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Calixto C, Soldatelli MD, Jaimes C, Warfield SK, Gholipour A, Karimi D. A detailed spatio-temporal atlas of the white matter tracts for the fetal brain. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.26.590815. [PMID: 38712296 PMCID: PMC11071632 DOI: 10.1101/2024.04.26.590815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
This study presents the construction of a comprehensive spatiotemporal atlas detailing the development of white matter tracts in the fetal brain using diffusion magnetic resonance imaging (dMRI). Our research leverages data collected from fetal MRI scans conducted between 22 and 37 weeks of gestation, capturing the dynamic changes in the brain's microstructure during this critical period. The atlas includes 60 distinct white matter tracts, including commissural, projection, and association fibers. We employed advanced fetal dMRI processing techniques and tractography to map and characterize the developmental trajectories of these tracts. Our findings reveal that the development of these tracts is characterized by complex patterns of fractional anisotropy (FA) and mean diffusivity (MD), reflecting key neurodevelopmental processes such as axonal growth, involution of the radial-glial scaffolding, and synaptic pruning. This atlas can serve as a useful resource for neuroscience research and clinical practice, improving our understanding of the fetal brain and potentially aiding in the early diagnosis of neurodevelopmental disorders. By detailing the normal progression of white matter tract development, the atlas can be used as a benchmark for identifying deviations that may indicate neurological anomalies or predispositions to disorders.
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Affiliation(s)
- Camilo Calixto
- Computational Radiology Laboratory (CRL), Boston Children's Hospital, Harvard Medical School
| | | | - Camilo Jaimes
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | - Simon K Warfield
- Computational Radiology Laboratory (CRL), Boston Children's Hospital, Harvard Medical School
| | - Ali Gholipour
- Computational Radiology Laboratory (CRL), Boston Children's Hospital, Harvard Medical School
| | - Davood Karimi
- Computational Radiology Laboratory (CRL), Boston Children's Hospital, Harvard Medical School
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2
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Sanders AFP, Tirado B, Seider NA, Triplett RL, Lean RE, Neil JJ, Miller JP, Tillman R, Smyser TA, Barch DM, Luby JL, Rogers CE, Smyser CD, Warner BB, Chen E, Miller GE. Prenatal exposure to maternal disadvantage-related inflammatory biomarkers: associations with neonatal white matter microstructure. Transl Psychiatry 2024; 14:72. [PMID: 38307841 PMCID: PMC10837200 DOI: 10.1038/s41398-024-02782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/04/2024] Open
Abstract
Prenatal exposure to heightened maternal inflammation has been associated with adverse neurodevelopmental outcomes, including atypical brain maturation and psychiatric illness. In mothers experiencing socioeconomic disadvantage, immune activation can be a product of the chronic stress inherent to such environmental hardship. While growing preclinical and clinical evidence has shown links between altered neonatal brain development and increased inflammatory states in utero, the potential mechanism by which socioeconomic disadvantage differentially impacts neural-immune crosstalk remains unclear. In the current study, we investigated associations between socioeconomic disadvantage, gestational inflammation, and neonatal white matter microstructure in 320 mother-infant dyads over-sampled for poverty. We analyzed maternal serum levels of four cytokines (IL-6, IL-8, IL-10, TNF-α) over the course of pregnancy in relation to offspring white matter microstructure and socioeconomic disadvantage. Higher average maternal IL-6 was associated with very low socioeconomic status (SES; INR < 200% poverty line) and lower neonatal corticospinal fractional anisotropy (FA) and lower uncinate axial diffusivity (AD). No other cytokine was associated with SES. Higher average maternal IL-10 was associated with lower FA and higher radial diffusivity (RD) in corpus callosum and corticospinal tracts, higher optic radiation RD, lower uncinate AD, and lower FA in inferior fronto-occipital fasciculus and anterior limb of internal capsule tracts. SES moderated the relationship between average maternal TNF-α levels during gestation and neonatal white matter diffusivity. When these interactions were decomposed, the patterns indicated that this association was significant and positive among very low SES neonates, whereby TNF-α was inversely and significantly associated with inferior cingulum AD. By contrast, among the more advantaged neonates (lower-to-higher SES [INR ≥ 200% poverty line]), TNF-α was positively and significantly associated with superior cingulum AD. Taken together, these findings suggest that the relationship between prenatal cytokine exposure and white matter microstructure differs as a function of SES. These patterns are consistent with a scenario where gestational inflammation's effects on white matter development diverge depending on the availability of foundational resources in utero.
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Affiliation(s)
- Ashley F P Sanders
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA.
| | - Brian Tirado
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Nicole A Seider
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Regina L Triplett
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Rachel E Lean
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Jeffrey J Neil
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - J Philip Miller
- Division of Biostatistics, Institute for Informatics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Psychological and Brain Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Newborn Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Edith Chen
- Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Gregory E Miller
- Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
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3
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Takahashi Y, Takahashi T, Usuda H, Carter S, Fee EL, Furfaro L, Chemtob S, Olson DM, Keelan JA, Kallapur S, Kemp MW. Pharmacological blockade of the interleukin-1 receptor suppressed Escherichia coli lipopolysaccharide-induced neuroinflammation in preterm fetal sheep. Am J Obstet Gynecol MFM 2023; 5:101124. [PMID: 37597799 DOI: 10.1016/j.ajogmf.2023.101124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/23/2023] [Accepted: 08/03/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Intraamniotic inflammation is associated with preterm birth, especially in cases occurring before 32 weeks' gestation, and is causally linked with an increased risk for neonatal mortality and morbidity. Targeted anti-inflammatory interventions may assist in improving the outcomes for pregnancies impacted by intrauterine inflammation. Interleukin-1 is a central upstream mediator of inflammation. Accordingly, interleukin-1 is a promising candidate target for intervention therapies and has been targeted previously using the interleukin-1 receptor antagonist, anakinra. Recent studies have shown that the novel, noncompetitive, allosteric interleukin-1 receptor inhibitor, rytvela, partially resolved inflammation associated with preterm birth and fetal injury. In this study, we used a preterm sheep model of chorioamnionitis to investigate the anti-inflammatory efficacy of rytvela and anakinra, administered in the amniotic fluid in the setting of intraamniotic Escherichia coli lipopolysaccharide exposure. OBJECTIVE We hypothesized that both rytvela and anakinra would reduce lipopolysaccharide-induced intrauterine inflammation and protect the fetal brain. STUDY DESIGN Ewes with a singleton fetus at 105 days of gestation (term is ∼150 days) were randomized to one of the following groups: (1) intraamniotic injections of 2 mL saline at time=0 and time=24 hours as a negative control group (saline group, n=12); (2) intraamniotic injection of 10 mg Escherichia coli lipopolysaccharide in 2 mL saline and intraamniotic injections of 2 mL saline at time=0 hours and time=24 hours as an inflammation positive control group (lipopolysaccharide group, n=11); (3) intraamniotic injection of Escherichia coli lipopolysaccharide in 2 mL saline and intraamniotic injections of 2.5 mg rytvela at time=0 hours and time=24 hours to test the anti-inflammatory efficacy of rytvela (lipopolysaccharide + rytvela group, n=10); or (4) intraamniotic injection of Escherichia coli lipopolysaccharide in 2 mL saline and intraamniotic injections of 100 mg anakinra at time=0 hours and time=24 hours to test the anti-inflammatory efficacy of anakinra (lipopolysaccharide + anakinra group, n=12). Amniotic fluid was sampled at time 0, 24, and 48 hours (ie, at each intervention and at delivery). Fetal umbilical cord blood was collected at delivery for differential blood counts and chemical studies. Inflammation was characterized by the analysis of fetal tissue cytokine and chemokine levels using quantitative polymerase chain reaction, enzyme-linked inmmunosorbent assay, and histology. The primary study outcome of interest was the assessment of anakinra and rytvela brain-protective effects in the setting of Escherichia coli lipopolysaccharide-induced intrauterine inflammation. Secondary outcomes of interest were to assess protection from fetal and intrauterine (ie, amniotic fluid, chorioamnion) inflammation. RESULTS Intraamniotic administration of lipopolysaccharide caused inflammation of the fetal lung, brain, and chorioamnionitis in preterm fetal sheep. Relative to treatment with saline only in the setting of lipopolysaccharide exposure, intraamniotic administration of both rytvela and anakinra both significantly prevented periventricular white matter injury, microglial activation, and histologic chorioamnionitis. Anakinra showed additional efficacy in inhibiting fetal lung myeloperoxidase activity, but its use was associated with metabolic acidaemia and reduced fetal plasma insulin-like growth factor-1 levels at delivery. CONCLUSION Intraamniotic administration of rytvela or anakinra significantly inhibited fetal brain inflammation and chorioamnionitis in preterm fetal sheep exposed to intraamniotic lipopolysaccharide. In addition, anakinra treatment was associated with potential negative impacts on the developing fetus.
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Affiliation(s)
- Yuki Takahashi
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp); Centre for Perinatal and Neonatal Medicine, Tohoku University Hospital, Sendai, Japan (Drs Y Takahashi, T Takahashi, Usuda, and Kemp).
| | - Tsukasa Takahashi
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp); Centre for Perinatal and Neonatal Medicine, Tohoku University Hospital, Sendai, Japan (Drs Y Takahashi, T Takahashi, Usuda, and Kemp)
| | - Haruo Usuda
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp); Centre for Perinatal and Neonatal Medicine, Tohoku University Hospital, Sendai, Japan (Drs Y Takahashi, T Takahashi, Usuda, and Kemp)
| | - Sean Carter
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp); Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Dr S Carter, and Kemp)
| | - Erin L Fee
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp)
| | - Lucy Furfaro
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp)
| | - Sylvain Chemtob
- Department of Pharmacology and Physiology, University of Montreal, Montreal, Canada (Dr Chemtob)
| | - David M Olson
- Departments of Obstetrics and Gynecology, Pediatrics, and Physiology, University of Alberta, Alberta, Canada (Dr Olson)
| | - Jeffrey A Keelan
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp)
| | - Suhas Kallapur
- Department of Neonatology and Developmental Biology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA (Dr Kallapur)
| | - Matthew W Kemp
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, Western Australia, Australia (Drs Y Takahashi, T Takahashi, M Usuda, and Carter, Ms Fee, and Drs Furfaro, Keelan, and Kemp); Centre for Perinatal and Neonatal Medicine, Tohoku University Hospital, Sendai, Japan (Drs Y Takahashi, T Takahashi, Usuda, and Kemp); School of Veterinary and Life Sciences, Murdoch University, Perth, Australia (Dr Kemp); Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Dr S Carter, and Kemp)
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Pretzsch CM, Ecker C. Structural neuroimaging phenotypes and associated molecular and genomic underpinnings in autism: a review. Front Neurosci 2023; 17:1172779. [PMID: 37457001 PMCID: PMC10347684 DOI: 10.3389/fnins.2023.1172779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Autism has been associated with differences in the developmental trajectories of multiple neuroanatomical features, including cortical thickness, surface area, cortical volume, measures of gyrification, and the gray-white matter tissue contrast. These neuroimaging features have been proposed as intermediate phenotypes on the gradient from genomic variation to behavioral symptoms. Hence, examining what these proxy markers represent, i.e., disentangling their associated molecular and genomic underpinnings, could provide crucial insights into the etiology and pathophysiology of autism. In line with this, an increasing number of studies are exploring the association between neuroanatomical, cellular/molecular, and (epi)genetic variation in autism, both indirectly and directly in vivo and across age. In this review, we aim to summarize the existing literature in autism (and neurotypicals) to chart a putative pathway from (i) imaging-derived neuroanatomical cortical phenotypes to (ii) underlying (neuropathological) biological processes, and (iii) associated genomic variation.
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Affiliation(s)
- Charlotte M. Pretzsch
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Christine Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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5
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Wilson S, Pietsch M, Cordero-Grande L, Christiaens D, Uus A, Karolis VR, Kyriakopoulou V, Colford K, Price AN, Hutter J, Rutherford MA, Hughes EJ, Counsell SJ, Tournier JD, Hajnal JV, Edwards AD, O’Muircheartaigh J, Arichi T. Spatiotemporal tissue maturation of thalamocortical pathways in the human fetal brain. eLife 2023; 12:e83727. [PMID: 37010273 PMCID: PMC10125021 DOI: 10.7554/elife.83727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/31/2023] [Indexed: 04/04/2023] Open
Abstract
The development of connectivity between the thalamus and maturing cortex is a fundamental process in the second half of human gestation, establishing the neural circuits that are the basis for several important brain functions. In this study, we acquired high-resolution in utero diffusion magnetic resonance imaging (MRI) from 140 fetuses as part of the Developing Human Connectome Project, to examine the emergence of thalamocortical white matter over the second to third trimester. We delineate developing thalamocortical pathways and parcellate the fetal thalamus according to its cortical connectivity using diffusion tractography. We then quantify microstructural tissue components along the tracts in fetal compartments that are critical substrates for white matter maturation, such as the subplate and intermediate zone. We identify patterns of change in the diffusion metrics that reflect critical neurobiological transitions occurring in the second to third trimester, such as the disassembly of radial glial scaffolding and the lamination of the cortical plate. These maturational trajectories of MR signal in transient fetal compartments provide a normative reference to complement histological knowledge, facilitating future studies to establish how developmental disruptions in these regions contribute to pathophysiology.
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Affiliation(s)
- Siân Wilson
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
| | - Maximilian Pietsch
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de MadridMadridSpain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN)MadridSpain
| | - Daan Christiaens
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Department of Electrical Engineering (ESAT/PSI), Katholieke Universiteit LeuvenLeuvenBelgium
| | - Alena Uus
- Department of Biomedical Engineering, School Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas' HospitalLondonUnited Kingdom
| | - Vyacheslav R Karolis
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Vanessa Kyriakopoulou
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Kathleen Colford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Anthony N Price
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Jana Hutter
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Emer J Hughes
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Jacques-Donald Tournier
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
| | - Jonathan O’Muircheartaigh
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
- Department of Forensic and Neurodevelopmental Sciences, King’s College LondonLondonUnited Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Neurodevelopmental Disorders, King’s College LondonLondonUnited Kingdom
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation TrustLondonUnited Kingdom
- Department of Bioengineering, Imperial College LondonLondonUnited Kingdom
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6
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Yu Q, Ouyang M, Detre J, Kang H, Hu D, Hong B, Fang F, Peng Y, Huang H. Infant brain regional cerebral blood flow increases supporting emergence of the default-mode network. eLife 2023; 12:e78397. [PMID: 36693116 PMCID: PMC9873253 DOI: 10.7554/elife.78397] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
Human infancy is characterized by most rapid regional cerebral blood flow (rCBF) increases across lifespan and emergence of a fundamental brain system default-mode network (DMN). However, how infant rCBF changes spatiotemporally across the brain and how the rCBF increase supports emergence of functional networks such as DMN remains unknown. Here, by acquiring cutting-edge multi-modal MRI including pseudo-continuous arterial-spin-labeled perfusion MRI and resting-state functional MRI of 48 infants cross-sectionally, we elucidated unprecedented 4D spatiotemporal infant rCBF framework and region-specific physiology-function coupling across infancy. We found that faster rCBF increases in the DMN than visual and sensorimotor networks. We also found strongly coupled increases of rCBF and network strength specifically in the DMN, suggesting faster local blood flow increase to meet extraneuronal metabolic demands in the DMN maturation. These results offer insights into the physiological mechanism of brain functional network emergence and have important implications in altered network maturation in brain disorders.
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Affiliation(s)
- Qinlin Yu
- Department of Radiology, Children’s Hospital of PhiladelphiaPhiladelphiaUnited States
- Department of Radiology, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
| | - Minhui Ouyang
- Department of Radiology, Children’s Hospital of PhiladelphiaPhiladelphiaUnited States
- Department of Radiology, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
| | - John Detre
- Department of Radiology, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
- Department of Neurology, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
| | - Huiying Kang
- Department of Radiology, Children’s Hospital of PhiladelphiaPhiladelphiaUnited States
- Department of Radiology, Beijing Children’s Hospital, Capital Medical UniversityBeijingChina
| | - Di Hu
- Department of Radiology, Children’s Hospital of PhiladelphiaPhiladelphiaUnited States
- Department of Radiology, Beijing Children’s Hospital, Capital Medical UniversityBeijingChina
| | - Bo Hong
- Department of Biomedical Engineering, Tsinghua UniversityBeijingChina
| | - Fang Fang
- School of Psychological and Cognitive Sciences, Peking UniversityBeijingChina
| | - Yun Peng
- Department of Radiology, Beijing Children’s Hospital, Capital Medical UniversityBeijingChina
| | - Hao Huang
- Department of Radiology, Children’s Hospital of PhiladelphiaPhiladelphiaUnited States
- Department of Radiology, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
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7
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Oldham S, Fulcher BD, Aquino K, Arnatkevičiūtė A, Paquola C, Shishegar R, Fornito A. Modeling spatial, developmental, physiological, and topological constraints on human brain connectivity. SCIENCE ADVANCES 2022; 8:eabm6127. [PMID: 35658036 PMCID: PMC9166341 DOI: 10.1126/sciadv.abm6127] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/14/2022] [Indexed: 05/10/2023]
Abstract
The complex connectivity of nervous systems is thought to have been shaped by competitive selection pressures to minimize wiring costs and support adaptive function. Accordingly, recent modeling work indicates that stochastic processes, shaped by putative trade-offs between the cost and value of each connection, can successfully reproduce many topological properties of macroscale human connectomes measured with diffusion magnetic resonance imaging. Here, we derive a new formalism that more accurately captures the competing pressures of wiring cost minimization and topological complexity. We further show that model performance can be improved by accounting for developmental changes in brain geometry and associated wiring costs, and by using interregional transcriptional or microstructural similarity rather than topological wiring rules. However, all models struggled to capture topographical (i.e., spatial) network properties. Our findings highlight an important role for genetics in shaping macroscale brain connectivity and indicate that stochastic models offer an incomplete account of connectome organization.
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Affiliation(s)
- Stuart Oldham
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Ben D. Fulcher
- School of Physics, The University of Sydney, Sydney, NSW, Australia
| | - Kevin Aquino
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
- School of Physics, The University of Sydney, Sydney, NSW, Australia
| | - Aurina Arnatkevičiūtė
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
| | - Casey Paquola
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | - Rosita Shishegar
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
- The Australian e-Health Research Centre, CSIRO, Melbourne, VIC, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
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8
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Beeraka NM, Vikram PRH, Greeshma MV, Uthaiah CA, Huria T, Liu J, Kumar P, Nikolenko VN, Bulygin KV, Sinelnikov MY, Sukocheva O, Fan R. Recent Investigations on Neurotransmitters' Role in Acute White Matter Injury of Perinatal Glia and Pharmacotherapies-Glia Dynamics in Stem Cell Therapy. Mol Neurobiol 2022; 59:2009-2026. [PMID: 35041139 DOI: 10.1007/s12035-021-02700-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/10/2021] [Indexed: 02/05/2023]
Abstract
Periventricular leukomalacia (PVL) and cerebral palsy are two neurological disease conditions developed from the premyelinated white matter ischemic injury (WMI). The significant pathophysiology of these diseases is accompanied by the cognitive deficits due to the loss of function of glial cells and axons. White matter makes up 50% of the brain volume consisting of myelinated and non-myelinated axons, glia, blood vessels, optic nerves, and corpus callosum. Studies over the years have delineated the susceptibility of white matter towards ischemic injury especially during pregnancy (prenatal, perinatal) or immediately after child birth (postnatal). Impairment in membrane depolarization of neurons and glial cells by ischemia-invoked excitotoxicity is mediated through the overactivation of NMDA receptors or non-NMDA receptors by excessive glutamate influx, calcium, or ROS overload and has been some of the well-studied molecular mechanisms conducive to the injury of white matter. Expression of glutamate receptors (GluR) and transporters (GLT1, EACC1, and GST) has significant influence in glial and axonal-mediated injury of premyelinated white matter during PVL and cerebral palsy. Predominantly, the central premyelinated axons express extensive levels of functional NMDA GluR receptors to confer ischemic injury to premyelinated white matter which in turn invoke defects in neural plasticity. Several underlying molecular mechanisms are yet to be unraveled to delineate the complete pathophysiology of these prenatal neurological diseases for developing the novel therapeutic modalities to mitigate pathophysiology and premature mortality of newborn babies. In this review, we have substantially discussed the above multiple pathophysiological aspects of white matter injury along with glial dynamics, and the pharmacotherapies including recent insights into the application of MSCs as therapeutic modality in treating white matter injury.
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Affiliation(s)
- Narasimha M Beeraka
- Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People's Republic of China
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru, Karnataka, India
- Department of Human Anatomy, I. M. Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - P R Hemanth Vikram
- Department of Pharmaceutical Chemistry, JSS Pharmacy College, Mysuru, Karnataka, India
| | - M V Greeshma
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru, Karnataka, India
| | - Chinnappa A Uthaiah
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru, Karnataka, India
| | - Tahani Huria
- Faculty of Medicine, Benghazi University, Benghazi, Libya
- Department of Cell Physiology and Pharmacology, University of Leicester, Leicester, LE1 7RH, UK
| | - Junqi Liu
- Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People's Republic of China
| | - Pramod Kumar
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER-Guwahati), SilaKatamur (Halugurisuk), Changsari, Kamrup, 781101, Assam, India
| | - Vladimir N Nikolenko
- Department of Human Anatomy, I. M. Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
- Department of Normal and Topographic Anatomy, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Kirill V Bulygin
- Department of Human Anatomy, I. M. Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Mikhail Y Sinelnikov
- Department of Human Anatomy, I. M. Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
- Research Institute of Human Morphology, 3 Tsyurupy Street, Moscow, 117418, Russian Federation
| | - Olga Sukocheva
- Discipline of Health Sciences, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, Australia
| | - Ruitai Fan
- Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People's Republic of China.
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Hagler DJ, Thompson WK, Chen CH, Reuter C, Akshoomoff N, Brown TT. Do aggregate, multimodal structural neuroimaging measures replicate regional developmental differences observed in highly cited cellular histological studies? Dev Cogn Neurosci 2022; 54:101086. [PMID: 35220023 PMCID: PMC8889098 DOI: 10.1016/j.dcn.2022.101086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 02/05/2022] [Accepted: 02/16/2022] [Indexed: 11/20/2022] Open
Abstract
Influential investigations of postmortem human brain tissue showed regional differences in tissue properties at early phases of development, such as between prefrontal and primary sensory cortical regions. Large-scale neuroimaging studies enable characterization of age-related trajectories with much denser sampling of cortical regions, assessment ages, and demographic variables than postmortem tissue analyses, but no single imaging measure perfectly captures what is measured with histology. Using publicly available data from the Pediatric Imaging, Neurocognition, and Genetics (PING) study, including 951 participants with ages ranging from 3 to 21 years, we characterized cortical regional variability in developmental trajectories of multimodal brain imaging measures. Multivariate analyses integrated morphometric and microstructural cortical surface measures. To replicate foundational histological work showing delayed synapse elimination in middle frontal gyrus relative to primary sensory areas, we tested whether developmental trajectories differ between prefrontal and visual or auditory cortex. We extended this to a whole-cortex analysis of interregional differences, producing cortical parcellations with maximally different developmental trajectories. Consistent with the general conclusions of postmortem analyses, our imaging results suggest that prefrontal regions show a protracted period of greater developmental change; however, they also illustrate the challenges of drawing conclusions about the relative maturational phases of different brain regions. Multimodal, multivariate, nonlinear modeling, integrating morphometric and microstructural measures. Tested regional developmental differences previously found in highly influential cellular histological studies. Produced cortical parcellations with maximally different, multimodal, developmental trajectories. Findings converge with evidence from histological studies showing delayed prefrontal cortical development. Interregional differences vary by measure and illustrate complexities of defining which regions mature first.
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10
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S100B Maternal Blood Levels in Gestational Diabetes Mellitus Are Birthweight, Gender and Delivery Mode Dependent. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031028. [PMID: 35162052 PMCID: PMC8834559 DOI: 10.3390/ijerph19031028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/04/2023]
Abstract
Gestational Diabetes Mellitus (GDM) is one of the main causes of perinatal mortality/morbidity. Today, a parameter offering useful information on fetal central nervous system (CNS) development/damage is eagerly awaited. We investigated the role of brain-protein S100B in the maternal blood of GDM pregnancies by means of a prospective case–control study in 646 pregnancies (GDM: n = 106; controls: n = 530). Maternal blood samples for S100B measurement were collected at four monitoring time-points from 24 weeks of gestation to term. Data was corrected for gender and delivery mode and correlated with gestational age and weight at birth. Results showed higher (p < 0.05) S100B from 24 to 32 weeks and at term in GDM fetuses than controls. Higher (p < 0.05) S100B was observed in GDM male new-borns than in females from 24 to 32 weeks and at term, in GDM cases delivering vaginally than by caesarean section. Finally, S100B positively correlated with gestational age and weight at birth (R = 0.27; R = 0.37, respectively; p < 0.01). The present findings show the usefulness of S100B in CNS to monitor high-risk pregnancies during perinatal standard-of-care procedures. The results suggest that further investigations into its potential role as an early marker of CNS growth/damage in GDM population are needed.
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11
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Dudink I, Hüppi PS, Sizonenko SV, Castillo-Melendez M, Sutherland AE, Allison BJ, Miller SL. Altered trajectory of neurodevelopment associated with fetal growth restriction. Exp Neurol 2021; 347:113885. [PMID: 34627856 DOI: 10.1016/j.expneurol.2021.113885] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/23/2021] [Accepted: 10/02/2021] [Indexed: 12/17/2022]
Abstract
Fetal growth restriction (FGR) is principally caused by suboptimal placental function. Poor placental function causes an under supply of nutrients and oxygen to the developing fetus, restricting development of individual organs and overall growth. Estimated fetal weight below the 10th or 3rd percentile with uteroplacental dysfunction, and knowledge regarding the onset of growth restriction (early or late), provide diagnostic criteria for fetuses at greatest risk for adverse outcome. Brain development and function is altered with FGR, with ongoing clinical and preclinical studies elucidating neuropathological etiology. During the third trimester of pregnancy, from ~28 weeks gestation, neurogenesis is complete and neuronal complexity is expanding, through axonal and dendritic outgrowth, dendritic branching and synaptogenesis, accompanied by myelin production. Fetal compromise over this period, as occurs in FGR, has detrimental effects on these processes. Total brain volume and grey matter volume is reduced in infants with FGR, first evident in utero, with cortical volume particularly vulnerable. Imaging studies show that cerebral morphology is disturbed in FGR, with altered cerebral cortex, volume and organization of brain networks, and reduced connectivity of long- and short-range circuits. Thus, FGR induces a deviation in brain development trajectory affecting both grey and white matter, however grey matter volume is preferentially reduced, contributed by cell loss, and reduced neurite outgrowth of surviving neurons. In turn, cell-to-cell local networks are adversely affected in FGR, and whole brain left and right intrahemispheric connections and interhemispheric connections are altered. Importantly, disruptions to region-specific brain networks are linked to cognitive and behavioral impairments.
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Affiliation(s)
- Ingrid Dudink
- The Ritchie Centre, Hudson Institute of Medical Research, Translational Research Facility, Clayton, Victoria, Australia; Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia
| | - Petra S Hüppi
- Department of Pediatrics, Obstetrics and Gynecology, University of Geneva, Switzerland
| | - Stéphane V Sizonenko
- Department of Pediatrics, Obstetrics and Gynecology, University of Geneva, Switzerland
| | - Margie Castillo-Melendez
- The Ritchie Centre, Hudson Institute of Medical Research, Translational Research Facility, Clayton, Victoria, Australia
| | - Amy E Sutherland
- The Ritchie Centre, Hudson Institute of Medical Research, Translational Research Facility, Clayton, Victoria, Australia; Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia
| | - Beth J Allison
- The Ritchie Centre, Hudson Institute of Medical Research, Translational Research Facility, Clayton, Victoria, Australia; Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia
| | - Suzanne L Miller
- The Ritchie Centre, Hudson Institute of Medical Research, Translational Research Facility, Clayton, Victoria, Australia; Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia.
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12
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Inder TE, de Vries LS, Ferriero DM, Grant PE, Ment LR, Miller SP, Volpe JJ. Neuroimaging of the Preterm Brain: Review and Recommendations. J Pediatr 2021; 237:276-287.e4. [PMID: 34146549 DOI: 10.1016/j.jpeds.2021.06.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
| | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neonatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Donna M Ferriero
- Department of Neurology, University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Francisco, San Francisco, CA; Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA
| | - P Ellen Grant
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Laura R Ment
- Department of Pediatrics, Yale School of Medicine, New Haven, CT; Department of Neurology, Yale School of Medicine, New Haven, CT
| | - Steven P Miller
- Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | - Joseph J Volpe
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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13
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Yu Q, Peng Y, Kang H, Peng Q, Ouyang M, Slinger M, Hu D, Shou H, Fang F, Huang H. Differential White Matter Maturation from Birth to 8 Years of Age. Cereb Cortex 2021; 30:2673-2689. [PMID: 31819951 PMCID: PMC7175013 DOI: 10.1093/cercor/bhz268] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/23/2019] [Accepted: 09/17/2019] [Indexed: 12/14/2022] Open
Abstract
Comprehensive delineation of white matter (WM) microstructural maturation from birth to childhood is critical for understanding spatiotemporally differential circuit formation. Without a relatively large sample of datasets and coverage of critical developmental periods of both infancy and early childhood, differential maturational charts across WM tracts cannot be delineated. With diffusion tensor imaging (DTI) of 118 typically developing (TD) children aged 0–8 years and 31 children with autistic spectrum disorder (ASD) aged 2–7 years, the microstructure of every major WM tract and tract group was measured with DTI metrics to delineate differential WM maturation. The exponential model of microstructural maturation of all WM was identified. The WM developmental curves were separated into fast, intermediate, and slow phases in 0–8 years with distinctive time period of each phase across the tracts. Shorter periods of the fast and intermediate phases in certain tracts, such as the commissural tracts, indicated faster earlier development. With TD WM maturational curves as the reference, higher residual variance of WM microstructure was found in children with ASD. The presented comprehensive and differential charts of TD WM microstructural maturation of all major tracts and tract groups in 0–8 years provide reference standards for biomarker detection of neuropsychiatric disorders.
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Affiliation(s)
- Qinlin Yu
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Huiying Kang
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Qinmu Peng
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Minhui Ouyang
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Michelle Slinger
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Di Hu
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Haochang Shou
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Fang Fang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China.,Key Laboratory of Machine Perception, Peking University, Beijing 100871, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing 100871, China.,PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
| | - Hao Huang
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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14
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Fouladivanda M, Kazemi K, Makki M, Khalilian M, Danyali H, Gervain J, Aarabi A. Multi-scale structural rich-club organization of the brain in full-term newborns: a combined DWI and fMRI study. J Neural Eng 2021; 18. [PMID: 33930878 DOI: 10.1088/1741-2552/abfd46] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/30/2021] [Indexed: 12/11/2022]
Abstract
Objective.Our understanding of early brain development is limited due to rapid changes in white matter pathways after birth. In this study, we introduced a multi-scale cross-modal approach to investigate the rich club (RC) organization and topology of the structural brain networks in 40 healthy neonates using diffusion-weighted imaging and resting-state fMRI data.Approach.A group independent component analysis was first performed to identify eight resting state networks (RSNs) used as functional modules. A groupwise whole-brain functional parcellation was also performed at five scales comprising 100-900 parcels. The distribution of RC nodes was then investigated within and between the RSNs. We further assessed the distribution of short and long-range RC, feeder and local connections across different parcellation scales.Main results.Sharing the scale-free characteristic of small-worldness, the neonatal structural brain networks exhibited an RC organization at different nodal scales (NSs). The subcortical, sensory-motor and default mode networks were found to be strongly involved in the RC organization of the structural brain networks, especially in the zones where the RSNs overlapped, with an average cross-scale proportion of 45.9%, 28.5% and 10.5%, respectively. A large proportion of the connector hubs were found to be RC members for the coarsest (73%) to finest (92%) NSs. Our results revealed a prominent involvement of cortico-subcortical and cortico-cerebellar white matter pathways in the RC organization of the neonatal brain. Regardless of the NS, the majority (more than 65.2%) of the inter-RSN connections were long distance RC or feeder with an average physical connection of 105.5 and 97.4 mm, respectively. Several key RC regions were identified, including the insula and cingulate gyri, middle and superior temporal gyri, hippocampus and parahippocampus, fusiform gyrus, precuneus, superior frontal and precentral gyri, calcarine fissure and lingual gyrus.Significance.Our results emphasize the importance of the multi-scale connectivity analysis in assessing the cross-scale reproducibility of the connectivity results concerning the global and local topological properties of the brain networks. Our findings may improve our understanding of the early brain development.
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Affiliation(s)
- Mahshid Fouladivanda
- Department of Electrical and Electronics Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Kamran Kazemi
- Department of Electrical and Electronics Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Malek Makki
- Laboratory of Functional Neuroscience and Pathologies (LNFP), University Research Center (CURS), University Hospital, Amiens, France
| | - Maedeh Khalilian
- Laboratory of Functional Neuroscience and Pathologies (LNFP), University Research Center (CURS), University Hospital, Amiens, France
| | - Habibollah Danyali
- Department of Electrical and Electronics Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Judit Gervain
- Integrative Neuroscience and Cognition Center, CNRS & Université de Paris, Paris, France.,Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Ardalan Aarabi
- Laboratory of Functional Neuroscience and Pathologies (LNFP), University Research Center (CURS), University Hospital, Amiens, France.,Faculty of Medicine, University of Picardy Jules Verne, Amiens, France
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15
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Development of human white matter pathways in utero over the second and third trimester. Proc Natl Acad Sci U S A 2021; 118:2023598118. [PMID: 33972435 PMCID: PMC8157930 DOI: 10.1073/pnas.2023598118] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
During the second and third trimesters of human gestation, rapid neurodevelopment is underpinned by fundamental processes including neuronal migration, cellular organization, cortical layering, and myelination. In this time, white matter growth and maturation lay the foundation for an efficient network of structural connections. Detailed knowledge about this developmental trajectory in the healthy human fetal brain is limited, in part, due to the inherent challenges of acquiring high-quality MRI data from this population. Here, we use state-of-the-art high-resolution multishell motion-corrected diffusion-weighted MRI (dMRI), collected as part of the developing Human Connectome Project (dHCP), to characterize the in utero maturation of white matter microstructure in 113 fetuses aged 22 to 37 wk gestation. We define five major white matter bundles and characterize their microstructural features using both traditional diffusion tensor and multishell multitissue models. We found unique maturational trends in thalamocortical fibers compared with association tracts and identified different maturational trends within specific sections of the corpus callosum. While linear maturational increases in fractional anisotropy were seen in the splenium of the corpus callosum, complex nonlinear trends were seen in the majority of other white matter tracts, with an initial decrease in fractional anisotropy in early gestation followed by a later increase. The latter is of particular interest as it differs markedly from the trends previously described in ex utero preterm infants, suggesting that this normative fetal data can provide significant insights into the abnormalities in connectivity which underlie the neurodevelopmental impairments associated with preterm birth.
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16
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Hadders-Algra M. Early Diagnostics and Early Intervention in Neurodevelopmental Disorders-Age-Dependent Challenges and Opportunities. J Clin Med 2021; 10:861. [PMID: 33669727 PMCID: PMC7922888 DOI: 10.3390/jcm10040861] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 12/20/2022] Open
Abstract
This review discusses early diagnostics and early intervention in developmental disorders in the light of brain development. The best instruments for early detection of cerebral palsy (CP) with or without intellectual disability are neonatal magnetic resonance imaging, general movements assessment at 2-4 months and from 2-4 months onwards, the Hammersmith Infant Neurological Examination and Standardized Infant NeuroDevelopmental Assessment. Early detection of autism spectrum disorders (ASD) is difficult; its first signs emerge at the end of the first year. Prediction with the Modified Checklist for Autism in Toddlers and Infant Toddler Checklist is possible to some extent and improves during the second year, especially in children at familial risk of ASD. Thus, prediction improves substantially when transient brain structures have been replaced by permanent circuitries. At around 3 months the cortical subplate has dissolved in primary motor and sensory cortices; around 12 months the cortical subplate in prefrontal and parieto-temporal cortices and cerebellar external granular layer have disappeared. This review stresses that families are pivotal in early intervention. It summarizes evidence on the effectiveness of early intervention in medically fragile neonates, infants at low to moderate risk, infants with or at high risk of CP and with or at high risk of ASD.
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Affiliation(s)
- Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics-Section Developmental Neurology, 9713 GZ Groningen, The Netherlands
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17
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Yoneda S. Method to evaluate intravenous maintenance tocolysis for preterm labor. J Obstet Gynaecol Res 2020; 46:2518-2525. [PMID: 32929810 DOI: 10.1111/jog.14484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/28/2020] [Accepted: 08/30/2020] [Indexed: 11/27/2022]
Abstract
AIM Despite the lack of evidence-based medicine, continuous intravenous maintenance tocolysis is the main treatment for preterm labor (PTL) in Japan because it is considered to prolong the gestational period. This treatment needs to be evaluated in more detail, and we herein propose one method to assess maintenance tocolysis using the timing of delivery by PTL patients. METHODS PTL patients (n = 307) were divided into three groups according to delivery weeks of gestation. Group A (severe PTL) delivered at <34 weeks, group B (mild PTL) at 34-37 weeks and group C (cases suspected overtreatment) at ≥38 weeks. The percentages of patients in each group was calculated and clinical characteristics were compared between groups. RESULTS The percentages of patients (%) in groups A, B and C were 33.9, 43.6 and 22.5, respectively. Gestational weeks on admission, maternal white blood cell count and C-reactive protein, PTL index, fetal fibronectin levels in vaginal secretions, amniotic fluid interleukin-8 levels, staying at neonatal intensive care unit were significantly different between these three groups by analysis of variance. Furthermore, amniotic fluid interleukin-8 levels were significantly higher in group B (3.5 [0.1-46.5] ng/mL) than in group C (1.7 [0.1-16.1], P < 0.05). CONCLUSIONS PTL patients were classified according to the prognosis. The ratio of patients in each group represented the severity of PTL and the risk of overtreatment. When this ratio is investigated on a nationwide scale, the use of intravenous maintenance tocolysis or definition of PTL may need to be reconsidered.
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Affiliation(s)
- Satoshi Yoneda
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
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18
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HIFα Regulates Developmental Myelination Independent of Autocrine Wnt Signaling. J Neurosci 2020; 41:251-268. [PMID: 33208471 DOI: 10.1523/jneurosci.0731-20.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 10/15/2020] [Accepted: 11/11/2020] [Indexed: 01/17/2023] Open
Abstract
The developing CNS is exposed to physiological hypoxia, under which hypoxia-inducible factor α (HIFα) is stabilized and plays a crucial role in regulating neural development. The cellular and molecular mechanisms of HIFα in developmental myelination remain incompletely understood. A previous concept proposes that HIFα regulates CNS developmental myelination by activating the autocrine Wnt/β-catenin signaling in oligodendrocyte progenitor cells (OPCs). Here, by analyzing a battery of genetic mice of both sexes, we presented in vivo evidence supporting an alternative understanding of oligodendroglial HIFα-regulated developmental myelination. At the cellular level, we found that HIFα was required for developmental myelination by transiently controlling upstream OPC differentiation but not downstream oligodendrocyte maturation and that HIFα dysregulation in OPCs but not oligodendrocytes disturbed normal developmental myelination. We demonstrated that HIFα played a minor, if any, role in regulating canonical Wnt signaling in the oligodendroglial lineage or in the CNS. At the molecular level, blocking autocrine Wnt signaling did not affect HIFα-regulated OPC differentiation and myelination. We further identified HIFα-Sox9 regulatory axis as an underlying molecular mechanism in HIFα-regulated OPC differentiation. Our findings support a concept shift in our mechanistic understanding of HIFα-regulated CNS myelination from the previous Wnt-dependent view to a Wnt-independent one and unveil a previously unappreciated HIFα-Sox9 pathway in regulating OPC differentiation.SIGNIFICANCE STATEMENT Promoting disturbed developmental myelination is a promising option in treating diffuse white matter injury, previously called periventricular leukomalacia, a major form of brain injury affecting premature infants. In the developing CNS, hypoxia-inducible factor α (HIFα) is a key regulator that adapts neural cells to physiological and pathologic hypoxic cues. The role and mechanism of HIFα in oligodendroglial myelination, which is severely disturbed in preterm infants affected with diffuse white matter injury, is incompletely understood. Our findings presented here represent a concept shift in our mechanistic understanding of HIFα-regulated developmental myelination and suggest the potential of intervening with an oligodendroglial HIFα-mediated signaling pathway to mitigate disturbed myelination in premature white matter injury.
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19
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Peterson BS, Rosen T, Dingman S, Toth ZR, Sawardekar S, Hao X, Liu F, Xu D, Dong Z, Peterson JB, Ryoo JH, Serino D, Branch CA, Bansal R. Associations of Maternal Prenatal Drug Abuse With Measures of Newborn Brain Structure, Tissue Organization, and Metabolite Concentrations. JAMA Pediatr 2020; 174:831-842. [PMID: 32539126 PMCID: PMC7296459 DOI: 10.1001/jamapediatrics.2020.1622] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
IMPORTANCE Increasing rates of illicit drug use during pregnancy may be associated with risk for long-term health problems in prenatally exposed children. OBJECTIVE To identify the associations of prenatal exposure to illicit drugs with organization of the newborn brain. DESIGN, SETTING, AND PARTICIPANTS For this cohort study, a volunteer sample of 210 illicit drug-using and nonusing mothers and their newborns was enrolled from prenatal clinics and drug abuse treatment programs in New York, New York. Enrollment, scanning, and long-term follow-up occurred from September 2004 through February 2012, and image processing and statistical analyses continued through fall 2018. In addition to 26 participants with incomplete data, a total of 64 mothers were lost to follow-up during pregnancy, and 13 newborns were lost to follow-up at birth because of perinatal complications. EXPOSURES Newborns were assigned to 1 of 4 primary exposure groups based on the history of most frequent maternal drug use: marijuana, cocaine, methadone maintenance, and/or heroin. Unexposed newborns were controls. MAIN OUTCOMES AND MEASURES Unsedated magnetic resonance imaging (MRI) of newborn brains was performed shortly after birth. Infant neurodevelopmental outcomes were assessed at age 12 months. MRI modalities included anatomical imaging, diffusion tensor imaging, T2 relaxometry, and magnetic resonance spectroscopic imaging. Infant neurodevelopmental outcomes included Bayley scales of infant development-III and Vineland Adaptive Behavior Scales. Statistical analyses were performed with results represented on the brain images. RESULTS Of 118 mothers, 42 (35%) were in the control group (mean [SD] age, 25.9 [6.1] years), 29 (25%) were in the cocaine group (mean [SD] age, 29.0 [6.1] years), 29 (25%) were in the marijuana group (mean [SD] age, 24.3 [5.5] years), and 18 (15%) were in the methadone and/or heroin group (mean [SD] age, 30.9 [5.7] years). Not all newborns could be scanned successfully; therefore, usable MRIs were acquired for 118 newborns from predominantly minority groups and with economically disadvantaged mothers. Anatomic abnormalities were detected in similar locations across all 3 drug exposures and included smaller volumes in the dorsal, medial, and ventral surfaces of the frontal lobe and dose-related increases in volumes in the lateral temporal lobe, dorsal parietal lobe, and superior frontal gyrus. Dose-related increases in diffusion tensor measures of tissue organization, decreases in T2 relaxometry times, and increases in spectroscopy metabolite concentrations were similar across exposures. These associations of exposures with brain measures were similar to the associations of newborn age with brain measures. The anatomic and diffusion tensor imaging measures suppressively mediated the associations of prenatal exposure with poorer 12-month infant outcomes. CONCLUSIONS AND RELEVANCE The findings suggest that prenatal drug exposure is associated with measures of newborn brain tissue in patterns that may indicate that exposures accelerated normal fetal brain maturation, which in turn mediated the associations with poorer 12-month infant outcomes.
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Affiliation(s)
- Bradley S. Peterson
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California,Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles
| | - Tove Rosen
- Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Sherry Dingman
- Department of Psychology, Marist College, Poughkeepsie, New York
| | - Zachary R. Toth
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Siddhant Sawardekar
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Xuejun Hao
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Feng Liu
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Dongrong Xu
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Zhengchao Dong
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Jarod B. Peterson
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Ji Hoon Ryoo
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Dana Serino
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Craig A. Branch
- Department of Radiology and Physiology, Albert Einstein School of Medicine, Bronx, New York,Department of Biophysics, Albert Einstein School of Medicine, Bronx, New York
| | - Ravi Bansal
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California,Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles
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20
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Zhou KQ, Draghi V, Lear CA, Dean JM, Ashton JL, Hou Y, Bennet L, Gunn AJ, Davidson JO. Protection of axonal integrity with 48 or 72 h of cerebral hypothermia in near-term fetal sheep. Pediatr Res 2020; 88:48-56. [PMID: 31234193 DOI: 10.1038/s41390-019-0475-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Therapeutic hypothermia is partially protective for neonatal hypoxic-ischemic encephalopathy (HIE). Damage to the white matter tracts is highly associated with adverse outcomes after HIE, but the effectiveness and optimal duration of hypothermia to attenuate axonal injury are unclear. METHODS Near-term fetal sheep were randomized to sham control or cerebral ischemia for 30 min with normothermia or cerebral hypothermia from 3 to either 48 or 72 h. Sheep were killed after 7 days. SMI-312-labeled axons and myelin basic protein were quantified in the intragyral white matter of the first and second parasagittal gyri. RESULTS Ischemia was associated with reduced axonal and myelin area fraction (p < 0.05); loss of axonal and myelin linearity (p < 0.05); and thin, sparse axons, with spheroids, compared to dense, linear morphology in sham controls and associated with induction of microglia in an amoeboid morphology. Both ischemia-48 h hypothermia and ischemia-72 h hypothermia improved axonal area fraction and linearity (p < 0.05), although abnormal morphological features were seen in a subset. Microglial induction was partially suppressed by ischemia-48 h hypothermia, with a ramified morphology. CONCLUSIONS These data suggest that therapeutic hypothermia can alleviate post-ischemic axonopathy, in part by suppressing secondary inflammation.
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Affiliation(s)
- Kelly Q Zhou
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Vittoria Draghi
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher A Lear
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Justin M Dean
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Jesse L Ashton
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Yufeng Hou
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Laura Bennet
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Alistair J Gunn
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand.
| | - Joanne O Davidson
- Department of Physiology, School of Medical Sciences, University of Auckland, Auckland, New Zealand
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21
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Whitehead K, Papadelis C, Laudiano-Dray MP, Meek J, Fabrizi L. The Emergence of Hierarchical Somatosensory Processing in Late Prematurity. Cereb Cortex 2020; 29:2245-2260. [PMID: 30843584 PMCID: PMC6458926 DOI: 10.1093/cercor/bhz030] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/30/2019] [Accepted: 02/11/2019] [Indexed: 12/21/2022] Open
Abstract
The somatosensory system has a hierarchical organization. Information processing increases in complexity from the contralateral primary sensory cortex to bilateral association cortices and this is represented by a sequence of somatosensory-evoked potentials recorded with scalp electroencephalographies. The mammalian somatosensory system matures over the early postnatal period in a rostro-caudal progression, but little is known about the development of hierarchical information processing in the human infant brain. To investigate the normal human development of the somatosensory hierarchy, we recorded potentials evoked by mechanical stimulation of hands and feet in 34 infants between 34 and 42 weeks corrected gestational age, with median postnatal age of 3 days. We show that the shortest latency potential was evoked for both hands and feet at all ages with a contralateral somatotopic source in the primary somatosensory cortex (SI). However, the longer latency responses, localized in SI and beyond, matured with age. They gradually emerged for the foot and, although always present for the hand, showed a shift from purely contralateral to bilateral hemispheric activation. These results demonstrate the rostro-caudal development of human somatosensory hierarchy and suggest that the development of its higher tiers is complete only just before the time of normal birth.
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Affiliation(s)
- K Whitehead
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - C Papadelis
- Laboratory of Children's Brain Dynamics, Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - M P Laudiano-Dray
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - J Meek
- Neonatal Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London, UK
| | - L Fabrizi
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
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22
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Pinar C, Trivino-Paredes J, Perreault ST, Christie BR. Hippocampal cognitive impairment in juvenile rats after repeated mild traumatic brain injury. Behav Brain Res 2020; 387:112585. [DOI: 10.1016/j.bbr.2020.112585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 11/25/2022]
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23
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Son JH, Stevenson TJ, Bowles MD, Scholl EA, Bonkowsky JL. Dopaminergic Co-Regulation of Locomotor Development and Motor Neuron Synaptogenesis is Uncoupled by Hypoxia in Zebrafish. eNeuro 2020; 7:ENEURO.0355-19.2020. [PMID: 32001551 PMCID: PMC7046933 DOI: 10.1523/eneuro.0355-19.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/10/2020] [Accepted: 01/17/2020] [Indexed: 11/21/2022] Open
Abstract
Hypoxic injury to the developing human brain is a complication of premature birth and is associated with long-term impairments of motor function. Disruptions of axon and synaptic connectivity have been linked to developmental hypoxia, but the fundamental mechanisms impacting motor function from altered connectivity are poorly understood. We investigated the effects of hypoxia on locomotor development in zebrafish. We found that developmental hypoxia resulted in decreased spontaneous swimming behavior in larva, and that this motor impairment persisted into adulthood. In evaluation of the diencephalic dopaminergic neurons, which regulate early development of locomotion and constitute an evolutionarily conserved component of the vertebrate dopaminergic system, hypoxia caused a decrease in the number of synapses from the descending dopaminergic diencephalospinal tract (DDT) to spinal cord motor neurons. Moreover, dopamine signaling from the DDT was coupled jointly to motor neuron synaptogenesis and to locomotor development. Together, these results demonstrate the developmental processes regulating early locomotor development and a requirement for dopaminergic projections and motor neuron synaptogenesis. Our findings suggest new insights for understanding the mechanisms leading to motor disability from hypoxic injury of prematurity.
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Affiliation(s)
- Jong-Hyun Son
- Department of Biology, University of Scranton, Scranton, PA 18510
| | - Tamara J Stevenson
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84132
| | - Miranda D Bowles
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84132
| | - Erika A Scholl
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84132
| | - Joshua L Bonkowsky
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84132
- Brain and Spine Center, Primary Children's Hospital, Salt Lake City, UT 84108
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24
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Agut T, Alarcon A, Cabañas F, Bartocci M, Martinez-Biarge M, Horsch S. Preterm white matter injury: ultrasound diagnosis and classification. Pediatr Res 2020; 87:37-49. [PMID: 32218534 PMCID: PMC7098888 DOI: 10.1038/s41390-020-0781-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
White matter injury (WMI) is the most frequent form of preterm brain injury. Cranial ultrasound (CUS) remains the preferred modality for initial and sequential neuroimaging in preterm infants, and is reliable for the diagnosis of cystic periventricular leukomalacia. Although magnetic resonance imaging is superior to CUS in detecting the diffuse and more subtle forms of WMI that prevail in very premature infants surviving nowadays, recent improvement in the quality of neonatal CUS imaging has broadened the spectrum of preterm white matter abnormalities that can be detected with this technique. We propose a structured CUS assessment of WMI of prematurity that seeks to account for both cystic and non-cystic changes, as well as signs of white matter loss and impaired brain growth and maturation, at or near term equivalent age. This novel assessment system aims to improve disease description in both routine clinical practice and clinical research. Whether this systematic assessment will improve prediction of outcome in preterm infants with WMI still needs to be evaluated in prospective studies.
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Affiliation(s)
- Thais Agut
- Department of Neonatology, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
| | - Ana Alarcon
- 0000 0001 0663 8628grid.411160.3Department of Neonatology, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Fernando Cabañas
- 0000 0000 8970 9163grid.81821.32Department of Neonatology, Quironsalud Madrid University Hospital and Biomedical Research Foundation, La Paz University Hospital Madrid, Madrid, Spain
| | - Marco Bartocci
- Department of Women’s and Children’s Health, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Miriam Martinez-Biarge
- 0000 0001 2113 8111grid.7445.2Department of Paediatrics, Imperial College London, London, UK
| | - Sandra Horsch
- 0000 0000 8778 9382grid.491869.bDepartment of Neonatology, Helios Klinikum Berlin Buch, Berlin, Germany ,0000 0004 1937 0626grid.4714.6Department Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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25
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Marinelli B, Pluchinotta F, Cozzolino V, Barlafante G, Strozzi MC, Marinelli E, Franchini S, Gazzolo D. Osteopathic Manipulation Treatment Improves Cerebro-splanchnic Oximetry in Late Preterm Infants. Molecules 2019; 24:molecules24183221. [PMID: 31487945 PMCID: PMC6767098 DOI: 10.3390/molecules24183221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/22/2019] [Accepted: 08/27/2019] [Indexed: 12/18/2022] Open
Abstract
Background: To evaluate the effectiveness/side-effects of osteopathic manipulation treatment (OMT) performed on the 7th post-natal day, on cerebro-splanchnic oximetry, tissue activation and hemodynamic redistribution in late preterm (LP) infants by using near infrared spectroscopy (NIRS). Methods: Observational pretest-test study consisting in a cohort of 18 LPs who received OMT on the 7th post-natal day. NIRS monitoring was performed at three different time-points: 30 min before (T0), (30 min during (T1) and 30 min after OMT (T2). We evaluated the effects of OMT on the following NIRS parameters: cerebral (c), splanchnic (s) regional oximetry (rSO2), cerebro-splanchnic fractional tissue oxygen extraction (FTOE) and hemodynamic redistribution (CSOR). Results: crSO2 and cFTOE significantly (P < 0.001) improved at T0-T2; srSO2 significantly (P < 0.001) decreased and sFTOE increased at T0-T1. Furthermore, srSO2 and sFTOE significantly improved at T1-T2. Finally, CSOR significantly (P < 0.05) increased at T0-T2. Conclusions: The present data show that OMT enhances cerebro-splanchnic oximetry, tissue activation and hemodynamic redistribution in the absence of any adverse clinical or laboratory pattern. The results indicate the usefulness of further randomized studies in wider populations comparing the effectiveness of OMT with standard rehabilitation programs.
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Affiliation(s)
- Benedetta Marinelli
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Francesca Pluchinotta
- Laboratory Research, Department of Paediatric Cardiovascular Surgery, San Donato Milanese University Hospital, 20097 San Donato, Italy
| | - Vincenzo Cozzolino
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Gina Barlafante
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Maria Chiara Strozzi
- Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, 15121 Alessandria, Italy
| | - Eleonora Marinelli
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Simone Franchini
- Neonatal Intensive Care Unit G. D'Annunzio University of Chieti, 66100 Chieti, Italy
| | - Diego Gazzolo
- Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, 15121 Alessandria, Italy.
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26
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Passera S, Contarino V, Scarfone G, Scola E, Fontana C, Peccatori F, Cinnante C, Counsell S, Ossola M, Pisoni S, Pesenti N, Grossi E, Amant F, Mosca F, Triulzi F, Fumagalli M. Effects of in-utero exposure to chemotherapy on fetal brain growth. Int J Gynecol Cancer 2019; 29:1195-1202. [PMID: 31395614 DOI: 10.1136/ijgc-2019-000416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Children exposed to chemotherapy in the prenatal period demonstrate normal neurocognitive development at 3 years but concerns regarding fetal brain growth remain high considering its vulnerability to external stimuli. Our aim was to evaluate the impact of in-utero chemotherapy exposure on brain growth and its effects on neurodevelopmental outcome. METHODS The protocol was approved by the local ethics committee. Brain regional volumes at term postmenstrual age were measured by MRI in children exposed to in-utero chemotherapy and compared with normal MRI controls. Brain segmentation was performed by Advanced Normalization Tools (ANTs)-based transformations of the Neonatal Brain Atlas (ALBERT). Neurodevelopmental assessment (Bayley-III scales) was performed at 18 months corrected age in both exposed infants and in a group of healthy controls. Multiple linear regressions and false discovery rate correction for multiple comparisons were performed. RESULTS Twenty-one newborns prenatally exposed to chemotherapy (epirubicin administered in 81% of mothers) were enrolled in the study: the mean gestational age was 36.4±2.4 weeks and the mean birthweight was 2,753±622 g. Brain MRI was performed at mean postmenstrual age of 41.1±1.4 weeks. No statistically significant differences were identified between the children exposed to chemotherapy and controls in both the total (398±55 cm3 vs 427±56 cm3, respectively) and regional brain volumes. Exposed children showed normal Bayley-III scores (cognitive 110.2±14.5, language 99.1±11.3, and motor 102.6±7.3), and no significant correlation was identified between the brain volumes and neurodevelopmental outcome. CONCLUSION Prenatal exposure to anthracycline/cyclophosphamide-based chemotherapy does not impact fetal brain growth, thus supporting the idea that oncological treatment in pregnant women seems to be feasible and safe for the fetus.
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Affiliation(s)
| | - Valeria Contarino
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Scarfone
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Obstetrics and Gynecology, University of Milan, Milan, Italy
| | - Elisa Scola
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Fedro Peccatori
- Fertility and Procreation Unit, Gynecologic Oncology Programme, European Institute of Oncology, Milan, Italy
| | - Claudia Cinnante
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Serena Counsell
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, Kings College, London, UK
| | - Maneula Ossola
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Pisoni
- Neonatology Unit, Mother and Child Department, Del Ponte Hospital, Azienda Socio Sanitaria Territoriale (ASST) Sette Laghi, Varese, Italy
| | - Nicola Pesenti
- Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Elena Grossi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Obstetrics and Gynecology, University of Milan, Milan, Italy
| | - Frédéric Amant
- Centre for Gynaecologic Oncology Amsterdam, Antoni van Leeuwenhoek-Netherlands Cancer Institute, and Amsterdam University Medical Centres, Amsterdam, The Netherlands.,Department of Oncology, Katholieke Universiteit Leuven, Loeven, Belgium
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fabio Triulzi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Monica Fumagalli
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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27
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Lee S, Eyer J, Letournel F, Boumil E, Hall G, Shea TB. Neurofilaments form flexible bundles during neuritogenesis in culture and in mature axons in situ. J Neurosci Res 2019; 97:1306-1318. [PMID: 31304612 DOI: 10.1002/jnr.24482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/07/2022]
Abstract
Neurofilaments (NFs) undergo cation-dependent phospho-mediated associations with each other and other cytoskeletal elements that support axonal outgrowth. Progressive NF-NF associations generate a resident, bundled population that undergoes exchange with transporting NFs. We examined the properties of bundled NFs. Bundles did not always display a fully linear profile but curved and twisted at various points along the neurite length. Bundles retracted faster than neurites and retracted bundles did not expand following extraction with Triton, indicating that they coiled passively rather than due to pressure from the cell. Bundles consisted of helically wound NFs, which may provide flexibility necessary for turning of growing axons during pathfinding. Interactions between NFs and other cytoskeletal elements may be disrupted en masse during neurite retraction or regionally during remodeling. It is suggested that bundles within long axons that cannot be fully retracted into the soma could provide maintain proximal support yet still allow more distal flexibility for remodeling and changing direction during pathfinding.
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Affiliation(s)
- Sangmook Lee
- Laboratory for Neuroscience, Department of Biology Science, UMass Lowell, Lowell, Massachusetts
| | - Joel Eyer
- Institut de Biologie en Santé PBH-IRIS, Universitaire d'Angers, Angers, France
| | | | - Edward Boumil
- Center for Vision Research, SUNY Upstate, Syracuse, New York
| | - Garth Hall
- Laboratory for Neuroscience, Department of Biology Science, UMass Lowell, Lowell, Massachusetts
| | - Thomas B Shea
- Laboratory for Neuroscience, Department of Biology Science, UMass Lowell, Lowell, Massachusetts
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28
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Volpe JJ. Dysmaturation of Premature Brain: Importance, Cellular Mechanisms, and Potential Interventions. Pediatr Neurol 2019; 95:42-66. [PMID: 30975474 DOI: 10.1016/j.pediatrneurol.2019.02.016] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 02/07/2023]
Abstract
Prematurity, especially preterm birth (less than 32 weeks' gestation), is common and associated with high rates of both survival and neurodevelopmental disability, especially apparent in cognitive spheres. The neuropathological substrate of this disability is now recognized to be related to a variety of dysmaturational disturbances of the brain. These disturbances follow initial brain injury, particularly cerebral white matter injury, and involve many of the extraordinary array of developmental events active in cerebral white and gray matter structures during the premature period. This review delineates these developmental events and the dysmaturational disturbances that occur in premature infants. The cellular mechanisms involved in the genesis of the dysmaturation are emphasized, with particular focus on the preoligodendrocyte. A central role for the diffusely distributed activated microglia and reactive astrocytes in the dysmaturation is now apparent. As these dysmaturational cellular mechanisms appear to occur over a relatively long time window, interventions to prevent or ameliorate the dysmaturation, that is, neurorestorative interventions, seem possible. Such interventions include pharmacologic agents, especially erythropoietin, and particular attention has also been paid to such nutritional factors as quality and source of milk, breastfeeding, polyunsaturated fatty acids, iron, and zinc. Recent studies also suggest a potent role for interventions directed at various experiential factors in the neonatal period and infancy, i.e., provision of optimal auditory and visual exposures, minimization of pain and stress, and a variety of other means of environmental behavioral enrichment, in enhancing brain development.
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Affiliation(s)
- Joseph J Volpe
- Department of Neurology, Harvard Medical School, Boston, Massachusetts; Department of Pediatric Newborn Medicine, Harvard Medical School, Boston, Massachusetts.
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29
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Grometto A, Pluchinotta F, Gazzolo F, Strozzi MC, Gazzolo D. NIRS cerebral patterns in healthy late preterm and term infants are gender- and gestational age-dependent. Acta Paediatr 2019; 108:1036-1041. [PMID: 30461055 DOI: 10.1111/apa.14655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/06/2018] [Accepted: 11/16/2018] [Indexed: 11/30/2022]
Abstract
AIM Near-infrared spectroscopy (NIRS) has been proposed to provide reliable information concerning brain oximetry and tissue activation level in the perinatal period. We aimed to investigate whether NIRS brain patterns in healthy preterm (PT) and term (T) infants were gender- and gestational age (GA)-dependent. METHODS We conducted an observational study in 74 newborns, from consecutive singleton pregnancies, of whom 37 were born at term (male: n = 19 female: n = 18) and 37 (male: n = 18 female: n = 19) were PT. Cerebral oximetry (crSO2 ) and fractional tissue oxygen extraction (cFTOE), were recorded on the 5th day from birth. RESULTS crSO2 was significantly higher and cFTOE lower (p < 0.001, for both) in the PT female than male group. At term, crSO2 was significantly higher and cFTOE lower (p < 0.001, for both) in males. crSO2 (male: R = 0.84, p < 0.001; female: R = 0.74, p < 0.001) and cFTOE (male: R = 0.72, p < 0.001; female: R = 0.72, p < 0.001) in male and female groups correlated positively with GA at recording. CONCLUSION Different brain oximetry between males and females in PT a T infants, may suggest that in the perinatal period brain development is gender- and time-dependent. Data support the use of NIRS as a feasible tool for non-invasive cerebral monitoring.
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Affiliation(s)
- Alice Grometto
- Faculty of Biology University of Pavia Pavia Italy
- Department of Maternal Fetal and Neonatal Medicine C. Arrigo Children's Hospital Alessandria Italy
| | - Francesca Pluchinotta
- Laboratory Research Department of Paediatric Cardiovascular Surgery San Donato Milanese University Hospital San Donato Italy
| | | | - Maria Chiara Strozzi
- Department of Maternal Fetal and Neonatal Medicine C. Arrigo Children's Hospital Alessandria Italy
| | - Diego Gazzolo
- Department of Maternal Fetal and Neonatal Medicine C. Arrigo Children's Hospital Alessandria Italy
- Neonatal Intensive Care Unit G. D'Annunzio University of Chieti Chieti Italy
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30
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Yin W, Chen MH, Hung SC, Baluyot KR, Li T, Lin W. Brain functional development separates into three distinct time periods in the first two years of life. Neuroimage 2019; 189:715-726. [PMID: 30641240 DOI: 10.1016/j.neuroimage.2019.01.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/25/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022] Open
Abstract
Recently, resting functional MRI has provided invaluable insight into the brain developmental processes of early infancy and childhood. A common feature of previous functional development studies is the use of age to separate subjects into different cohorts for group comparisons. However, functional maturation paces vary tremendously from subject to subject. Since this is particularly true for the first years of life, an alternative to physical age alone is needed for cluster analysis. Here, a data-driven approach based on individual brain functional connectivity was employed to cluster typically developing children who were longitudinally imaged using MRI without sedation for the first two years of life. Specifically, three time periods were determined based on the distinction of brain functional connectivity patterns, including 0-1 month (group 1), 2-7 months (group 2), and 8-24 (group 3) of age, respectively. From groups 1 to 2, connection density increased by almost two-fold, local efficacy (LE) is significantly improved, and there was no change in global efficiency (GE). From groups 2 to 3, connection density increased slightly, LE showed no change, and a significant increase in GE were observed. Furthermore, 27 core brain regions were identified which yielded clustering results that resemble those obtained using all brain regions. These core regions were largely associated with the motor, visual and language functional domains as well as regions associated with higher order cognitive functional domains. Both visual and language functional domains exhibited a persistent and significant increase within domain connection from groups 1 to 3, while no changes were observed for the motor domain. In contrast, while a reduction of inter-domain connection was the general developmental pattern, the motor domain exhibited an interesting "V" shape pattern in its relationship to visual and language associated areas, showing a decrease from groups 1 to 2, followed by an increase from groups 2 to 3. In summary, our results offer new insights into functional brain development and identify 27 core brain regions critically important for early brain development.
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Affiliation(s)
- Weiyan Yin
- Department of Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Che Hung
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristine R Baluyot
- Department of Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tengfei Li
- Department of Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Weili Lin
- Department of Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Collin G, Keshavan MS. Connectome development and a novel extension to the neurodevelopmental model of schizophrenia. DIALOGUES IN CLINICAL NEUROSCIENCE 2018. [PMID: 30250387 PMCID: PMC6136123 DOI: 10.31887/dcns.2018.20.2/gcollin] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The brain is the ultimate adaptive system, a complex network organized across multiple levels of spatial and temporal resolution that is sculpted over several decades via its interactions with the environment. This review sets out to examine how fundamental biological processes in early and late neurodevelopment, in interaction with environmental inputs, guide the formation of the brain's network and its ongoing reorganization throughout the course of development. Moreover, we explore how disruptions in these processes could lead to abnormal brain network architecture and organization and thereby give rise to schizophrenia. Arguing that the neurodevelopmental trajectory leading up to the manifestation of psychosis may best be understood from the sequential trajectory of connectome formation and maturation, we propose a novel extension to the neurodevelopmental model of the illness that posits that schizophrenia is a disorder of connectome development.
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Affiliation(s)
- Guusje Collin
- Harvard Medical School at Beth Israel Deaconess Medical Center, Department of Psychiatry, Boston, Massachusetts, USA; Massachusetts Institute of Technology, Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Cambridge, Massachusetts, USA
| | - Matcheri S Keshavan
- Massachusetts Institute of Technology, Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Cambridge, Massachusetts, USA
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Whitehead K, Meek J, Fabrizi L. Developmental trajectory of movement-related cortical oscillations during active sleep in a cross-sectional cohort of pre-term and full-term human infants. Sci Rep 2018; 8:17516. [PMID: 30504857 PMCID: PMC6269518 DOI: 10.1038/s41598-018-35850-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/09/2018] [Indexed: 12/13/2022] Open
Abstract
In neonatal animal models, isolated limb movements during active sleep provide input to immature somatomotor cortex necessary for its development and are somatotopically encoded by alpha-beta oscillations as late as the equivalent of human full-term. Limb movements elicit similar neural patterns in very pre-term human infants (average 30 corrected gestational weeks), suggesting an analogous role in humans, but it is unknown until when they subserve this function. In a cohort of 19 neonates (31-42 corrected gestational weeks) we showed that isolated hand movements during active sleep continue to induce these same somatotopically distributed oscillations well into the perinatal period, but that these oscillations decline towards full-term and fully disappear at 41 corrected gestational weeks (equivalent to the end of gestation). We also showed that these highly localised alpha-beta oscillations are associated with an increase in delta oscillations which extends to the frontal area and does not decline with age. These results suggest that isolated limb movements during active sleep could have an important role in experience-dependent somatomotor development up until normal birth in humans.
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Affiliation(s)
- Kimberley Whitehead
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, WC1E 6BT, United Kingdom.
| | - Judith Meek
- Elizabeth Garrett Anderson Obstetric Wing, University College London Hospitals, London, WC1E 6BD, United Kingdom
| | - Lorenzo Fabrizi
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, WC1E 6BT, United Kingdom
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Gertsvolf N, Votava-Smith JK, Ceschin R, Del Castillo S, Lee V, Lai HA, Bluml S, Paquette L, Panigrahy A. Association between Subcortical Morphology and Cerebral White Matter Energy Metabolism in Neonates with Congenital Heart Disease. Sci Rep 2018; 8:14057. [PMID: 30232359 PMCID: PMC6145929 DOI: 10.1038/s41598-018-32288-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/05/2018] [Indexed: 12/11/2022] Open
Abstract
Complex congenital heart disease (CHD) is associated with neurodevelopmental impairment, the mechanism of which is unknown. Cerebral cortical dysmaturation in CHD is linked to white matter abnormalities, including developmental vulnerability of the subplate, in relation to oxygen delivery and metabolism deficits. In this study, we report associations between subcortical morphology and white matter metabolism in neonates with CHD using quantitative magnetic resonance imaging (MRI) and spectroscopy (MRS). Multi-modal brain imaging was performed in three groups of neonates close to term-equivalent age: (1) term CHD (n = 56); (2) preterm CHD (n = 37) and (3) preterm control group (n = 22). Thalamic volume and cerebellar transverse diameter were obtained in relation to cerebral metrics and white matter metabolism. Short echo single-voxel MRS of parietal and frontal white matter was used to quantitate metabolites related to brain maturation (n-acetyl aspartate [NAA], choline, myo-inositol), neurotransmitter (glutamate), and energy metabolism (glutamine, citrate, creatine and lactate). Multi-variate regression was performed to delineate associations between subcortical morphological measurements and white matter metabolism controlling for age and white matter injury. Reduced thalamic volume, most pronounced in the preterm control group, was associated with increased citrate levels in all three group in the parietal white matter. In contrast, reduced cerebellar volume, most pronounced in the preterm CHD group, was associated with reduced glutamine in parietal grey matter in both CHD groups. Single ventricle anatomy, aortic arch obstruction, and cyanotic lesion were predictive of the relationship between reduced subcortical morphometry and reduced GLX (particularly glutamine) in both CHD cohorts (frontal white matter and parietal grey matter). Subcortical morphological associations with brain metabolism were also distinct within each of the three groups, suggesting these relationships in the CHD groups were not directly related to prematurity or white matter injury alone. Taken together, these findings suggest that subplate vulnerability in CHD is likely relevant to understanding the mechanism of both cortical and subcortical dysmaturation in CHD infants. Future work is needed to link this potential pattern of encephalopathy of CHD (including the constellation of grey matter, white matter and brain metabolism deficits) to not only abnormal fetal substrate delivery and oxygen conformance, but also regional deficits in cerebral energy metabolism.
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Affiliation(s)
- Nina Gertsvolf
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jodie K Votava-Smith
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Pediatrics, Division of Cardiology, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Rafael Ceschin
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC and University of Pittsburgh School of Medicine, Pittsburgh, USA
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Sylvia Del Castillo
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Anesthesiology, Critical Care Medicine Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Vince Lee
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC and University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Hollie A Lai
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Radiology, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Stefan Bluml
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Radiology, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Lisa Paquette
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Pediatrics, Division of Neonatology, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Ashok Panigrahy
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC and University of Pittsburgh School of Medicine, Pittsburgh, USA.
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, USA.
- Department of Radiology, Children's Hospital of Los Angeles, Los Angeles, CA, USA.
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Zhang Z, Rasmussen L, Saraswati M, Koehler RC, Robertson C, Kannan S. Traumatic Injury Leads to Inflammation and Altered Tryptophan Metabolism in the Juvenile Rabbit Brain. J Neurotrauma 2018; 36:74-86. [PMID: 30019623 DOI: 10.1089/neu.2017.5450] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Neuroinflammation after traumatic brain injury (TBI) contributes to widespread cell death and tissue loss. Here, we evaluated sequential inflammatory response in the brain, as well as inflammation-induced changes in brain tryptophan metabolism over time, in a rabbit pediatric TBI model. On post-natal days 5-7 (P5-P7), New Zealand white rabbit littermates were randomized into three groups: naïve (no injury), sham (craniotomy alone), and TBI (controlled cortical impact). Animals were sacrificed at 6 h and 1, 3, 7, and 21 days post-injury for evaluating levels of pro- and anti-inflammatory cytokines, as well as the major components in the tryptophan-kynurenine pathway. We found that 1) pro- and anti-inflammatory cytokine levels in the brain injury area were differentially regulated in a time-dependent manner post-injury; 2) indoleamine 2,3 dioxygeenase 1 (IDO1) was upregulated around the injury area in TBI kits that persisted at 21 days post-injury; 3) mean length of serotonin-staining fibers was significantly reduced in the injured brain region in TBI kits for at least 21 days post-injury; and 4) kynurenine level significantly increased at 7 days post-injury. A significant decrease in serotonin/tryptophan ratio and melatonin/tryptophan ratio at 21 days post-injury was noted, suggesting that tryptophan metabolism is altered after TBI. A better understanding of the temporal evolution of immune responses and tryptophan metabolism during injury and repair after TBI is crucial for the development of novel therapeutic strategies targeting these pathways.
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Affiliation(s)
- Zhi Zhang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School f Medicine , Baltimore, Maryland
| | - Lindsey Rasmussen
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School f Medicine , Baltimore, Maryland
| | - Manda Saraswati
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School f Medicine , Baltimore, Maryland
| | - Raymond C Koehler
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School f Medicine , Baltimore, Maryland
| | - Courtney Robertson
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School f Medicine , Baltimore, Maryland
| | - Sujatha Kannan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School f Medicine , Baltimore, Maryland
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Hadders-Algra M. Early human brain development: Starring the subplate. Neurosci Biobehav Rev 2018; 92:276-290. [PMID: 29935204 DOI: 10.1016/j.neubiorev.2018.06.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/15/2018] [Accepted: 06/19/2018] [Indexed: 12/16/2022]
Abstract
This review summarizes early human brain development on the basis of neuroanatomical data and functional connectomics. It indicates that the most significant changes in the brain occur during the second half of gestation and the first three months post-term, in particular in the cortical subplate and cerebellum. As the transient subplate pairs a high rate of intricate developmental changes and interactions with clear functional activity, two phases of development are distinguished: a) the transient cortical subplate phase, ending at 3 months post-term when the permanent circuitries in the primary motor, somatosensory and visual cortices have replaced the subplate; and subsequently, b) the phase in which the permanent circuitries dominate. In the association areas the subplate dissolves in the remainder of the first postnatal year. During both phases developmental changes are paralleled by continuous reconfigurations in network activity. The reviewed literature also suggests that disruption of subplate development may play a pivotal role in developmental disorders, such as cerebral palsy, autism spectrum disorders, attention deficit hyperactivity disorder and schizophrenia.
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Affiliation(s)
- Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Dept. Pediatrics - Section Developmental Neurology, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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Sainio MT, Ylikallio E, Mäenpää L, Lahtela J, Mattila P, Auranen M, Palmio J, Tyynismaa H. Absence of NEFL in patient-specific neurons in early-onset Charcot-Marie-Tooth neuropathy. Neurol Genet 2018; 4:e244. [PMID: 29888333 PMCID: PMC5991776 DOI: 10.1212/nxg.0000000000000244] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/19/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We used patient-specific neuronal cultures to characterize the molecular genetic mechanism of recessive nonsense mutations in neurofilament light (NEFL) underlying early-onset Charcot-Marie-Tooth (CMT) disease. METHODS Motor neurons were differentiated from induced pluripotent stem cells of a patient with early-onset CMT carrying a novel homozygous nonsense mutation in NEFL. Quantitative PCR, protein analytics, immunocytochemistry, electron microscopy, and single-cell transcriptomics were used to investigate patient and control neurons. RESULTS We show that the recessive nonsense mutation causes a nearly total loss of NEFL messenger RNA (mRNA), leading to the complete absence of NEFL protein in patient's cultured neurons. Yet the cultured neurons were able to differentiate and form neuronal networks and neurofilaments. Single-neuron gene expression fingerprinting pinpointed NEFL as the most downregulated gene in the patient neurons and provided data of intermediate filament transcript abundancy and dynamics in cultured neurons. Blocking of nonsense-mediated decay partially rescued the loss of NEFL mRNA. CONCLUSIONS The strict neuronal specificity of neurofilament has hindered the mechanistic studies of recessive NEFL nonsense mutations. Here, we show that such mutation leads to the absence of NEFL, causing childhood-onset neuropathy through a loss-of-function mechanism. We propose that the neurofilament accumulation, a common feature of many neurodegenerative diseases, mimics the absence of NEFL seen in recessive CMT if aggregation prevents the proper localization of wild-type NEFL in neurons. Our results suggest that the removal of NEFL as a proposed treatment option is harmful in humans.
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Affiliation(s)
- Markus T Sainio
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
| | - Emil Ylikallio
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
| | - Laura Mäenpää
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
| | - Jenni Lahtela
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
| | - Pirkko Mattila
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
| | - Mari Auranen
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
| | - Johanna Palmio
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
| | - Henna Tyynismaa
- Research Programs Unit (M.T.S., E.Y., L.M., M.A., H.T.), Molecular Neurology, University of Helsinki; Clinical Neurosciences, Neurology (E.Y., M.A.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (FIMM) (J.L., P.M.), University of Helsinki; Neuromuscular Research Center (J.P.), Tampere University Hospital and University of Tampere; and Department of Medical and Clinical Genetics (H.T.), University of Helsinki, Finland
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Giordano E, Quadro L. Lutein, zeaxanthin and mammalian development: Metabolism, functions and implications for health. Arch Biochem Biophys 2018; 647:33-40. [PMID: 29654731 PMCID: PMC5949277 DOI: 10.1016/j.abb.2018.04.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/05/2018] [Accepted: 04/10/2018] [Indexed: 01/04/2023]
Abstract
It is now widely accepted that nutrition during critical periods in early development, both pre- and postnatal, may have lifetime consequences in determining health or onset of major diseases in the adult life. Dietary carotenoids have shown beneficial health effects throughout the life cycle due to their potential antioxidant properties, their ability to serves as precursors of vitamin A and to the emerging signaling functions of their metabolites. The non-provitamin A carotenoids lutein and zeaxanthin are emerging as important modulators of infant and child visual and cognitive development, as well as critical effectors in the prevention and treatment of morbidity associated with premature births. This review provides a general overview of lutein and zeaxanthin metabolism in mammalian tissues and highlights the major advancements and remaining gaps in knowledge in regards to their metabolism and health effects during pre- and early post-natal development. Furthering our knowledge in this area of research will impact dietary recommendation and supplementation strategies aimed at sustaining proper fetal and infant growth.
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Affiliation(s)
- Elena Giordano
- Department of Food Science; Rutgers Center for Lipid Research; New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ 08901, United States
| | - Loredana Quadro
- Department of Food Science; Rutgers Center for Lipid Research; New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ 08901, United States.
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Yoneda S, Yoneda N, Shiozaki A, Yoshino O, Ueno T, Niimi H, Kitajima I, Tamura K, Kawasaki Y, Makimoto M, Yoshida T, Saito S. 17OHP-C in patients with spontaneous preterm labor and intact membranes: is there an effect according to the presence of intra-amniotic inflammation? Am J Reprod Immunol 2018; 80:e12867. [PMID: 29709096 DOI: 10.1111/aji.12867] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 04/04/2018] [Indexed: 01/22/2023] Open
Abstract
PROBLEM It is not known whether 17-alpha-hydroxyprogesterone caproate (17OHP-C) is effective for preventing preterm delivery with an episode of preterm labor (PTL) with or without intra-amniotic inflammation/infection. METHODS OF STUDY This was a retrospective cohort study. One hundred and seven PTL patients were selected and divided into a 17OHP-C group (use of 17OHP-C: n = 53) and a no-treatment group (no use of 17OHP-C: n = 54). Moreover, the patients were divided into three subgroups (subgroup A: without intra-amniotic inflammation, B: with mild intra-amniotic inflammation, and C: with severe intra-amniotic inflammation) according to their level of amniotic interleukin (IL)-8, and perinatal prognosis was analyzed. RESULTS Interval from admission to delivery (days) in the 17OHP-C group (76 [13-126], n = 34) was significantly longer than that in the no-treatment group (50 [8-104], n = 33; P = .012) in subgroup B. In cases without intra-amniotic microbes in subgroup B, a significant prolongation of gestational days was associated with the 17OHP-C group (79 [13-126], n = 25) compared with the no-treatment group (50 [8-104], n = 29; P = .029). However, there were no significant differences in subgroups A or C. CONCLUSION 17OHP-C could prolong gestational period in limited PTL cases with sterile mild intra-amniotic inflammation.
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Affiliation(s)
- Satoshi Yoneda
- Department of Obstetrics and Gynecology, University of Toyama, Sugitani, Toyama, Japan
| | - Noriko Yoneda
- Department of Obstetrics and Gynecology, University of Toyama, Sugitani, Toyama, Japan
| | - Arihiro Shiozaki
- Department of Obstetrics and Gynecology, University of Toyama, Sugitani, Toyama, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Toyama, Sugitani, Toyama, Japan
| | - Tomohiro Ueno
- Clinical Laboratory Center, University of Toyama, Sugitani, Toyama, Japan
| | - Hideki Niimi
- Clinical Laboratory Center, University of Toyama, Sugitani, Toyama, Japan
| | - Isao Kitajima
- Clinical Laboratory Center, University of Toyama, Sugitani, Toyama, Japan
| | - Kentaro Tamura
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Sugitani, Toyama, Japan
| | - Yukako Kawasaki
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Sugitani, Toyama, Japan
| | - Masami Makimoto
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Sugitani, Toyama, Japan
| | - Taketoshi Yoshida
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Sugitani, Toyama, Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama, Sugitani, Toyama, Japan
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Natarajan G, Shankaran S, Saha S, Laptook A, Das A, Higgins R, Stoll BJ, Bell EF, Carlo WA, D'Angio C, DeMauro SB, Sanchez P, Van Meurs K, Vohr B, Newman N, Hale E, Walsh M. Antecedents and Outcomes of Abnormal Cranial Imaging in Moderately Preterm Infants. J Pediatr 2018; 195:66-72.e3. [PMID: 29395186 PMCID: PMC5869095 DOI: 10.1016/j.jpeds.2017.11.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/09/2017] [Accepted: 11/16/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To describe the frequency and findings of cranial imaging in moderately preterm infants (born at 290/7-336/7 weeks of gestation) across centers, and to examine the association between abnormal imaging and clinical characteristics. STUDY DESIGN We used data from the Neonatal Research Network Moderately Preterm Registry, including the most severe early (≤28 days) and late (>28 days) cranial imaging. Stepwise logistic regression and CART analysis were performed after adjustment for gestational age, antenatal steroid use, and center. RESULTS Among 7021 infants, 4184 (60%) underwent cranial imaging. These infants had lower gestational ages and birth weights and higher rates of small for gestational age, outborn birth, cesarean delivery, neonatal resuscitation, and treatment with surfactant, compared with those without imaging (P < .0001). Imaging abnormalities noted in 15% of the infants included any intracranial hemorrhage (13.2%), grades 3-4 intracranial hemorrhage (1.7%), cystic periventricular leukomalacia (2.6%), and ventriculomegaly (6.6%). Histologic chorioamnionitis (OR, 1.47; 95% CI, 1.19-1.83), gestational age (0.95; 95% CI, 0.94-0.97), antenatal steroids (OR, 0.55; 95% CI, 0.41-0.74), and cesarean delivery (OR, 0.66; 95% CI, 0.53-0.81) were associated with abnormal imaging. The center with the highest rate of cranial imaging, compared with the lowest, had a higher risk of abnormal imaging (OR, 2.08; 95% CI, 1.10-3.92). On the classification and regression-tree model, cesarean delivery, center, antenatal steroids, and chorioamnionitis, in that order, predicted abnormal imaging. CONCLUSION Among the 60% of moderately preterm infants with cranial imaging, 15% had intracranial hemorrhage, cystic periventricular leukomalacia or late ventriculomegaly. Further correlation of imaging and long-term neurodevelopmental outcomes in moderately preterm infants is needed.
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Affiliation(s)
| | | | - Shampa Saha
- RTI International, Research Triangle Park, NC
| | - Abbot Laptook
- Women and Infants Hospital of Rhode Island, Providence, RI
| | - Abhik Das
- RTI International, Research Triangle Park, NC
| | - Rosemary Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Barbara J Stoll
- Department of Pediatrics, UT Health McGovern Medical School, Houston, TX
| | - Edward F Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA
| | - Waldemar A Carlo
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Carl D'Angio
- University of Rochester Medical Center, Rochester, NY
| | - Sara B DeMauro
- Department of Pediatrics, University of Pennsylvania, PA
| | - Pablo Sanchez
- Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, OH
| | - Krisa Van Meurs
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA
| | - Betty Vohr
- Women and Infants Hospital of Rhode Island, Providence, RI
| | - Nancy Newman
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH
| | | | - Michele Walsh
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH
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Yoneda S, Yoneda N, Fukuta K, Shima T, Nakashima A, Shiozaki A, Yoshino O, Kigawa M, Yoshida T, Saito S. In which preterm labor-patients is intravenous maintenance tocolysis effective? J Obstet Gynaecol Res 2017; 44:397-407. [DOI: 10.1111/jog.13547] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 10/08/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Satoshi Yoneda
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - Noriko Yoneda
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - Kaori Fukuta
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - Tomoko Shima
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - Arihiro Shiozaki
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - Mika Kigawa
- Faculty of Health and Social Services; Kanagawa University of Human Services; Yokosuka Japan
| | - Taketoshi Yoshida
- Division of Neonatology Maternal and Perinatal Center; Toyama University Hospital; Toyama Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
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Picone S, Ritieni A, Fabiano A, Graziani G, Paolillo P, Livolti G, Galvano F, Gazzolo D. Lutein levels in arterial cord blood correlate with neuroprotein activin A in healthy preterm and term newborns: A trophic role for lutein? Clin Biochem 2017; 52:80-84. [PMID: 29195833 DOI: 10.1016/j.clinbiochem.2017.11.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/26/2017] [Accepted: 11/27/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lutein (LT) is a naturally occurring xanthophyll carotenoid most predominant in the central nervous system (CNS), but its neurotrophic role is still debated. We therefore investigated whether cord blood concentrations correlated with a well-established neurobiomarker, namely activin A. METHODS We conducted a prospective study on the distribution of LT and activin A in arterial cord blood of healthy preterm (n=50) and term (n=82) newborns according to weeks of gestational age (wGA) and gender. RESULTS LT and activin A showed a pattern of concentration characterized by higher levels (P<0.01, for all) at 33-36 wGA followed by a progressive decrease (P<0.01, for all) from 37 onwards with a dip at term. Both LT and activin A were gender-dependent with significantly (P<0.01, for all) higher levels in all recruited females and after sub-grouping for preterm and term births. LT (R=0.33; P<0.001) correlated with wGA at sampling. There were significant positive correlations between lutein and activin A in male (R=0.93; P<0.001) and female (R=0.89; P<0.001) groups. CONCLUSIONS The present data showing a correlation between LT and activin A support the notion of a neurotrophic role gender-dependent for LT and open the way to further investigations correlating LT with well-established biochemical markers of CNS development/damage.
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Affiliation(s)
| | | | - Adele Fabiano
- Neonatal Intensive Care Unit, Policlinico Casilino, Rome, Italy
| | | | | | | | | | - Diego Gazzolo
- Dept. of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, Alessandria, Italy; Neonatal Intensive Care Unit G. d'Annunzio University, Chieti, Italy.
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Grometto A, Pizzo B, Strozzi MC, Gazzolo F, Gazzolo D. Cerebral NIRS patterns in late preterm and very preterm infants becoming late preterm. J Matern Fetal Neonatal Med 2017; 32:1124-1129. [PMID: 29157051 DOI: 10.1080/14767058.2017.1401605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Near Infrared Spectroscopy (NIRS) has been proposed as a useful, noninvasive monitoring technique providing reliable information about central nervous system (CNS) oximetry and function. Recently, brain damage has been reconsidered as a dynamic process evolving over the weeks of gestation. We therefore investigated NIRS cerebral pattern differences between healthy late preterm infants (LPTo) and very preterm infants becoming late preterm (LPT). METHODS We conducted an observational study in 40 healthy late preterm infants, matched for gestational age at monitoring, of whom 20 where LPTo and 20 LPT. Clinical, diagnostic and laboratory monitoring procedures and cerebral oximetry (crSO2) and function (cFTOE) were recorded on admission into the study. RESULTS No significant differences (p > .05, for all) were found between groups regarding clinical, diagnostic or laboratory parameters. Higher crSO2 and lower cFTOE (p < .001, for both) were found in the LPTo group. CONCLUSIONS Our results, showing impaired oximetry and function of CNS in LPT, offer additional support to NIRS parameters as a useful tool for longitudinal CNS monitoring of very preterm infants becoming LPT. Future studies correlating NIRS variables and long-term neurological outcome in LPT are needed to elucidate the concept of dynamic brain damage pathogenesis.
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Affiliation(s)
- Alice Grometto
- a Faculty of Biology , University of Pavia , Pavia , Italy.,b Department of Maternal, Fetal and Neonatal Medicine , C. Arrigo Children's Hospital , Alessandria , Italy
| | - Benedetta Pizzo
- b Department of Maternal, Fetal and Neonatal Medicine , C. Arrigo Children's Hospital , Alessandria , Italy.,c Faculty of Biology , University of Oriental Piedmont , Alessandria , Italy
| | - Maria Chiara Strozzi
- b Department of Maternal, Fetal and Neonatal Medicine , C. Arrigo Children's Hospital , Alessandria , Italy
| | - Francesca Gazzolo
- c Faculty of Biology , University of Oriental Piedmont , Alessandria , Italy
| | - Diego Gazzolo
- b Department of Maternal, Fetal and Neonatal Medicine , C. Arrigo Children's Hospital , Alessandria , Italy.,d Neonatal Intensive Care Unit , "G d'Annunzio" University of Chieti , Chieti , Italy
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Serpero LD, Bianchi V, Pluchinotta F, Conforti E, Baryshnikova E, Guaschino R, Cassinari M, Trifoglio O, Calevo MG, Gazzolo D. S100B maternal blood levels are gestational age- and gender-dependent in healthy pregnancies. Clin Chem Lab Med 2017; 55:1770-1776. [PMID: 28282292 DOI: 10.1515/cclm-2016-1127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 01/23/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND S100B is a well-established biomarker of central nervous system (CNS) development and damage in the perinatal period. Because the fetal CNS induces an overproduction of S100B measurable in the maternal bloodstream we evaluated S100B protein in healthy pregnancies in order to provide a reference curve of the protein in the second and third trimesters and to provide information on CNS development when standard monitoring procedures could be silent or unavailable. METHODS Between July 2012 and December 2014 we conducted a prospective study in 1213 healthy pregnancies delivering healthy newborns. Maternal blood samples were collected for standard monitoring procedures and S100B assessment. S100B correlations with selected outcomes (gestational age at sampling, gender of fetus, gestational age and weight at birth, delivery mode) were calculated using multiple forward stepwise regression analysis. RESULTS S100B concentrations in the second and third trimesters of pregnancy were found to be gestational age-, gender- and delivery mode-dependent (p<0.05, for all). Multiple forward stepwise regression analysis with S100B as the dependent variable and gestational age at sampling, gender, delivery mode, gestational age and weight at birth as independent variables, showed a significant correlation between S100B and gestational age at sampling (R=0.13; p<0.001). CONCLUSIONS The present findings offering a S100B protein reference curve in maternal blood suggest that non-invasive fetal CNS monitoring is becoming feasible and open the way to further research in neuro-biomarker assessment in the maternal bloodstream.
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Qi W, Gao S, Liu C, Lan G, Yang X, Guo Q. Diffusion tensor MR imaging characteristics of cerebral white matter development in fetal pigs. BMC Med Imaging 2017; 17:50. [PMID: 28830463 PMCID: PMC5568215 DOI: 10.1186/s12880-017-0205-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 05/03/2017] [Indexed: 01/16/2023] Open
Abstract
Background The purpose of this study was to investigate the anisotropic features of fetal pig cerebral white matter (WM) development by magnetic resonance diffusion tensor imaging, and to evaluate the developmental status of cerebral WM in different anatomical sites at different times. Methods Fetal pigs were divided into three groups according to gestational age: E69 (n = 8), E85 (n = 11), and E114 (n = 6). All pigs were subjected to conventional magnetic resonance imaging (MRI) and diffusion tensor imaging using a GE Signa 3.0 T MRI system (GE Healthcare, Sunnyvale, CA, USA). Fractional anisotropy (FA) was measured in deep WM structures and peripheral WM regions. After the MRI scans,the animals were sacrificed and pathology sections were prepared for hematoxylin & eosin (HE) staining and luxol fast blue (LFB) staining. Data were statistically analyzed with SPSS version 16.0 (SPSS, Chicago, IL, USA). A P-value < 0.05 was considered statistically significant. Mean FA values for each subject region of interest (ROI), and deep and peripheral WM at different gestational ages were calculated, respectively, and were plotted against gestational age with linear correlation statistical analyses. The differences of data were analyzed with univariate ANOVA analyses. Results There were no significant differences in FAs between the right and left hemispheres. Differences were observed between peripheral WM and deep WM in fetal brains. A significant FA growth with increased gestational age was found when comparing E85 group and E114 group. There was no difference in the FA value of deep WM between the E69 group and E85 group. The HE staining and LFB staining of fetal cerebral WM showed that the development from the E69 group to the E85 group, and the E85 group to the E114 group corresponded with myelin gliosis and myelination, respectively. Conclusions FA values can be used to quantify anisotropy of the different cerebral WM areas. FA values did not change significantly between 1/2 way and 3/4 of the way through gestation but was then increased dramatically at term, which could be explained by myelin gliosis and myelination ,respectively.
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Affiliation(s)
- Wenxu Qi
- Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, 110004, People's Republic of China
| | - Song Gao
- Morphology Teaching and Reasearch Section, Liaoning Vocational College of Medcine, Shenyang, 110100, People's Republic of China
| | - Caixia Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang, 110004, People's Republic of China
| | - Gongyu Lan
- Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, 110004, People's Republic of China
| | - Xue Yang
- Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang, 110004, People's Republic of China
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, 110004, People's Republic of China.
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Djuric U, Rodrigues DC, Batruch I, Ellis J, Shannon P, Diamandis P. Spatiotemporal Proteomic Profiling of Human Cerebral Development. Mol Cell Proteomics 2017; 16:1548-1562. [PMID: 28687556 DOI: 10.1074/mcp.m116.066274] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 05/30/2017] [Indexed: 12/21/2022] Open
Abstract
Mass spectrometry (MS) analysis of human post-mortem central nervous system (CNS) tissue and induced pluripotent stem cell (iPSC)-based directed differentiations offer complementary avenues to define protein signatures of neurodevelopment. Methodological improvements of formalin-fixed, paraffin-embedded (FFPE) protein isolation now enable widespread proteomic analysis of well-annotated archival tissue samples in the context of development and disease. Here, we utilize a shotgun label-free quantification (LFQ) MS method to profile magnetically enriched human cortical neurons and neural progenitor cells (NPCs) derived from iPSCs. We use these signatures to help define spatiotemporal protein dynamics of developing human FFPE cerebral regions. We show that the use of high resolution Q Exactive mass spectrometers now allow simultaneous quantification of >2700 proteins in a single LFQ experiment and provide sufficient coverage to define novel biomarkers and signatures of NPC maintenance and differentiation. Importantly, we show that this abbreviated strategy allows efficient recovery of novel cytoplasmic, membrane-specific and synaptic proteins that are shared between both in vivo and in vitro neuronal differentiation. This study highlights the discovery potential of non-comprehensive high-throughput proteomic profiling of unfractionated clinically well-annotated FFPE human tissue from a diverse array of development and diseased states.
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Affiliation(s)
- Ugljesa Djuric
- From the ‡Laboratory Medicine and Pathology Program, University Health Network, Toronto, Ontario, M5G 2C4, Canada
| | - Deivid C Rodrigues
- §Department of Developmental and Stem Cell Biology, The Hospital for Sick Children, Toronto, Ontario, M5G 1L7, Canada
| | - Ihor Batruch
- ¶Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada
| | - James Ellis
- §Department of Developmental and Stem Cell Biology, The Hospital for Sick Children, Toronto, Ontario, M5G 1L7, Canada.,‖Department of Molecular Genetics, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
| | - Patrick Shannon
- ¶Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada.,**Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, M5S 1A1, Canada; and
| | - Phedias Diamandis
- From the ‡Laboratory Medicine and Pathology Program, University Health Network, Toronto, Ontario, M5G 2C4, Canada; .,**Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, M5S 1A1, Canada; and
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Kirkcaldie MTK, Dwyer ST. The third wave: Intermediate filaments in the maturing nervous system. Mol Cell Neurosci 2017; 84:68-76. [PMID: 28554564 DOI: 10.1016/j.mcn.2017.05.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/10/2017] [Accepted: 05/25/2017] [Indexed: 01/16/2023] Open
Abstract
Intermediate filaments are critical for the extreme structural specialisations of neurons, providing integrity in dynamic environments and efficient communication along axons a metre or more in length. As neurons mature, an initial expression of nestin and vimentin gives way to the neurofilament triplet proteins and α-internexin, substituted by peripherin in axons outside the CNS, which physically consolidate axons as they elongate and find their targets. Once connection is established, these proteins are transported, assembled, stabilised and modified, structurally transforming axons and dendrites as they acquire their full function. The interaction between these neurons and myelinating glial cells optimises the structure of axons for peak functional efficiency, a property retained across their lifespan. This finely calibrated structural regulation allows the nervous system to maintain timing precision and efficient control across large distances throughout somatic growth and, in maturity, as a plasticity mechanism allowing functional adaptation.
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Affiliation(s)
- Matthew T K Kirkcaldie
- School of Medicine, Wicking Dementia Research and Education Centre, Faculty of Health, University of Tasmania, Australia.
| | - Samuel T Dwyer
- School of Medicine, Wicking Dementia Research and Education Centre, Faculty of Health, University of Tasmania, Australia
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Kelly CE, Cheong JLY, Gabra Fam L, Leemans A, Seal ML, Doyle LW, Anderson PJ, Spittle AJ, Thompson DK. Moderate and late preterm infants exhibit widespread brain white matter microstructure alterations at term-equivalent age relative to term-born controls. Brain Imaging Behav 2016; 10:41-9. [PMID: 25739350 DOI: 10.1007/s11682-015-9361-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Despite the many studies documenting cerebral white matter microstructural alterations associated with very preterm birth (<32 weeks' gestation), there is a dearth of similar research in moderate and late preterm infants (born 32-36 weeks' gestation), who experience higher rates of neurodevelopmental delays than infants born at term (≥ 37 weeks' gestation). We therefore aimed to determine whether whole brain white matter microstructure differs between moderate and late preterm infants and term-born controls at term-equivalent age, as well as to identify potential perinatal risk factors for white matter microstructural alterations in moderate and late preterm infants. Whole brain white matter microstructure was studied in 193 moderate and late preterm infants and 83 controls at term-equivalent age by performing Tract-Based Spatial Statistics analysis of diffusion tensor imaging data. Moderate and late preterm infants had lower fractional anisotropy and higher mean, axial and radial diffusivities compared with controls in nearly 70% of the brain's major white matter fiber tracts. In the moderate and late preterm group, being born small for gestational age and male sex were associated with lower fractional anisotropy, largely within the optic radiation, corpus callosum and corona radiata. In conclusion, moderate and late preterm infants exhibit widespread brain white matter microstructural alterations compared with controls at term-equivalent age, in patterns consistent with delayed or disrupted white matter microstructural development. These findings may underpin some of the neurodevelopmental delays observed in moderate and late preterm children.
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Affiliation(s)
- Claire E Kelly
- Murdoch Childrens Research Institute, Melbourne, Australia.
- Victorian Infant Brain Study (VIBeS), Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia.
| | - Jeanie L Y Cheong
- Murdoch Childrens Research Institute, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Lillian Gabra Fam
- Murdoch Childrens Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marc L Seal
- Murdoch Childrens Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Alicia J Spittle
- Murdoch Childrens Research Institute, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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Milash B, Gao J, Stevenson TJ, Son JH, Dahl T, Bonkowsky JL. Temporal Dysynchrony in brain connectivity gene expression following hypoxia. BMC Genomics 2016; 17:334. [PMID: 27146468 PMCID: PMC4857255 DOI: 10.1186/s12864-016-2638-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/22/2016] [Indexed: 11/17/2022] Open
Abstract
Background Despite the fundamental biological importance and clinical relevance of characterizing the effects of chronic hypoxia exposure on central nervous system (CNS) development, the changes in gene expression from hypoxia are unknown. It is not known if there are unifying principles, properties, or logic in the response of the developing CNS to hypoxic exposure. Here, we use the small vertebrate zebrafish (Danio rerio) to study the effects of hypoxia on connectivity gene expression across development. We perform transcriptional profiling at high temporal resolution to systematically determine and then experimentally validate the response of CNS connectivity genes to hypoxia exposure. Results We characterized mRNA changes during development, comparing the effects of chronic hypoxia exposure at different time-points. We focused on changes in expression levels of a subset of 1270 genes selected for their roles in development of CNS connectivity, including axon pathfinding and synapse formation. We found that the majority of CNS connectivity genes were unaffected by hypoxia. However, for a small subset of genes hypoxia significantly affected their gene expression profiles. In particular, hypoxia appeared to affect both the timing and levels of expression, including altering expression of interacting gene pairs in a fashion that would potentially disrupt normal function. Conclusions Overall, our study identifies the response of CNS connectivity genes to hypoxia exposure during development. While for most genes hypoxia did not significantly affect expression, for a subset of genes hypoxia changed both levels and timing of expression. Importantly, we identified that some genes with interacting proteins, for example receptor/ligand pairs, had dissimilar responses to hypoxia that would be expected to interfere with their function. The observed dysynchrony of gene expression could impair the development of normal CNS connectivity maps. Electronic supplementary material The online version of this article (doi:10.1186/s12864-016-2638-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brett Milash
- Bioinformatics Shared Resource, Huntsman Cancer Institute, Salt Lake City, USA
| | - Jingxia Gao
- Department of Pediatrics, University of Utah, 295 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Tamara J Stevenson
- Department of Pediatrics, University of Utah, 295 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Jong-Hyun Son
- Department of Pediatrics, University of Utah, 295 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Tiffanie Dahl
- Department of Pediatrics, University of Utah, 295 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Joshua L Bonkowsky
- Department of Pediatrics, University of Utah, 295 Chipeta Way, 84108, Salt Lake City, UT, USA. .,Department of Neurobiology and Anatomy, University of Utah School of Medicine, Salt Lake City, UT, USA.
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Joseph RM, O’Shea TM, Allred EN, Heeren T, Hirtz D, Jara H, Leviton A, Kuban KC. Neurocognitive and Academic Outcomes at Age 10 Years of Extremely Preterm Newborns. Pediatrics 2016; 137:peds.2015-4343. [PMID: 27006473 PMCID: PMC4811321 DOI: 10.1542/peds.2015-4343] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Despite reductions in mortality and morbidity among children born extremely preterm, they remain at high risk of neurocognitive deficits, with up to 40% having significant cognitive deficits at school age. We assessed the rate of neurocognitive impairment in a contemporary US cohort of 873 children aged 10 years who were born <28 weeks' gestation. METHODS The families of 889 of 966 (92%) children enrolled from 2002 to 2004 at 14 sites in 5 states returned at age 10 years for a comprehensive assessment of IQ, language, attention, executive function, processing speed, visual perception, visual-motor function, and academic achievement. RESULTS A total of 873 children were assessed with well-validated tests of cognitive and academic function. Distributions of test scores were consistently and markedly shifted below normative expectation, with one-third to two-thirds of children performing >1 SD below age expectation. The most extreme downward shifts were on measures of executive control and processing speed. Multivariate analyses, adjusted for socioeconomic status, growth restriction, and other potential confounders, revealed that the risk of poor outcome was highest at the lowest gestational age across all 18 measures. CONCLUSIONS More than half of our extremely preterm cohort exhibited moderate or severe neurocognitive deficits at age 10 years, with the most extensive impairments found among those born at the lowest gestational age. Children born extremely preterm continue to be at significant risk of persistent impairments in neurocognitive function and academic achievement, underscoring the need for monitoring and remediating such outcomes beginning in early childhood.
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Affiliation(s)
| | - Thomas M. O’Shea
- Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina
| | - Elizabeth N. Allred
- Department of Neurology, Harvard Medical School, Boston, Massachusetts;,Neuroepidemiology Unit, Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts
| | - Tim Heeren
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts
| | - Deborah Hirtz
- National Institute of Neurologic Disorders and Stroke, Bethesda, Maryland; and
| | | | - Alan Leviton
- Department of Neurology, Harvard Medical School, Boston, Massachusetts;,Neuroepidemiology Unit, Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts
| | - Karl C.K. Kuban
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
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