Original ArticlesAltered Cerebral Perfusion in Infants Born Preterm Compared with Infants Born Full Term
Section snippets
Methods
Infants were prospectively enrolled at Children's National Health System (Washington, DC) from June 2012 to December 2015.5 Infants born preterm were eligible if born before 32 weeks of gestation with a birth weight <1500 g. Exclusion criteria included chromosomal anomalies, dysmorphic features, congenital brain malformations, central nervous system infection, metabolic disorders, severe brain injury (defined using brain scoring classification),21 and residual active analgesic/sedative
Results
Of the 128 infants born preterm scanned at TEA, 30 (23%) infants born preterm were excluded: 9 (7%) infants had residual analgesic/sedative effects at the time of MRI, 13 (10%) had severe brain injury, 5 (3%) exceeded our TEA window (38-44 weeks of postmenstrual age [PMA]), and 3 (2%) had unusable data as the result of excessive motion. Of the 115 healthy infants born at full term with ASL data, 6 (5%) were scanned after 44 weeks PMA and 5 (4%) presented with motion corrupted data and were
Discussion
In this prospective, observational study, we demonstrated that global and regional CBF was altered in a large cohort of infants born very preterm assessed at TEA compared with healthy newborns born full term. We found that relative CBF in the insula, ACC, and auditory cortex was lower in infants born preterm. Within the cohort born preterm, there was an association between parenchymal brain injury, cardiac vasopressor support, and decreased regional CBF. Collectively, these results suggest
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A novel Ontology-guided Attribute Partitioning ensemble learning model for early prediction of cognitive deficits using quantitative Structural MRI in very preterm infants
2022, NeuroImageCitation Excerpt :Altered cortical development has been detected on brain sMRI images in very preterm infants at term-equivalent age. For example, greater cortical thickness in frontal, insular, and anterior parietal cortices was observed in preterm infants compared with term infants (Bouyssi-Kobar et al., 2018; Kline et al., 2020; Parikh, 2016). These studies demonstrate the promise of brain maturation and geometric features as predictive biomarkers for later neurodevelopmental deficits.
Dear reviewers: Responses to common reviewer critiques about infant neuroimaging studies
2022, Developmental Cognitive NeuroscienceCitation Excerpt :Post-mortem studies of human neurovascular development show that infant humans do not reach adult-like levels of capillary density until after five months of age, and development until that point is nonuniform across cortical layers (Norman and O'kusky, 1986). Further, there is a small but growing body of literature indicating that cerebral blood flow increases across the first year of infancy (Bouyssi-Kobar et al., 2018; Camacho et al., 2019; Liu et al., 2019). Finally, how local blood flow responds to stimuli—e.g., the hemodynamic response function (HRF)—likely changes across the last weeks of pregnancy, the perinatal period and infancy (Arichi et al., 2012) and the age at which the adult-like hemodynamic response emerges remains unknown.
Arterial spin labeling perfusion in neonates
2020, Seminars in Fetal and Neonatal MedicineCitation Excerpt :Interestingly, brain perfusion patterns at term equivalent age are different in healthy preterm and term neonates (Fig. 2). Indeed, a few studies performed with different techniques revealed that preterm neonates have significantly higher CBF values in gray matter structures, including basal ganglia, thalami, and cerebral cortex [14,15,24,25]. These findings further suggest that perfusion values in neonatal brain are directly related to postnatal age which, in turn, reflects the degree of synaptogenesis, myelination, and cortical functional activity [20,26].
Imaging of the Newborn Brain
2019, Seminars in Pediatric NeurologyCitation Excerpt :This is likely associated with the finding that preterm infants with MRI evidence of brain injury have reduced blood flow in the pons and thalami as compared to preterm infants of the same gestational age without injury 20 and impaired cerebellar-dependent-associated learning.21 In contrast, a study of 104 full term and 98 preterm infants without evidence of cerebral injury, showed higher global cerebral blood flow (CBF), and higher regional CBF in the preterm infants in all areas except the insula.22 Overall, mounting evidence appears to support hypotheses that premature birth is strongly associated with impaired cerebellar development.
Altered Functional Brain Network Integration, Segregation, and Modularity in Infants Born Very Preterm at Term-Equivalent Age
2019, Journal of PediatricsCitation Excerpt :Infants born very preterm and healthy controls born at full term were enrolled in 2 prospective observational studies.14
Supported by the Canadian Institutes of Health Research (MOP-81116), the SickKids Foundation (XG 06-069), and the National Institutes of Health (R01 HL116585-01). M.B.-K. is a PhD student in the Molecular Medicine Program of the Institute for Biomedical Sciences at the George Washington University. This work is from a dissertation to be presented to the aforementioned program in partial fulfillment of the requirements for the PhD degree. The authors declare no conflicts of interest.