Neurodevelopmental Outcomes in Preterm Infants with White Matter Injury Using a New MRI Classification

Neonatology ◽  
2019 ◽  
Vol 116 (3) ◽  
pp. 227-235 ◽  
Author(s):  
Miriam Martinez-Biarge ◽  
Floris Groenendaal ◽  
Karina J. Kersbergen ◽  
Manon J.N.L. Benders ◽  
Francesca Foti ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
White Matter Injury ◽  
Neurodevelopmental Outcomes

scholarly journals Factors associated with neurodevelopment in preterm infants with systematic inflammation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eun Sun Lee ◽  
Ee-Kyung Kim ◽  
Seung han Shin ◽  
Young-Hun Choi ◽  
Young Hwa Jung ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
Systemic Inflammation ◽  
Head Circumference ◽  
Brain Mri ◽  
White Matter Injury ◽  
Social Emotional ◽  
Postmenstrual Age ◽  
Neurodevelopmental Impairment ◽  
Near Term

Abstract Background Several studies have suggested that adverse neurodevelopment could be induced by systemic inflammation in preterm infants. We aimed to investigate whether preterm infants with systemic inflammation would have impaired neurodevelopment and which biomarkers and neurophysiologic studies during inflammation are associated with poor neurodevelopment. Methods This prospective cohort study enrolled infants born before 30 weeks of gestation or with birth weight < 1250 g. Infants were grouped according to the presence of systemic inflammation: Control (no inflammation, n = 49), I (systemic inflammation, n = 45). Blood and cerebrospinal fluid samples for markers of brain injury and inflammation were collected and amplitude-integrated electroencephalography (aEEG) was performed within 4 h of septic workup. We evaluated aEEG at 35 weeks postmenstrual age (PMA), head circumference at 36 weeks PMA, and brain MRI at discharge. The Bayley Scales of Infant and Toddler Development III (Bayley-III) was performed at a corrected age (CA) of 18 months. Results The I group had more white matter injuries (2 vs. 26.7%, Control vs. I, respectively) at the time of discharge, lower brain functional maturation (9.5 vs. 8), and smaller head size (z-score − 1.45 vs. -2.12) at near-term age and poorer neurodevelopment at a CA of 18 months than the control (p < 0.05). Among the I group, the proportion of immature neutrophils (I/T ratios) and IL-1 beta levels in the CSF were associated with aEEG measures at the day of symptom onset (D0). Seizure spike on aEEG at D0 was significantly correlated with motor and social-emotional domains of Bayley-III (p < 0.05). The I/T ratio and CRP and TNF-α levels of blood at D0, white matter injury on MRI at discharge, head circumference and seizure spikes on aEEG at near-term age were associated with Bayley-III scores at a CA of 18 months. Conclusions Systemic inflammation induced by clinical infection and NEC are associated with neurodevelopmental impairment in preterm infants. The seizure spike on aEEG, elevated I/T ratio, CRP, and plasma TNF-alpha during inflammatory episodes are associated with poor neurodevelopment.

scholarly journals A Web-Based Calculator for the Prediction of Severe Neurodevelopmental Impairment in Preterm Infants Using Clinical and Imaging Characteristics

Children ◽  
2018 ◽  
Vol 5 (11) ◽  
pp. 151
Author(s):  
Zachary Vesoulis ◽  
Nathalie El Ters ◽  
Maja Herco ◽  
Halana Whitehead ◽  
Amit Mathur
Keyword(s):  
Preterm Infants ◽  
Predictive Value ◽  
White Matter Injury ◽  
Delivery Mode ◽  
Clinical Factors ◽  
Binary Logistic Regression Model ◽  
Neurodevelopmental Outcomes ◽  
Web Based ◽  
Antenatal Steroids ◽  
Imaging Characteristics

Although the most common forms of brain injury in preterm infants have been associated with adverse neurodevelopmental outcomes, existing MRI scoring systems lack specificity, do not incorporate clinical factors, and are technically challenging to perform. The objective of this study was to develop a web-based, clinically-focused prediction system which differentiates severe neurodevelopmental outcomes from normal-moderate outcomes at two years. Infants were retrospectively identified as those who were born ≤30 weeks gestation and who had MRI imaging at term-equivalent age and neurodevelopmental testing at 18–24 months. Each MRI was scored on injury in three domains (intraventricular hemorrhage, white matter injury, and cerebellar hemorrhage) and clinical factors that were strongly predictive of an outcome were investigated. A binary logistic regression model was then generated from the composite of clinical and imaging components. A total of 154 infants were included (mean gestational age = 26.1 ± 1.8 weeks, birth weight = 889.1 ± 226.2 g). The final model (imaging score + ventilator days + delivery mode + antenatal steroids + retinopathy of prematurity requiring surgery) had strong discriminatory power for severe disability (AUC = 0.850), with a PPV (positive predictive value) of 76% and an NPV (negative predictive value) of 90%. Available as a web-based tool, it can be useful for prognostication and targeting early intervention services to infants who may benefit the most from such services.

scholarly journals Correlation Between White Matter Injury Identified by Neonatal Diffusion Tensor Imaging and Neurodevelopmental Outcomes Following Term Neonatal Asphyxia and Therapeutic Hypothermia: An Exploratory Pilot Study

2019 ◽  
Vol 34 (10) ◽  
pp. 556-566 ◽  
Author(s):  
Gwendolyn J. Gerner ◽  
Eric I. Newman ◽  
V. Joanna Burton ◽  
Brenton Roman ◽  
Elizabeth A. Cristofalo ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Pilot Study ◽  
Therapeutic Hypothermia ◽  
Diffusion Tensor ◽  
White Matter Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
Group Differences ◽  
Neurodevelopmental Outcomes ◽  
Ischemic Encephalopathy

Aim: Hypoxic-ischemic encephalopathy is associated with damage to deep gray matter; however, white matter involvement has become recognized. This study explored differences between patients and clinical controls on diffusion tensor imaging, and relationships between diffusion tensor imaging and neurodevelopmental outcomes. Method: Diffusion tensor imaging was obtained for 31 neonates after hypoxic-ischemic encephalopathy treated with therapeutic hypothermia and 10 clinical controls. A subgroup of patients with hypoxic-ischemic encephalopathy (n = 14) had neurodevelopmental outcomes correlated with diffusion tensor imaging scalars. Results: Group differences in diffusion tensor imaging scalars were observed in the putamen, anterior and posterior centrum semiovale, and the splenium of the corpus callosum. Differences in these regions of interest were correlated with neurodevelopmental outcomes between ages 20 and 32 months. Conclusion: Therapeutic hypothermia may not be a complete intervention for hypoxic-ischemic encephalopathy, as neonatal white matter changes may continue to be evident, but further research is warranted. Patterns of white matter change on neonatal diffusion tensor imaging correlated with neurodevelopmental outcomes in this exploratory pilot study.

Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes

2017 ◽  
Vol 103 (3) ◽  
pp. F238-F244 ◽  
Author(s):  
Reina Hyodo ◽  
Yoshiaki Sato ◽  
Miharu Ito ◽  
Yuichiro Sugiyama ◽  
Chikako Ogawa ◽  
...  
Keyword(s):  
White Matter ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Preterm Infants ◽  
Normal Development ◽  
Resonance Spectroscopy ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Equivalent Age ◽  
Frontal White Matter

ObjectiveTo compare magnetic resonance spectroscopy (MRS) metabolite ratios in preterm infants at term-equivalent age with those in term infants and to evaluate the association between MRS metabolites and neurodevelopmental outcomes at 18 months corrected age in preterm infants.DesignWe studied infants born at a gestational age <37 weeks and weighing <1500 g during 2009–2013 using MRS at term-equivalent age. Infants with major brain abnormalities were excluded. The ratios of N-acetylaspartate (NAA) to creatine (Cre), NAA to choline-containing compounds (Cho) and Cho to Cre in the frontal white matter and thalamus were measured using multivoxel point-resolved proton spectroscopy sequence. Neurodevelopmental outcomes were assessed at 18 months corrected age.ResultsThirty-three preterm infants and 16 term infants were enrolled in this study. Preterm infants with normal development at 18 months showed significantly lower NAA/Cho ratios in the frontal white matter than term infants. There were no differences in the Cre/Cho ratios between preterm and term infants. At 18 months corrected age, 9 preterm infants with a mild developmental delay showed significantly lower NAA/Cho ratios in the thalamus than 24 preterm infants with normal development.ConclusionsPreterm infants at term-equivalent age showed reduced MRS metabolites (NAA/Cho) compared with term infants. Decreased NAA/Cho ratios in the thalamus were associated with neurodevelopmental delay at 18 months corrected age in preterm infants.

Neonatal Nucleated Red Blood Cells and the Prediction of Cerebral White Matter Injury in Preterm Infants

2006 ◽  
Vol 107 (3) ◽  
pp. 550-556 ◽  
Author(s):  
Anadir M. Silva ◽  
Randi N. Smith ◽  
Christoph U. Lehmann ◽  
Elizabeth A. Johnson ◽  
Cynthia J. Holcroft ◽  
...  
Keyword(s):  
White Matter ◽  
Red Blood Cells ◽  
Preterm Infants ◽  
Blood Cells ◽  
White Matter Injury ◽  
Cerebral White Matter ◽  
Nucleated Red Blood Cells

scholarly journals White matter injury but not germinal matrix hemorrhage induces elevated osteopontin expression in human preterm brains

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Gisela Nilsson ◽  
Ana A. Baburamani ◽  
Mary A. Rutherford ◽  
Changlian Zhu ◽  
Carina Mallard ◽  
...  
Keyword(s):  
Brain Injury ◽  
White Matter ◽  
Preterm Infants ◽  
Tissue Injury ◽  
White Matter Injury ◽  
Matricellular Protein ◽  
Perinatal Brain Injury ◽  
Germinal Matrix ◽  
Deep White Matter ◽  
Germinal Matrix Hemorrhage

AbstractOsteopontin (OPN) is a matricellular protein that mediates various physiological functions and is implicated in neuroinflammation, myelination, and perinatal brain injury. However, its expression in association with brain injury in preterm infants is unexplored. Here we examined the expression of OPN in postmortem brains of preterm infants and explored how this expression is affected in brain injury. We analyzed brain sections from cases with white matter injury (WMI) and cases with germinal matrix hemorrhage (GMH) and compared them to control cases having no brain injury. WMI cases displayed moderate to severe tissue injury in the periventricular and deep white matter that was accompanied by an increase of microglia with amoeboid morphology. Apart from visible hemorrhage in the germinal matrix, GMH cases displayed diffuse white matter injury in the periventricular and deep white matter. In non-injured preterm brains, OPN was expressed at low levels in microglia, astrocytes, and oligodendrocytes. OPN expression was significantly increased in regions with white matter injury in both WMI cases and GMH cases. The main cellular source of OPN in white matter injury areas was amoeboid microglia, although a significant increase was also observed in astrocytes in WMI cases. OPN was not expressed in the germinal matrix of any case, regardless of whether there was hemorrhage. In conclusion, preterm brain injury induces elevated OPN expression in microglia and astrocytes, and this increase is found in sites closely related to injury in the white matter regions but not with the hemorrhage site in the germinal matrix. Thus, it appears that OPN takes part in the inflammatory process in white matter injury in preterm infants, and these findings facilitate our understanding of OPN’s role under both physiological and pathological conditions in the human brain that may lead to greater elucidation of disease mechanisms and potentially better treatment strategies.

663 The voiding pattern of preterm infants with serious periventricular white matter injury

2014 ◽  
Vol 13 (1) ◽  
pp. e663
Author(s):  
Y.L. Wang ◽  
J.G. Wen ◽  
Y.B. Wen ◽  
L. Xing ◽  
Y.S. Zhang ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
White Matter Injury ◽  
Periventricular White Matter ◽  
Voiding Pattern
Sign in / Sign up

Export Citation Format

Share Document