Volumetric and anatomical MRI for hypoxic–ischemic encephalopathy: relationship to hypothermia therapy and neurosensory impairments

Parikh, Nehal A.; Lasky, Robert E.; Garza, Christen N.; Bonfante-Mejia, Eliana; Shankaran, Seetha; Tyson, Jon E.

doi:10.1038/jp.2008.184

Cited by 27 publications

(22 citation statements)

References 31 publications

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“…7, 8, 45 Axonal injury assessed by βAPP staining is present in white matter of neonates who suffered birth asphyxia, 46 and WMI was observed in a neonatal pig model of HIE. 47 MRI studies suggest that changes in axonal microstructure accompany early myelination of cerebral white matter.…”

Section: Discussionmentioning

confidence: 98%

Central axons preparing to myelinate are highly sensitivity to ischemic injury

Alix

Zammit

Riddle

et al. 2012

Annals of Neurology

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Objective Developing central white matter is subject to ischemic-type injury during the period that precedes myelination. At this stage in maturation, central axons initiate a programme of radial expansion and ion channel re-distribution. Here we test the hypothesis that during radial expansion axons display heightened ischemic sensitivity, when clusters of Ca2+ channels decorate future node of Ranvier sites. Methods Functionality and morphology of central axons and glia were examined during and after a period of modeled ischemia. Pathological changes in axons undergoing radial expansion were probed using electrophysiological, quantitative ultrastructural and morphometric analysis in neonatal rodent optic nerve and peri-ventricular white matter axons studied under modeled ischemia in vitro or after hypoxia-ischemia in vivo. Results Acute ischemic injury of central axons undergoing initial radial expansion was mediated by Ca2+ influx through Ca2+ channels expressed in axolemma clusters. This form of injury operated only in this axon population, which was more sensitive to injury than neighboring myelinated axons, smaller axons yet to initiate radial expansion, astrocytes or oligodendroglia. A pharmacological strategy designed to protect both small and large diameter pre-myelinated axons proved 100% protective against acute ischemia studied under modeled ischemia in vitro or after hypoxia-ischemia in vivo. Interpretation Recent clinical data highlight the importance of axon pathology in developing white matter injury. The elevated susceptibility of early maturing axons to ischemic injury described here may significantly contribute to selective white matter pathology and places these axons alongside pre-oligodendrocytes as a potential primary target of both injury and therapeutics.

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Section: Discussionmentioning

confidence: 98%

Central axons preparing to myelinate are highly sensitivity to ischemic injury

Alix

Zammit

Riddle

et al. 2012

Annals of Neurology

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“…This approach employed manual segmentation of subcortical structures, that was built on works published earlier [67,68]. The manual annotation delineated nine structures, namely the cerebellum, brain stem, amygdalae, hippocampus, accumbens, corpus callosum, thalamus, caudate and lenticular nuclei.…”

Section: Authors Validation Metricsmentioning

confidence: 99%

Neonatal brain MRI segmentation: A review

Devi¹,

Chandrasekharan²,

Sundararaman³

et al. 2015

Computers in Biology and Medicine

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“…88 Finally, a study of volumetric and anatomic magnetic resonance imaging in a subset of 14 patients from the NICHD cooling study showed that infants treated with hypothermia therapy had increased volume of subcortical white matter compared to controls. 89 …”

Section: Physiologic Effects Of Hypothermiamentioning

confidence: 99%

Physiologic and pharmacologic considerations for hypothermia therapy in neonates

2010

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With mounting evidence that hypothermia is neuroprotective in newborns with hypoxic-ischemic encephalopathy (HIE), an increasing number of centers are offering this therapy. Hypothermia is associated with a wide range of physiologic changes affecting every organ system, and awareness of these effects is essential for optimum patient management. Lowering the core temperature also alters pharmacokinetic and pharmacodynamic properties of medications commonly used in asphyxiated neonates, necessitating close attention to drug efficacy and side effects. Rewarming introduces additional risks and challenges as the hypothermia-associated physiologic and pharmacologic changes are reversed. In this review we provide an organ system-based assessment of physiologic changes associated with hypothermia. We also summarize evidence from randomized controlled trials showing lack of serious adverse effects of moderate hypothermia therapy in term and near-term newborns with moderate-to-severe HIE. Finally, we review the effects of hypothermia on drug metabolism and clearance based on studies in animal models and human adults, and limited data from neonates.

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Volumetric and anatomical MRI for hypoxic–ischemic encephalopathy: relationship to hypothermia therapy and neurosensory impairments

Cited by 27 publications

References 31 publications

Central axons preparing to myelinate are highly sensitivity to ischemic injury

Central axons preparing to myelinate are highly sensitivity to ischemic injury

Neonatal brain MRI segmentation: A review

Physiologic and pharmacologic considerations for hypothermia therapy in neonates

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