Tags

Type your tag names separated by a space and hit enter

Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants.
Neuroimage Clin. 2014; 5:169-77.NC

Abstract

Structural brain abnormalities identified at near-term age have been recognized as potential predictors of neurodevelopment in children born preterm. The aim of this study was to examine the relationship between neonatal physiological risk factors and early brain structure in very-low-birth-weight (VLBW) preterm infants using structural MRI and diffusion tensor imaging (DTI) at near-term age. Structural brain MRI, diffusion-weighted scans, and neonatal physiological risk factors were analyzed in a cross-sectional sample of 102 VLBW preterm infants (BW ≤ 1500 g, gestational age (GA) ≤ 32 weeks), who were admitted to the Lucile Packard Children's Hospital, Stanford NICU and recruited to participate prior to routine near-term brain MRI conducted at 36.6 ± 1.8 weeks postmenstrual age (PMA) from 2010 to 2011; 66/102 also underwent a diffusion-weighted scan. Brain abnormalities were assessed qualitatively on structural MRI, and white matter (WM) microstructure was analyzed quantitatively on DTI in six subcortical regions defined by DiffeoMap neonatal brain atlas. Specific regions of interest included the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, the thalamus, and the globus pallidus. Regional fractional anisotropy (FA) and mean diffusivity (MD) were calculated using DTI data and examined in relation to neonatal physiological risk factors including gestational age (GA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis, as well as serum levels of C-reactive protein (CRP), glucose, albumin, and total bilirubin. Brain abnormalities were observed on structural MRI in 38/102 infants including 35% of females and 40% of males. Infants with brain abnormalities observed on MRI had higher incidence of BPD (42% vs. 25%) and sepsis (21% vs. 6%) and higher mean and peak serum CRP levels, respectively, (0.64 vs. 0.34 mg/dL, p = .008; 1.57 vs. 0.67 mg/dL, p= .006) compared to those without. The number of signal abnormalities observed on structural MRI correlated to mean and peak CRP (rho = .316, p = .002; rho = .318, p= .002). The number of signal abnormalities observed on MRI correlated with thalamus MD (left: r= .382, p= .002; right: r= .400, p= .001), controlling for PMA-at-scan. Thalamus WM microstructure demonstrated the strongest associations with neonatal risk factors. Higher thalamus MD on the left and right, respectively, was associated with lower GA (r = -.322, p = .009; r= -.381, p= .002), lower mean albumin (r = -.276, p= .029; r= -.385, p= .002), and lower mean bilirubin (r = -.293, p= .020; r= -.337 p= .007). Results suggest that at near-term age, thalamus WM microstructure may be particularly vulnerable to certain neonatal risk factors. Interactions between albumin, bilirubin, phototherapy, and brain development warrant further investigation. Identification of physiological risk factors associated with selective vulnerability of certain brain regions at near-term age may clarify the etiology of neurodevelopmental impairment and inform neuroprotective treatment for VLBW preterm infants.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA ; Motion Analysis Lab, Lucile Packard Children's Hospital, Stanford, CA, USA.Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA ; Motion Analysis Lab, Lucile Packard Children's Hospital, Stanford, CA, USA ; Department of Bioengineering, Stanford University, Stanford, CA, USA.Radiology Department, Universidad del Desarrollo, Facultad de Medicina Clínica Alemana, Chile.Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA.Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA.Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, CA, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25068107

Citation

Rose, Jessica, et al. "Neonatal Physiological Correlates of Near-term Brain Development On MRI and DTI in Very-low-birth-weight Preterm Infants." NeuroImage. Clinical, vol. 5, 2014, pp. 169-77.
Rose J, Vassar R, Cahill-Rowley K, et al. Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants. Neuroimage Clin. 2014;5:169-77.
Rose, J., Vassar, R., Cahill-Rowley, K., Stecher Guzman, X., Hintz, S. R., Stevenson, D. K., & Barnea-Goraly, N. (2014). Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants. NeuroImage. Clinical, 5, 169-77. https://doi.org/10.1016/j.nicl.2014.05.013
Rose J, et al. Neonatal Physiological Correlates of Near-term Brain Development On MRI and DTI in Very-low-birth-weight Preterm Infants. Neuroimage Clin. 2014;5:169-77. PubMed PMID: 25068107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants. AU - Rose,Jessica, AU - Vassar,Rachel, AU - Cahill-Rowley,Katelyn, AU - Stecher Guzman,Ximena, AU - Hintz,Susan R, AU - Stevenson,David K, AU - Barnea-Goraly,Naama, Y1 - 2014/06/02/ PY - 2014/03/01/received PY - 2014/05/09/revised PY - 2014/05/21/accepted PY - 2014/7/29/entrez PY - 2014/7/30/pubmed PY - 2014/7/30/medline KW - ALIC, anterior limb of the internal capsule KW - Brain development KW - CC, corpus callosum KW - DTI, diffusion tensor imaging KW - Diffusion tensor imaging KW - FA, fractional anisotropy KW - GA, gestational age KW - GloP, globus pallidus KW - IC, internal capsule KW - MD, mean diffusivity KW - MRI KW - PLIC, posterior limb of the internal capsule KW - PMA, post-menstrual age KW - Preterm infants KW - Risk factors KW - VLBW, very-low-birth-weight KW - White matter microstructure SP - 169 EP - 77 JF - NeuroImage. Clinical JO - Neuroimage Clin VL - 5 N2 - Structural brain abnormalities identified at near-term age have been recognized as potential predictors of neurodevelopment in children born preterm. The aim of this study was to examine the relationship between neonatal physiological risk factors and early brain structure in very-low-birth-weight (VLBW) preterm infants using structural MRI and diffusion tensor imaging (DTI) at near-term age. Structural brain MRI, diffusion-weighted scans, and neonatal physiological risk factors were analyzed in a cross-sectional sample of 102 VLBW preterm infants (BW ≤ 1500 g, gestational age (GA) ≤ 32 weeks), who were admitted to the Lucile Packard Children's Hospital, Stanford NICU and recruited to participate prior to routine near-term brain MRI conducted at 36.6 ± 1.8 weeks postmenstrual age (PMA) from 2010 to 2011; 66/102 also underwent a diffusion-weighted scan. Brain abnormalities were assessed qualitatively on structural MRI, and white matter (WM) microstructure was analyzed quantitatively on DTI in six subcortical regions defined by DiffeoMap neonatal brain atlas. Specific regions of interest included the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, the thalamus, and the globus pallidus. Regional fractional anisotropy (FA) and mean diffusivity (MD) were calculated using DTI data and examined in relation to neonatal physiological risk factors including gestational age (GA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis, as well as serum levels of C-reactive protein (CRP), glucose, albumin, and total bilirubin. Brain abnormalities were observed on structural MRI in 38/102 infants including 35% of females and 40% of males. Infants with brain abnormalities observed on MRI had higher incidence of BPD (42% vs. 25%) and sepsis (21% vs. 6%) and higher mean and peak serum CRP levels, respectively, (0.64 vs. 0.34 mg/dL, p = .008; 1.57 vs. 0.67 mg/dL, p= .006) compared to those without. The number of signal abnormalities observed on structural MRI correlated to mean and peak CRP (rho = .316, p = .002; rho = .318, p= .002). The number of signal abnormalities observed on MRI correlated with thalamus MD (left: r= .382, p= .002; right: r= .400, p= .001), controlling for PMA-at-scan. Thalamus WM microstructure demonstrated the strongest associations with neonatal risk factors. Higher thalamus MD on the left and right, respectively, was associated with lower GA (r = -.322, p = .009; r= -.381, p= .002), lower mean albumin (r = -.276, p= .029; r= -.385, p= .002), and lower mean bilirubin (r = -.293, p= .020; r= -.337 p= .007). Results suggest that at near-term age, thalamus WM microstructure may be particularly vulnerable to certain neonatal risk factors. Interactions between albumin, bilirubin, phototherapy, and brain development warrant further investigation. Identification of physiological risk factors associated with selective vulnerability of certain brain regions at near-term age may clarify the etiology of neurodevelopmental impairment and inform neuroprotective treatment for VLBW preterm infants. SN - 2213-1582 UR - https://www.unboundmedicine.com/medline/citation/25068107/Neonatal_physiological_correlates_of_near_term_brain_development_on_MRI_and_DTI_in_very_low_birth_weight_preterm_infants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-1582(14)00069-2 DB - PRIME DP - Unbound Medicine ER -