in Moldova is recommended as an opportunity to follow up these findings.

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Movement disorders due to bilirubin toxicity

Cited by 49 publications

References 34 publications

Demonstrating Microstructural Environment of the Brain in Neonatal Bilirubin Encephalopathy with Diffusion Kurtosis Imaging

Demonstrating Microstructural Environment of the Brain in Neonatal Bilirubin Encephalopathy with Diffusion Kurtosis Imaging

The effects of hyperbilirubinaemia on synaptic plasticity in the dentate gyrus region of the rat hippocampus in vivo

Risk factors for cerebral palsy in Moldova

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