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Pagnozzi AM, van Eijk L, Pannek K, Boyd RN, Saha S, George J, Bora S, Bradford D, Fahey M, Ditchfield M, Malhotra A, Liley H, Colditz PB, Rose S, Fripp J. Early brain morphometrics from neonatal MRI predict motor and cognitive outcomes at 2-years corrected age in very preterm infants. Neuroimage 2023; 267:119815. [PMID: 36529204 DOI: 10.1016/j.neuroimage.2022.119815] [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: 07/06/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Infants born very preterm face a range of neurodevelopmental challenges in cognitive, language, behavioural and/or motor domains. Early accurate identification of those at risk of adverse neurodevelopmental outcomes, through clinical assessment and Magnetic Resonance Imaging (MRI), enables prognostication of outcomes and the initiation of targeted early interventions. This study utilises a prospective cohort of 181 infants born <31 weeks gestation, who had 3T MRIs acquired at 29-35 weeks postmenstrual age and a comprehensive neurodevelopmental evaluation at 2 years corrected age (CA). Cognitive, language and motor outcomes were assessed using the Bayley Scales of Infant and Toddler Development - Third Edition and functional motor outcomes using the Neuro-sensory Motor Developmental Assessment. By leveraging advanced structural MRI pre-processing steps to standardise the data, and the state-of-the-art developing Human Connectome Pipeline, early MRI biomarkers of neurodevelopmental outcomes were identified. Using Least Absolute Shrinkage and Selection Operator (LASSO) regression, significant associations between brain structure on early MRIs with 2-year outcomes were obtained (r = 0.51 and 0.48 for motor and cognitive outcomes respectively) on an independent 25% of the data. Additionally, important brain biomarkers from early MRIs were identified, including cortical grey matter volumes, as well as cortical thickness and sulcal depth across the entire cortex. Adverse outcome on the Bayley-III motor and cognitive composite scores were accurately predicted, with an Area Under the Curve of 0.86 for both scores. These associations between 2-year outcomes and patient prognosis and early neonatal MRI measures demonstrate the utility of imaging prior to term equivalent age for providing earlier commencement of targeted interventions for infants born preterm.
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Affiliation(s)
- Alex M Pagnozzi
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia.
| | - Liza van Eijk
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia; Department of Psychology, James Cook University, Townsville, Queensland, Australia
| | - Kerstin Pannek
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia
| | - Roslyn N Boyd
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Susmita Saha
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia
| | - Joanne George
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Physiotherapy Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Samudragupta Bora
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - DanaKai Bradford
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia
| | - Michael Fahey
- Monash Health Paediatric Neurology Unit and Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Michael Ditchfield
- Monash Imaging, Monash Health, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Atul Malhotra
- Monash Health Paediatric Neurology Unit and Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Helen Liley
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul B Colditz
- Perinatal Research Centre, Faculty of Medicine, The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Stephen Rose
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia
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Ho SS, Zhou Y, Rajderkar D. Intracranial Imaging of Preterm Infants with Suspected Hypoxic Ischemic Encephalopathy: Comparing MRI and Ultrasound. Curr Pediatr Rev 2023; 19:179-186. [PMID: 35440311 DOI: 10.2174/1573396318666220417233146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/25/2022] [Accepted: 02/15/2022] [Indexed: 02/08/2023]
Abstract
AIMS We correlate ultrasound, MRI, and clinical findings in neonates with suspected hypoxic ischemic injury. BACKGROUND Recent advances in neuroimaging have led to improved detection of subtle insults associated with neurodevelopmental outcomes, beyond more historically described lesions such as large hemorrhages and hydrocephalus. OBJECTIVE In this study, we compare cranial ultrasound to MRI for the evaluation of suspected HIE in preterm infants. METHODS 147 premature infant patients with paired ultrasound and MRI exams were retrospectively analyzed to compare imaging finding accuracy and clinical value. RESULT We confirm that ultrasound is highly sensitive and specific for hydrocephalus, ventricular prominence, and gross structural abnormalities. Ultrasound is not a substitute for MRI in cases of small hemorrhages or white matter injury, however, certain US findings were associated with Apgar score and MRI sequelae of HIE. CONCLUSION Choosing between ultrasound and MRI for preterm neonates at risk for intracranial abnormalities based on their strengths can reduce cost and maximize clinical utility. MRI provides a highly sensitive identification of subtle brain injury, yet ultrasound is correlated with the peripartum clinical picture as measured by Apgar score.
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Affiliation(s)
- Simon S Ho
- Department of Radiology, College of Medicine, University of Florida, Gainesville FL, USA
| | - Yujia Zhou
- College of Medicine, Medical Student, University of Florida, Gainesville FL, USA
| | - Dhanashree Rajderkar
- Department of Radiology, College of Medicine, University of Florida, Gainesville FL, USA
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Tsujimura K, Shiohama T, Takahashi E. microRNA Biology on Brain Development and Neuroimaging Approach. Brain Sci 2022; 12:brainsci12101366. [PMID: 36291300 PMCID: PMC9599180 DOI: 10.3390/brainsci12101366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/22/2022] Open
Abstract
Proper brain development requires the precise coordination and orchestration of various molecular and cellular processes and dysregulation of these processes can lead to neurological diseases. In the past decades, post-transcriptional regulation of gene expression has been shown to contribute to various aspects of brain development and function in the central nervous system. MicroRNAs (miRNAs), short non-coding RNAs, are emerging as crucial players in post-transcriptional gene regulation in a variety of tissues, such as the nervous system. In recent years, miRNAs have been implicated in multiple aspects of brain development, including neurogenesis, migration, axon and dendrite formation, and synaptogenesis. Moreover, altered expression and dysregulation of miRNAs have been linked to neurodevelopmental and psychiatric disorders. Magnetic resonance imaging (MRI) is a powerful imaging technology to obtain high-quality, detailed structural and functional information from the brains of human and animal models in a non-invasive manner. Because the spatial expression patterns of miRNAs in the brain, unlike those of DNA and RNA, remain largely unknown, a whole-brain imaging approach using MRI may be useful in revealing biological and pathological information about the brain affected by miRNAs. In this review, we highlight recent advancements in the research of miRNA-mediated modulation of neuronal processes that are important for brain development and their involvement in disease pathogenesis. Also, we overview each MRI technique, and its technological considerations, and discuss the applications of MRI techniques in miRNA research. This review aims to link miRNA biological study with MRI analytical technology and deepen our understanding of how miRNAs impact brain development and pathology of neurological diseases.
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Affiliation(s)
- Keita Tsujimura
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Group of Brain Function and Development, Nagoya University Neuroscience Institute of the Graduate School of Science, Nagoya 4648602, Japan
- Research Unit for Developmental Disorders, Institute for Advanced Research, Nagoya University, Nagoya 4648602, Japan
- Correspondence: (K.T.); (E.T.)
| | - Tadashi Shiohama
- Department of Pediatrics, Chiba University Hospital, Chiba 2608677, Japan
| | - Emi Takahashi
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Correspondence: (K.T.); (E.T.)
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Vasung L, Charvet CJ, Shiohama T, Gagoski B, Levman J, Takahashi E. Ex vivo fetal brain MRI: Recent advances, challenges, and future directions. Neuroimage 2019; 195:23-37. [PMID: 30905833 PMCID: PMC6617515 DOI: 10.1016/j.neuroimage.2019.03.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 12/21/2022] Open
Abstract
During early development, the fetal brain undergoes dynamic morphological changes. These changes result from neurogenic events, such as neuronal proliferation, migration, axonal elongation, retraction, and myelination. The duration and intensity of these events vary across species. Comparative assessments of these neurogenic events give us insight into evolutionary changes and the complexity of human brain development. Recent advances in magnetic resonance imaging (MRI), especially ex vivo MRI, permit characterizing and comparing fetal brain development across species. Comparative ex vivo MRI studies support the detection of species-specific differences that occur during early brain development. In this review, we provide a comprehensive overview of ex vivo MRI studies that characterize early brain development in humans, monkeys, cats, as well as rats/mice. Finally, we discuss the current advantages and limitations of ex vivo fetal brain MRI.
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Affiliation(s)
- Lana Vasung
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 401 Park Dr., Boston, MA, 02215, USA
| | - Christine J Charvet
- Department of Molecular Biology and Genetics, Cornell University, 526 Campus Rd, Ithaca, NY, 14850, USA; Department of Psychology, Delaware State University, Dover, DE, 19901, USA
| | - Tadashi Shiohama
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 401 Park Dr., Boston, MA, 02215, USA; Department of Pediatrics, Chiba University Hospital, Inohana 1-8-1, Chiba-shi, Chiba, 2608670, Japan
| | - Borjan Gagoski
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 401 Park Dr., Boston, MA, 02215, USA
| | - Jacob Levman
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 401 Park Dr., Boston, MA, 02215, USA; Department of Mathematics, Statistics and Computer Science, St. Francis Xavier University, Antigonish, NS, B2G 2W5, Canada
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 401 Park Dr., Boston, MA, 02215, USA.
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