Neonatal Brain Magnetic Resonance Imaging Before Discharge Is Better Than Serial Cranial Ultrasound in Predicting Cerebral Palsy in Very Low Birth Weight Preterm Infants

Mirmiran, M.; Barnes, Patrick D.; Keller, Kathy; Constantinou, Janet C.; Fleisher, Barry E.; Hintz, Susan R.; Ariagno, Ronald L.

doi:10.1542/peds.2003-0772-l

Cited by 177 publications

(142 citation statements)

References 43 publications

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“…4 The effect of morbidities on subsequent outcome depends partly upon the previous probability up to that point (eg, the effect of a bilateral severe intracranial hemorrhage on the probability of a bad outcome will be larger in an infant with a high predicted probability of good outcome at birth and will be relatively small in an infant with a low predicted probability of good outcome at birth). Although MRI 5 and neurobehavioral assessments 6 may provide additional prognostic information, these are difficult to perform soon after birth in sick ELBW infants.…”

Section: Resultsmentioning

confidence: 99%

Outcome Trajectories in Extremely Preterm Infants

et al. 2012

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WHAT'S KNOWN ON THIS SUBJECT: Death or neurodevelopmental impairment in extremely premature neonates can be predicted at birth by considering gender, antenatal steroids, multiple birth, birth weight, and gestational age.WHAT THIS STUDY ADDS: Prediction of death or neurodevelopmental impairment in extremely premature infants is improved by using information available later during the clinical course. The importance of birth weight declines, whereas that of respiratory illness severity increases with advancing postnatal age. abstract OBJECTIVE: Methods are required to predict prognosis with changes in clinical course. Death or neurodevelopmental impairment in extremely premature neonates can be predicted at birth/admission to the ICU by considering gender, antenatal steroids, multiple birth, birth weight, and gestational age. Predictions may be improved by using additional information available later during the clinical course. Our objective was to develop serial predictions of outcome by using prognostic factors available over the course of NICU hospitalization.METHODS: Data on infants with birth weight #1.0 kg admitted to 18 large academic tertiary NICUs during 1998-2005 were used to develop multivariable regression models following stepwise variable selection. Models were developed by using all survivors at specific times during hospitalization (in delivery room [n = 8713], 7-day [n = 6996], 28-day [n = 6241], and 36-week postmenstrual age [n = 5118]) to predict death or death/neurodevelopmental impairment at 18 to 22 months. RESULTS:Prediction of death or neurodevelopmental impairment in extremely premature infants is improved by using information available later during the clinical course. The importance of birth weight declines, whereas the importance of respiratory illness severity increases with advancing postnatal age. The c-statistic in validation models ranged from 0.74 to 0.80 with misclassification rates ranging from 0.28 to 0.30.CONCLUSIONS: Dynamic models of the changing probability of individual outcome can improve outcome predictions in preterm infants. Various current and future scenarios can be modeled by input of different clinical possibilities to develop individual "outcome trajectories" and evaluate impact of possible morbidities on outcome. Pediatrics 2012;130:e115-e125 AUTHORS:

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Section: Resultsmentioning

confidence: 99%

Outcome Trajectories in Extremely Preterm Infants

et al. 2012

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“…DTI has been used to assess white-matter and gray-matter development before and after the onset of myelination in animals (Mori et al, 2001;Prayer et al, 2001;Zhang et al, 2003) and human neonates (Neil et al, 1998). Abnormal progression of DTI parameters is associated with perinatal injury, and it is being increasingly used to study human brain injury (Huppi and Inder, 2001;Miller et al, 2002;Mirmiran et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Developmental Changes in Diffusion Anisotropy Coincide with Immature Oligodendrocyte Progression and Maturation of Compound Action Potential

Drobyshevsky¹,

Song²,

Gamkrelidze³

et al. 2005

J. Neurosci.

182

148

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Disruption of oligodendrocyte lineage progression is implicated in the white-matter injury that occurs in cerebral palsy. We have previously published a model in rabbits consistent with cerebral palsy. Little is known of normal white-matter development in perinatal rabbits. Using a multidimensional approach, we defined the relationship of oligodendrocyte lineage progression and functional maturation of axons to structural development of selected cerebral white-matter tracts as determined by diffusion tensor imaging (DTI). Immunohistochemical studies showed that late oligodendrocyte progenitors appear at gestational age 22 [embryonic day 22 (E22)], whereas immature oligodendrocytes appear at E25, and both increase rapidly with time (ϳ13 cells/mm 2 /d) until the onset of myelination. Myelination began at postnatal day 5 (P5) (E36) in the internal capsule (IC) and at P11 in the medial corpus callosum (CC), as determined by localization of sodium channels and myelin basic protein. DTI of the CC and IC showed that fractional anisotropy (FA) increased rapidly between E25 and P1 (E32) (ϳ11% per day) and plateaued (Ͻ5% per day) after the onset of myelination. Postnatal maturation of the compound action potential (CAP) showed a developmental pattern similar to FA, with a rapid rise between E29 and P5 (in the CC, 18% per day) and a slower rise from P5 to P11 (in the CC, Ͻ5% per day). The development of immature oligodendrocytes after E29 coincides with changes in FA and CAP area in both the CC and IC. These findings suggest that developmental expansion of immature oligodendrocytes during the premyelination period may be important in defining structural and functional maturation of the white matter.

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“…Compared with US, conventional magnetic resonance imaging (MRI) provides more information on white matter (WM) (6), and moderate to severe WM injury predicts adverse neurodevelopmental outcome (7)(8)(9)(10). However, neurodevelopmental problems also occur in preterm infants with normal MRI (10,11).…”

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confidence: 99%

Cortical somatosensory processing measured by magnetoencephalography predicts neurodevelopment in extremely low-gestational-age infants

et al. 2013

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Neonatal Brain Magnetic Resonance Imaging Before Discharge Is Better Than Serial Cranial Ultrasound in Predicting Cerebral Palsy in Very Low Birth Weight Preterm Infants

Abstract: As a predictor of outcome for CP, MRI at near-term in very low birth weight preterm neonates is superior to US. However, both US and MRI demonstrate high specificity.

Cited by 177 publications

References 43 publications

Outcome Trajectories in Extremely Preterm Infants

Outcome Trajectories in Extremely Preterm Infants

Developmental Changes in Diffusion Anisotropy Coincide with Immature Oligodendrocyte Progression and Maturation of Compound Action Potential

Cortical somatosensory processing measured by magnetoencephalography predicts neurodevelopment in extremely low-gestational-age infants

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