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Wang X, de Groot ER, Tataranno ML, van Baar A, Lammertink F, Alderliesten T, Long X, Benders MJNL, Dudink J. Machine Learning-Derived Active Sleep as an Early Predictor of White Matter Development in Preterm Infants. J Neurosci 2024; 44:e1024232023. [PMID: 38124010 PMCID: PMC10860564 DOI: 10.1523/jneurosci.1024-23.2023] [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: 06/09/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 12/23/2023] Open
Abstract
White matter dysmaturation is commonly seen in preterm infants admitted to the neonatal intensive care unit (NICU). Animal research has shown that active sleep is essential for early brain plasticity. This study aimed to determine the potential of active sleep as an early predictor for subsequent white matter development in preterm infants. Using heart and respiratory rates routinely monitored in the NICU, we developed a machine learning-based automated sleep stage classifier in a cohort of 25 preterm infants (12 females). The automated classifier was subsequently applied to a study cohort of 58 preterm infants (31 females) to extract active sleep percentage over 5-7 consecutive days during 29-32 weeks of postmenstrual age. Each of the 58 infants underwent high-quality T2-weighted magnetic resonance brain imaging at term-equivalent age, which was used to measure the total white matter volume. The association between active sleep percentage and white matter volume was examined using a multiple linear regression model adjusted for potential confounders. Using the automated classifier with a superior sleep classification performance [mean area under the receiver operating characteristic curve (AUROC) = 0.87, 95% CI 0.83-0.92], we found that a higher active sleep percentage during the preterm period was significantly associated with an increased white matter volume at term-equivalent age [β = 0.31, 95% CI 0.09-0.53, false discovery rate (FDR)-adjusted p-value = 0.021]. Our results extend the positive association between active sleep and early brain development found in animal research to human preterm infants and emphasize the potential benefit of sleep preservation in the NICU setting.
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Affiliation(s)
- Xiaowan Wang
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht 3584 EA, The Netherlands
| | - Eline R de Groot
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht 3584 EA, The Netherlands
| | - Maria Luisa Tataranno
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht 3584 EA, The Netherlands
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht 3584 CX, The Netherlands
| | - Anneloes van Baar
- Child and Adolescent Studies, Utrecht University, Utrecht 3584 CS, The Netherlands
| | - Femke Lammertink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht 3584 EA, The Netherlands
| | - Thomas Alderliesten
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht 3584 EA, The Netherlands
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht 3584 CX, The Netherlands
| | - Xi Long
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven 5612 AZ, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht 3584 EA, The Netherlands
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht 3584 CX, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht 3584 EA, The Netherlands
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht 3584 CX, The Netherlands
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Hergenreder E, Minotti AP, Zorina Y, Oberst P, Zhao Z, Munguba H, Calder EL, Baggiolini A, Walsh RM, Liston C, Levitz J, Garippa R, Chen S, Ciceri G, Studer L. Combined small-molecule treatment accelerates maturation of human pluripotent stem cell-derived neurons. Nat Biotechnol 2024:10.1038/s41587-023-02031-z. [PMID: 38168993 DOI: 10.1038/s41587-023-02031-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/13/2023] [Indexed: 01/05/2024]
Abstract
The maturation of human pluripotent stem cell (hPSC)-derived neurons mimics the protracted timing of human brain development, extending over months to years for reaching adult-like function. Prolonged in vitro maturation presents a major challenge to stem cell-based applications in modeling and treating neurological disease. Therefore, we designed a high-content imaging assay based on morphological and functional readouts in hPSC-derived cortical neurons which identified multiple compounds that drive neuronal maturation including inhibitors of lysine-specific demethylase 1 and disruptor of telomerase-like 1 and activators of calcium-dependent transcription. A cocktail of four factors, GSK2879552, EPZ-5676, N-methyl-D-aspartate and Bay K 8644, collectively termed GENtoniK, triggered maturation across all parameters tested, including synaptic density, electrophysiology and transcriptomics. Maturation effects were further validated in cortical organoids, spinal motoneurons and non-neural lineages including melanocytes and pancreatic β-cells. The effects on maturation observed across a broad range of hPSC-derived cell types indicate that some of the mechanisms controlling the timing of human maturation might be shared across lineages.
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Affiliation(s)
- Emiliano Hergenreder
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Weill Graduate School of Medical Sciences of Cornell University, New York, NY, USA
| | - Andrew P Minotti
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Weill Graduate School of Medical Sciences of Cornell University, New York, NY, USA
| | - Yana Zorina
- Gene Editing and Screening Core Facility, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Polina Oberst
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
| | - Zeping Zhao
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Hermany Munguba
- Department of Biochemistry, Weill Cornell Medicine, New York, NY, USA
- Department of Psychiatry, Weill Cornell Medicine, New York, USA
| | - Elizabeth L Calder
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
| | - Arianna Baggiolini
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
| | - Ryan M Walsh
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
| | - Conor Liston
- Department of Psychiatry, Weill Cornell Medicine, New York, USA
| | - Joshua Levitz
- Department of Biochemistry, Weill Cornell Medicine, New York, NY, USA
| | - Ralph Garippa
- Gene Editing and Screening Core Facility, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
| | - Shuibing Chen
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Gabriele Ciceri
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA
| | - Lorenz Studer
- The Center for Stem Cell Biology, Sloan-Kettering Institute for Cancer Research, New York, NY, USA.
- Developmental Biology Program, Sloan-Kettering Institute for Cancer Research, New York, NY, USA.
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Anuar MA, Zainal Abidin M'A, Tan SH, Yeap CF, Yahaya NA. The Clinical Characteristics and Outcomes of Infantile Seizures in the First Year of Life: A Single-Center Study. Pediatr Neurol 2024; 150:10-14. [PMID: 37931500 DOI: 10.1016/j.pediatrneurol.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 08/29/2023] [Accepted: 10/12/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Epilepsy has a high incidence among infants during their first year of life, yet the prognosis can vary significantly. Although considerable research has been conducted on infantile spasms, studies examining infantile-onset epilepsy, excluding infantile spasms, remain limited, particularly concerning the factors influencing outcomes. Therefore, our study aims to elucidate seizure control, developmental outcomes, and prognostic factors in infants with epilepsy during their first year of life, within a single-center study in Malaysia. METHODS We retrieved data from patients who experienced seizures before age 12 months and were followed for over two years, using electronic patient records at Hospital Raja Perempuan Zainab II in Kelantan, a state in Malaysia's east coast. We retrospectively reviewed these records and assessed clinical outcomes based on the last follow-up. RESULTS Of 75 patients, 61 (81.3%) achieved good seizure control or remission. At the last follow-up, 24 (32%) exhibited developmental delay, whereas 19 (25.3%) displayed abnormal neuroimaging. Patients with abnormal background electroencephalographic (EEG) activity, as well as abnormal radiological findings, were more likely to experience poor seizure control and unfavorable developmental outcomes (P < 0.05). CONCLUSIONS Our study underscores that most infants with epilepsy can achieve seizure remission. However, poor seizure control and developmental delay are associated with abnormal EEG background and characteristics, as well as neuroimaging abnormalities. The management of infantile-onset epilepsies may necessitate substantial resources and precise interventions to enhance overall outcomes.
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Affiliation(s)
- Muhamad Azamin Anuar
- Department of Paediatrics, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; Department of Paediatrics, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia.
| | - Muhammad 'Adil Zainal Abidin
- Department of Public Health, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Soo Hong Tan
- Department of Paediatrics, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
| | - Cai Fong Yeap
- Department of Paediatrics, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
| | - Nor Azni Yahaya
- Department of Paediatrics, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
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Abbasi SF, Abbas A, Ahmad I, Alshehri MS, Almakdi S, Ghadi YY, Ahmad J. Automatic neonatal sleep stage classification: A comparative study. Heliyon 2023; 9:e22195. [PMID: 38058619 PMCID: PMC10695968 DOI: 10.1016/j.heliyon.2023.e22195] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/21/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023] Open
Abstract
Sleep is an essential feature of living beings. For neonates, it is vital for their mental and physical development. Sleep stage cycling is an important parameter to assess neonatal brain and physical development. Therefore, it is crucial to administer newborn's sleep in the neonatal intensive care unit (NICU). Currently, Polysomnography (PSG) is used as a gold standard method for classifying neonatal sleep patterns, but it is expensive and requires a lot of human involvement. Over the last two decades, multiple researchers are working on automatic sleep stage classification algorithms using electroencephalography (EEG), electrocardiography (ECG), and video. In this study, we present a comprehensive review of existing algorithms for neonatal sleep, their limitations and future recommendations. Additionally, a brief comparison of the extracted features, classification algorithms and evaluation parameters is reported in the proposed study.
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Affiliation(s)
- Saadullah Farooq Abbasi
- Department of Electronic, Electrical and System Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Awais Abbas
- Department of Electronic, Electrical and System Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Iftikhar Ahmad
- James Watt School of Engineering, University of Glasgow, United Kingdom
| | - Mohammed S. Alshehri
- Department of Computer Science, College of Computer Science and Information Systems, Najran University, Najran, Saudi Arabia
| | - Sultan Almakdi
- Department of Computer Science, College of Computer Science and Information Systems, Najran University, Najran, Saudi Arabia
| | - Yazeed Yasin Ghadi
- Department of Computer Science, Al Ain University, Abu Dhabi P.O. Box 112612, United Arab Emirates
| | - Jawad Ahmad
- School of Computing, Engineering and the Built Environment, Edinburgh Napier University, Edinburgh EH10 5DT, UK
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Lundy C, Boylan GB, Mathieson S, Proietti J, O'Toole JM. Quantitative analysis of high-frequency activity in neonatal EEG. Comput Biol Med 2023; 165:107468. [PMID: 37722158 DOI: 10.1016/j.compbiomed.2023.107468] [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: 03/10/2023] [Revised: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE To determine the presence and potential utility of independent high-frequency activity recorded from scalp electrodes in the electroencephalogram (EEG) of newborns. METHODS We compare interburst intervals and continuous activity at different frequencies for EEGs retrospectively recorded at 256 Hz from 4 newborn groups: 1) 36 preterms (<32 weeks' gestational age, GA); 2) 12 preterms (32-37 weeks' GA); 3) 91 healthy full terms; 4) 15 full terms with hypoxic-ischemic encephalopathy (HIE). At 4 standard frequency bands (delta, 0.5-3 Hz; theta, 3-8 Hz; alpha, 8-15 Hz; beta, 15-30 Hz) and 3 higher-frequency bands (gamma1, 30-48 Hz; gamma2, 52-99 Hz; gamma3, 107-127 Hz), we compared power spectral densities (PSDs), quantitative features, and machine learning model performance. Feature selection and further machine learning methods were performed on one cohort. RESULTS We found significant (P < 0.01) differences in PSDs, quantitative analysis, and machine learning modelling at the higher-frequency bands. Machine learning models using only high-frequency features performed best in preterm groups 1 and 2 with a median (95% confidence interval, CI) Matthews correlation coefficient (MCC) of 0.71 (0.12-0.88) and 0.66 (0.36-0.76) respectively. Interburst interval-detector models using both high- and standard-bandwidths produced the highest median MCCs in all four groups. High-frequency features were largely independent of standard-bandwidth features, with only 11/84 (13.1%) of correlations statistically significant. Feature selection methods produced 7 to 9 high-frequency features in the top 20 feature set. CONCLUSIONS This is the first study to identify independent high-frequency activity in newborn EEG using in-depth quantitative analysis. Expanding the EEG bandwidths of analysis has the potential to improve both quantitative and machine-learning analysis, particularly in preterm EEG.
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Affiliation(s)
- Christopher Lundy
- INFANT Research Centre, University College Cork, Cork, Ireland; Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Geraldine B Boylan
- INFANT Research Centre, University College Cork, Cork, Ireland; Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Sean Mathieson
- INFANT Research Centre, University College Cork, Cork, Ireland; Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Jacopo Proietti
- INFANT Research Centre, University College Cork, Cork, Ireland; Department of Neurosciences, Biomedicine and Movement, University of Verona, Italy
| | - John M O'Toole
- INFANT Research Centre, University College Cork, Cork, Ireland; Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
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Mathewson KJ, Beaton EA, Hobbs D, Hall GBC, Schulkin J, Van Lieshout RJ, Saigal S, Schmidt LA. Brain structure and function in the fourth decade of life after extremely low birth weight: An MRI and EEG study. Clin Neurophysiol 2023; 154:85-99. [PMID: 37595482 DOI: 10.1016/j.clinph.2023.06.006] [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: 12/22/2022] [Revised: 04/27/2023] [Accepted: 06/03/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To examine potential long-term effects of extremely low birth weight (ELBW; ≤ 1000 g) on adult brain structure, brain function, and cognitive-behavioral performance. METHODS A subset of survivors from the prospectively-followed McMaster ELBW Cohort (n = 23, MBW = 816 g) and their peers born at normal birth weight (NBW; ≥ 2500 g; n = 14, MBW = 3361 g) provided T1-weighted magnetic resonance imaging (MRI) brain scans, resting electroencephalographic (EEG) recordings, and behavioral responses to a face-processing task in their early thirties. RESULTS Visual discrimination accuracy for human faces, resting EEG alpha power, and long-distance alpha coherence were lower in ELBW survivors than NBW adults, and volumes of white matter hypointensities (WMH) were higher. Across groups, face-processing performance was correlated positively with posterior EEG spectral power and long-distance alpha and theta coherence, and negatively with WMH. The associations between face-processing scores and parietal alpha power and theta coherence were reduced after adjustment for WMH. CONCLUSIONS Electrocortical activity, brain functional connectivity, and higher-order processing ability may be negatively affected by WMH burden, which is greater in adults born extremely preterm. SIGNIFICANCE Decrements in electrocortical activity and behavioral performance in adult ELBW survivors may be partly explained by increased WMH volumes in this vulnerable population.
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Affiliation(s)
- Karen J Mathewson
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada.
| | - Elliott A Beaton
- Department of Psychology, University of New Orleans, New Orleans, LA, USA
| | - Diana Hobbs
- Department of Psychology, University of New Orleans, New Orleans, LA, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoffrey B C Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Jay Schulkin
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA; Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Saroj Saigal
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Louis A Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
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Koskela T, Meek J, Huertas-Ceballos A, Kendall GS, Whitehead K. Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage. Early Hum Dev 2023; 184:105840. [PMID: 37556995 DOI: 10.1016/j.earlhumdev.2023.105840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND In healthy preterm infants, cortical burst rate and temporal dynamics predict important measures such as brain growth. We hypothesised that in preterm infants with germinal matrix-intraventricular haemorrhage (GM-IVH), cortical bursting could provide prognostic information. AIMS We determined how cortical bursting was influenced by the injury, and whether this was related to developmental outcome. STUDY DESIGN Single-centre retrospective cohort study at University College London Hospitals, UK. SUBJECTS 33 infants with GM-IVH ≥ grade II (median gestational age: 25 weeks). OUTCOME MEASURES We identified 47 EEGs acquired between 24 and 40 weeks corrected gestational age as part of routine clinical care. In a subset of 33 EEGs from 25 infants with asymmetric injury, we used the least-affected hemisphere as an internal comparison. We tested whether cortical burst rate predicted survival without severe impairment (median 2 years follow-up). RESULTS In asymmetric injury, cortical burst rate was lower over the worst- than least-affected hemisphere, and bursts over the worst-affected hemisphere were less likely to immediately follow bursts over the least-affected hemisphere than vice versa. Overall, burst rate was lower in cases of GM-IVH with parenchymal involvement, relative to milder structural injury grades. Higher burst rate modestly predicted survival without severe language (AUC 0.673) or motor impairment (AUC 0.667), which was partly mediated by structural injury grade. CONCLUSIONS Cortical bursting can index the functional injury after GM-IVH: perturbed burst initiation (rate) and propagation (inter-hemispheric dynamics) likely reflect associated grey matter and white matter damage. Higher cortical burst rate is reassuring for a positive outcome.
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Affiliation(s)
- Tuomas Koskela
- Research IT Services, University College London, London WC1E 7HB, UK.
| | - Judith Meek
- Neonatal Intensive Care Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London WC1E 6DB, UK; Academic Neonatology, Institute for Women's Health, University College London, London WC1E 6HU, UK.
| | - Angela Huertas-Ceballos
- Neonatal Intensive Care Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London WC1E 6DB, UK.
| | - Giles S Kendall
- Neonatal Intensive Care Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London WC1E 6DB, UK; Academic Neonatology, Institute for Women's Health, University College London, London WC1E 6HU, UK.
| | - Kimberley Whitehead
- Neonatal Intensive Care Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London WC1E 6DB, UK; Department of Neuroscience, Physiology & Pharmacology, University College London, London WC1E 6BT, UK.
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Padilla N, Escrichs A, del Agua E, Kringelbach M, Donaire A, Deco G, Åden U. Disrupted resting-sate brain network dynamics in children born extremely preterm. Cereb Cortex 2023; 33:8101-8109. [PMID: 37083266 PMCID: PMC10321088 DOI: 10.1093/cercor/bhad101] [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: 08/31/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 04/22/2023] Open
Abstract
The developing brain has to adapt to environmental and intrinsic insults after extremely preterm (EPT) birth. Ongoing maturational processes maximize their fit to the environment and this can provide a substrate for neurodevelopmental failures. Resting-state functional magnetic resonance imaging was used to scan 33 children born EPT, at < 27 weeks of gestational age, and 26 full-term controls at 10 years of age. We studied the capability of a brain area to propagate neural information (intrinsic ignition) and its variability across time (node-metastability). This framework was computed for the dorsal attention network (DAN), frontoparietal, default-mode network (DMN), and the salience, limbic, visual, and somatosensory networks. The EPT group showed reduced intrinsic ignition in the DMN and DAN, compared with the controls, and reduced node-metastability in the DMN, DAN, and salience networks. Intrinsic ignition and node-metastability values correlated with cognitive performance at 12 years of age in both groups, but only survived in the term group after adjustment. Preterm birth disturbed the signatures of functional brain organization at rest in 3 core high-order networks: DMN, salience, and DAN. Identifying vulnerable resting-state networks after EPT birth may lead to interventions that aim to rebalance brain function.
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Affiliation(s)
- Nelly Padilla
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm S- 171 76, Sweden
| | - Anira Escrichs
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/ de Ramon Trias Fargas, 25, 08018 Barcelona, España
| | - Elvira del Agua
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/ de Ramon Trias Fargas, 25, 08018 Barcelona, España
| | - Morten Kringelbach
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford OX3 7JX, United Kingdom
- Center for Music in the Brain, Aarhus University Hospital Nørrebrogade 44, Building 10G, 4th and 5th floor, 8000 Aarhus C, Denmark
| | - Antonio Donaire
- Department of Neurology, Institute of Neuroscience, Hospital Clinic, Universidad de Barcelona and Institut D’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Gustavo Deco
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/ de Ramon Trias Fargas, 25, 08018 Barcelona, España
- School of Psychological Sciences, Monash University, Melbourne, Clayton, VIC 3800, Australia
- Institució Catalana de la Recerca i Estudis Avançats (ICREA), Passeig de Lluís Companys, 23, 08010, Barcelona, Catalonia, Spain
- Department of Neuropsychology, Max Planck Institute for human Cognitive and Brain Sciences, Leipzig 04103, Germany
| | - Ulrika Åden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm S- 171 76, Sweden
- Department of Neonatology, Karolinska University Hospital, Stockholm S- 171 76, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SE 58183, Sweden
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Nordvik T, Server A, Espeland CN, Schumacher EM, Larsson PG, Pripp AH, Stiris T. Combining MRI and Spectral EEG for Assessment of Neurocognitive Outcomes in Preterm Infants. Neonatology 2023; 120:482-490. [PMID: 37290419 DOI: 10.1159/000530648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/31/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Predicting impairment in preterm children is challenging. Our aim is to explore the association between MRI at term-equivalent age (TEA) and neurocognitive outcomes in late childhood and to assess whether the addition of EEG improves prognostication. METHODS This prospective observational study included forty infants with gestational age 24 + 0-30 + 6. Children were monitored with multichannel EEG for 72 h after birth. Total absolute band power for the delta band on day 2 was calculated. Brain MRI was performed at TEA and scored according to the Kidokoro scoring system. At 10-12 years of age, we evaluated neurocognitive outcomes with Wechsler Intelligence Scale for Children 4th edition, Vineland adaptive behavior scales 2nd edition and Behavior Rating Inventory of Executive Function. We performed linear regression analysis to examine the association between outcomes and MRI and EEG, respectively, and multiple regression analysis to explore the combination of MRI and EEG. RESULTS Forty infants were included. There was a significant association between global brain abnormality score and composite outcomes of WISC and Vineland test, but not the BRIEF test. The adjusted R2 was 0.16 and 0.08, respectively. For EEG, adjusted R2 was 0.34 and 0.15, respectively. When combining MRI and EEG data, adjusted R2 changed to 0.36 for WISC and 0.16 for the Vineland test. CONCLUSION There was a small association between TEA MRI and neurocognitive outcomes in late childhood. Adding EEG to the model improved the explained variance. Combining EEG and MRI data did not have any additional benefit over EEG alone.
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Affiliation(s)
- Tone Nordvik
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Andres Server
- Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Cathrine N Espeland
- Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Eva M Schumacher
- Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Pål G Larsson
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Are H Pripp
- Oslo Center of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Tom Stiris
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål, Oslo, Norway
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Sydnor VJ, Larsen B, Seidlitz J, Adebimpe A, Alexander-Bloch AF, Bassett DS, Bertolero MA, Cieslak M, Covitz S, Fan Y, Gur RE, Gur RC, Mackey AP, Moore TM, Roalf DR, Shinohara RT, Satterthwaite TD. Intrinsic activity development unfolds along a sensorimotor-association cortical axis in youth. Nat Neurosci 2023; 26:638-649. [PMID: 36973514 PMCID: PMC10406167 DOI: 10.1038/s41593-023-01282-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/15/2023] [Indexed: 03/29/2023]
Abstract
Animal studies of neurodevelopment have shown that recordings of intrinsic cortical activity evolve from synchronized and high amplitude to sparse and low amplitude as plasticity declines and the cortex matures. Leveraging resting-state functional MRI (fMRI) data from 1,033 youths (ages 8-23 years), we find that this stereotyped refinement of intrinsic activity occurs during human development and provides evidence for a cortical gradient of neurodevelopmental change. Declines in the amplitude of intrinsic fMRI activity were initiated heterochronously across regions and were coupled to the maturation of intracortical myelin, a developmental plasticity regulator. Spatiotemporal variability in regional developmental trajectories was organized along a hierarchical, sensorimotor-association cortical axis from ages 8 to 18. The sensorimotor-association axis furthermore captured variation in associations between youths' neighborhood environments and intrinsic fMRI activity; associations suggest that the effects of environmental disadvantage on the maturing brain diverge most across this axis during midadolescence. These results uncover a hierarchical neurodevelopmental axis and offer insight into the progression of cortical plasticity in humans.
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Affiliation(s)
- Valerie J Sydnor
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bart Larsen
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jakob Seidlitz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Penn-CHOP Lifespan Brain Institute, Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Azeez Adebimpe
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aaron F Alexander-Bloch
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Penn-CHOP Lifespan Brain Institute, Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Dani S Bassett
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
- Department of Electrical and Systems Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
- Department of Physics and Astronomy, College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Santa Fe Institute, Santa Fe, NM, USA
| | - Maxwell A Bertolero
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew Cieslak
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sydney Covitz
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Penn-CHOP Lifespan Brain Institute, Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn-CHOP Lifespan Brain Institute, Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Allyson P Mackey
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Tyler M Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn-CHOP Lifespan Brain Institute, Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - David R Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Russell T Shinohara
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Theodore D Satterthwaite
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Penn-CHOP Lifespan Brain Institute, Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA.
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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11
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Wang X, Bik A, de Groot ER, Tataranno ML, Benders MJNL, Dudink J. Feasibility of automated early postnatal sleep staging in extremely and very preterm neonates using dual-channel EEG. Clin Neurophysiol 2023; 146:55-64. [PMID: 36535092 DOI: 10.1016/j.clinph.2022.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 10/25/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the feasibility of automated sleep staging based on quantitative analysis of dual-channel electroencephalography (EEG) for extremely and very preterm infants during their first postnatal days. METHODS We enrolled 17 preterm neonates born between 25 and 30 weeks of gestational age. Three-hour behavioral sleep observations and simultaneous dual-channel EEG monitoring were conducted for each infant within their first 72 hours after birth. Four kinds of representative and complementary quantitative EEG (qEEG) metrics (i.e., bursting, synchrony, spectral power, and complexity) were calculated and compared between active sleep, quiet sleep, and wakefulness. All analyses were performed in offline mode. RESULTS In separate comparison analyses, significant differences between sleep-wake states were found for bursting, spectral power and complexity features. The automated sleep-wake state classifier based on the combination of all qEEG features achieved a macro-averaged area under the curve of receiver operating characteristic of 74.8%. The complexity features contributed the most to sleep-wake state classification. CONCLUSIONS It is feasible to distinguish between sleep-wake states within the first 72 postnatal hours for extremely and very preterm infants using qEEG metrics. SIGNIFICANCE Our findings offer the possibility of starting personalized care dependent on preterm infants' sleep-wake states directly after birth, potentially yielding long-run benefits for their developmental outcomes.
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Affiliation(s)
- Xiaowan Wang
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne Bik
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eline R de Groot
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maria Luisa Tataranno
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
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12
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Ryan MAJ, Mathieson SR, Livingstone V, O'Sullivan MP, Dempsey EM, Boylan GB. Sleep state organisation of moderate to late preterm infants in the neonatal unit. Pediatr Res 2023; 93:595-603. [PMID: 36474114 PMCID: PMC9988685 DOI: 10.1038/s41390-022-02319-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sleep supports neurodevelopment and sleep architecture reflects brain maturation. This prospective observational study describes the nocturnal sleep architecture of healthy moderate to late preterm (MLP) infants in the neonatal unit at 36 weeks post menstrual age (PMA). METHODS MLP infants, in the neonatal unit of a tertiary hospital in Ireland from 2017 to 2018, had overnight continuous electroencephalography (cEEG) with video for a minimum 12 h at 36 weeks PMA. The total sleep time (TST) including periods of active sleep (AS), quiet sleep (QS), indeterminate sleep (IS), wakefulness and feeding were identified, annotated and quantified. RESULTS A total of 98 infants had cEEG with video monitoring suitable for analysis. The median (IQR) of TST in the 12 h period was 7.09 h (IQR 6.61-7.76 h), 4.58 h (3.69-5.09 h) in AS, 2.02 h (1.76-2.36 h) in QS and 0.65 h (0.48-0.89 h) in IS. The total duration of AS was significantly lower in infants born at lower GA (p = 0.007) whilst the duration of individual QS periods was significantly higher (p = 0.001). CONCLUSION Overnight cEEG with video at 36 weeks PMA showed that sleep state architecture is dependent on birth GA. Infants with a lower birth GA have less AS and more QS that may have implications for later neurodevelopment. IMPACT EEG provides objective information about the sleep organisation of the moderate to late preterm (MLP) infant. Quantitative changes in sleep states occur with each week of advancing gestational age (GA). Active sleep (AS) is the dominant sleep state that was significantly lower in infants born at lower GA. MLP infants who were exclusively fed orally had a shorter total sleep time and less AS compared to infants who were fed via nasogastric tube.
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Affiliation(s)
- Mary Anne J Ryan
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.,Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - Sean R Mathieson
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Vicki Livingstone
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Marc Paul O'Sullivan
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Eugene M Dempsey
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.,Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - Geraldine B Boylan
- INFANT Research Centre, University College Cork, Cork, Ireland. .,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
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13
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Boskabadi H, Beiraghi Toosi M, Darabi A, Abadi JMT. Investigation of EEG changes before and after phototherapy in infants with severe hyperbilirubinemia. J Neonatal Perinatal Med 2022; 15:821-825. [PMID: 36189503 DOI: 10.3233/npm-221080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Despite the known effect of hyperbilirubinemia in neonates, the effect of phototherapy on electroencephalography (EEG) remains unknown. Therefore, we aimed to determine the alteration of electroencephalography in infants with hyperbilirubinemia before and after phototherapy. METHODS This cross-sectional study was performed on infants of≥35 weeks of gestation with hyperbilirubinemia. Information including age, sex, birth weight, hemoglobin levels, and treatment measures was recorded. In all studied infants, an EEG was performed before (in the first eight hours of hospitalization) and after treatment (after phototherapy or blood transfusion). The required duration of phototherapy, hospitalization and adverse effects were assessed then EEG of the neonates was compared before and after treatment. RESULTS A total of 52 infants (44% female and 56% male) were included in this study. Mean gestational age, weight, and bilirubin were 38.6±1.53 weeks, 3150±625 g, and 23.87±4.36 mg/dl, respectively. The most common findings before phototherapy were Frontal Theta (21 patients, 40.4 percent) and Delta Brush (14 patients, 26.9%), while the most common findings after phototherapy were Frontal Theta (20 patients, 38.5%) and Delta Brush (19 patients, 36.5%). Mean±SD of bilirubin in infants with and without Delta Brush was 21.30±1.67 mg/dl and 19.95±0.94 mg/dl, respectively. CONCLUSIONS Hyperbilirubinemia in newborns may be linked to altered EEG findings. After phototherapy, the Frontal theta was reduced, but the Delta brush was intensified. Bilirubin levels were higher in infants with Delta Brush in their EEG compared to infants without this finding.
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Affiliation(s)
- H Boskabadi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Beiraghi Toosi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Darabi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - J M T Abadi
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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14
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Failla A, Filatovaite L, Wang X, Vanhatalo S, Dudink J, de Vries LS, Benders M, Stevenson N, Tataranno ML. The relationship between interhemispheric synchrony, morphine and microstructural development of the corpus callosum in extremely preterm infants. Hum Brain Mapp 2022; 43:4914-4923. [PMID: 36073656 PMCID: PMC9582365 DOI: 10.1002/hbm.26040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 11/22/2022] Open
Abstract
The primary aim of this study is to examine whether bursting interhemispheric synchrony (bIHS) in the first week of life of infants born extremely preterm, is associated with microstructural development of the corpus callosum (CC) on term equivalent age magnetic resonance imaging scans. The secondary aim is to address the effects of analgesics such as morphine, on bIHS in extremely preterm infants. A total of 25 extremely preterm infants (gestational age [GA] < 28 weeks) were monitored with the continuous two-channel EEG during the first 72 h and after 1 week from birth. bIHS was analyzed using the activation synchrony index (ASI) algorithm. Microstructural development of the CC was assessed at ~ 30 and ~ 40 weeks of postmenstrual age (PMA) using fractional anisotropy (FA) measurements. Multivariable regression analyses were used to assess the primary and secondary aim. Analyses were adjusted for important clinical confounders: morphine, birth weight z-score, and white matter injury score. Due to the reduced sample size, only the most relevant variables, according to literature, were included. ASI was not significantly associated with FA of the CC at 30 weeks PMA and at 40 weeks PMA (p > .5). ASI was positively associated with the administration of morphine (p < .05). Early cortical synchrony may be affected by morphine and is not associated with the microstructural development of the CC. More studies are needed to evaluate the long-term effects of neonatal morphine treatment to optimize sedation in this high-risk population.
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Affiliation(s)
- Alberto Failla
- Department of NeonatologyWilhelmina Children's Hospital, Utrecht Medical CenterUtrechtThe Netherlands
| | - Lauryna Filatovaite
- Department of NeonatologyWilhelmina Children's Hospital, Utrecht Medical CenterUtrechtThe Netherlands
| | - Xiaowan Wang
- Department of NeonatologyWilhelmina Children's Hospital, Utrecht Medical CenterUtrechtThe Netherlands
| | - Sampsa Vanhatalo
- Department of Clinical Neurophysiology, BABA Center, Children's Hospital, HUS DiagnosticsHelsinki University HospitalHelsinkiFinland
- Neuroscience Center, HiLife, University of HelsinkiHelsinkiFinland
| | - Jeroen Dudink
- Department of NeonatologyWilhelmina Children's Hospital, Utrecht Medical CenterUtrechtThe Netherlands
| | - Linda S. de Vries
- Department of NeonatologyWilhelmina Children's Hospital, Utrecht Medical CenterUtrechtThe Netherlands
| | - Manon Benders
- Department of NeonatologyWilhelmina Children's Hospital, Utrecht Medical CenterUtrechtThe Netherlands
| | - Nathan Stevenson
- Brain Modelling Group, QIMR Berghofer Medical Research InstituteBrisbaneAustralia
| | - Maria Luisa Tataranno
- Department of NeonatologyWilhelmina Children's Hospital, Utrecht Medical CenterUtrechtThe Netherlands
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15
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Sensory-based interventions in the NICU: systematic review of effects on preterm brain development. Pediatr Res 2022; 92:47-60. [PMID: 34508227 DOI: 10.1038/s41390-021-01718-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear. METHODS A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth. RESULTS Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions. CONCLUSIONS Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU. IMPACT This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development. Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice. This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.
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16
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Keunen K, Sperna Weiland NH, de Bakker BS, de Vries LS, Stevens MF. Impact of surgery and anesthesia during early brain development: A perfect storm. Paediatr Anaesth 2022; 32:697-705. [PMID: 35266610 PMCID: PMC9311405 DOI: 10.1111/pan.14433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/06/2022] [Accepted: 02/20/2022] [Indexed: 11/27/2022]
Abstract
Neonatal surgery and concomitant anesthesia coincide with a timeframe of rapid brain development. The speed and complexity of early brain development superimposed on immature regulatory mechanisms that include incomplete cerebral autoregulation, insufficient free radical scavenging and an immature immune response puts the brain at risk. Brain injury may have long-term consequences for multiple functional domains including cognition, learning skills, and behavior. Neurodevelopmental follow-up studies have noted mild-to-moderate deficits in children who underwent major neonatal surgery and related anesthesia. The present review evaluates neonatal surgery against the background of neurobiological processes that unfold at a pace unparalleled by any other period of human brain development. First, a structured summary of early brain development is provided in order to establish theoretical groundwork. Next, literature on brain injury and neurodevelopmental outcome after neonatal surgery is discussed. Special attention is given to recent findings of structural brain damage reported after neonatal surgery. Notably, high-quality imaging data acquired before surgery are currently lacking. Third, mechanisms of injury are interrogated taking the perspective of early brain development into account. We propose a novel disease model that constitutes a triad of inflammation, vascular immaturity, and neurotoxicity of prolonged exposure to anesthetic drugs. With each of these components exacerbating the other, this amalgam incites the perfect storm, resulting in brain injury. When examining the brain, it seems intuitive to distinguish between neonates (i.e., <60 postconceptional weeks) and more mature infants, multiple and/or prolonged anesthesia exposure and single, short surgery. This review culminates in an outline of anesthetic considerations and future directions that we believe will help move the field forward.
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Affiliation(s)
- Kristin Keunen
- Department of Anaesthesiology, Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
| | - Nicolaas H. Sperna Weiland
- Department of Anaesthesiology, Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
| | - Bernadette S. de Bakker
- Department of Medical Biology Section Clinical Anatomy & Embryology, Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
| | - Linda S. de Vries
- Department of NeonatologyUniversity Medical CenterUtrechtThe Netherlands
| | - Markus F. Stevens
- Department of Anaesthesiology, Amsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
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17
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Luhmann HJ, Kanold PO, Molnár Z, Vanhatalo S. Early brain activity: Translations between bedside and laboratory. Prog Neurobiol 2022; 213:102268. [PMID: 35364141 PMCID: PMC9923767 DOI: 10.1016/j.pneurobio.2022.102268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/01/2022] [Accepted: 03/25/2022] [Indexed: 01/29/2023]
Abstract
Neural activity is both a driver of brain development and a readout of developmental processes. Changes in neuronal activity are therefore both the cause and consequence of neurodevelopmental compromises. Here, we review the assessment of neuronal activities in both preclinical models and clinical situations. We focus on issues that require urgent translational research, the challenges and bottlenecks preventing translation of biomedical research into new clinical diagnostics or treatments, and possibilities to overcome these barriers. The key questions are (i) what can be measured in clinical settings versus animal experiments, (ii) how do measurements relate to particular stages of development, and (iii) how can we balance practical and ethical realities with methodological compromises in measurements and treatments.
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Affiliation(s)
- Heiko J. Luhmann
- Institute of Physiology, University Medical Center of the Johannes Gutenberg University Mainz, Duesbergweg 6, Mainz, Germany.,Correspondence:, , ,
| | - Patrick O. Kanold
- Department of Biomedical Engineering and Kavli Neuroscience Discovery Institute, Johns Hopkins University, School of Medicine, 720 Rutland Avenue / Miller 379, Baltimore, MD 21205, USA.,Correspondence:, , ,
| | - Zoltán Molnár
- Department of Physiology, Anatomy and Genetics, Sherrington Building, University of Oxford, Parks Road, Oxford OX1 3PT, UK.
| | - Sampsa Vanhatalo
- BABA Center, Departments of Physiology and Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
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18
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Namiranian R, Rahimi Malakshan S, Abrishami Moghaddam H, Khadem A, Jafari R. Normal development of the brain: a survey of joint structural-functional brain studies. Rev Neurosci 2022; 33:745-765. [PMID: 35304982 DOI: 10.1515/revneuro-2022-0017] [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: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/15/2022]
Abstract
Joint structural-functional (S-F) developmental studies present a novel approach to address the complex neuroscience questions on how the human brain works and how it matures. Joint S-F biomarkers have the inherent potential to model effectively the brain's maturation, fill the information gap in temporal brain atlases, and demonstrate how the brain's performance matures during the lifespan. This review presents the current state of knowledge on heterochronous and heterogeneous development of S-F links during the maturation period. The S-F relationship has been investigated in early-matured unimodal and prolonged-matured transmodal regions of the brain using a variety of structural and functional biomarkers and data acquisition modalities. Joint S-F unimodal studies have employed auditory and visual stimuli, while the main focus of joint S-F transmodal studies has been resting-state and cognitive experiments. However, nonsignificant associations between some structural and functional biomarkers and their maturation show that designing and developing effective S-F biomarkers is still a challenge in the field. Maturational characteristics of brain asymmetries have been poorly investigated by the joint S-F studies, and the results were partially inconsistent with previous nonjoint ones. The inherent complexity of the brain performance can be modeled using multifactorial and nonlinear techniques as promising methods to simulate the impact of age on S-F relations considering their analysis challenges.
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Affiliation(s)
- Roxana Namiranian
- Department of Biomedical Engineering, Faculty of Electrical Engineering, K. N. Toosi University of Technology, Tehran 16317-14191, Iran
| | - Sahar Rahimi Malakshan
- Department of Biomedical Engineering, Faculty of Electrical Engineering, K. N. Toosi University of Technology, Tehran 16317-14191, Iran
| | - Hamid Abrishami Moghaddam
- Department of Biomedical Engineering, Faculty of Electrical Engineering, K. N. Toosi University of Technology, Tehran 16317-14191, Iran.,Inserm UMR 1105, Université de Picardie Jules Verne, 80054 Amiens, France
| | - Ali Khadem
- Department of Biomedical Engineering, Faculty of Electrical Engineering, K. N. Toosi University of Technology, Tehran 16317-14191, Iran
| | - Reza Jafari
- Department of Electrical and Computer Engineering, Thompson Engineering Building, University of Western Ontario, London, ON N6A 5B9, Canada
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19
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Del Rio-Bermudez C, Blumberg MS. Sleep as a window on the sensorimotor foundations of the developing hippocampus. Hippocampus 2022; 32:89-97. [PMID: 33945190 PMCID: PMC9118132 DOI: 10.1002/hipo.23334] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/21/2021] [Indexed: 02/03/2023]
Abstract
The hippocampal formation plays established roles in learning, memory, and related cognitive functions. Recent findings also suggest that the hippocampus integrates sensory feedback from self-generated movements to modulate ongoing motor responses in a changing environment. Such findings support the view of Bland and Oddie (Behavioural Brain Research, 2001, 127, 119-136) that the hippocampus is a site of sensorimotor integration. In further support of this view, we review neurophysiological evidence in developing rats that hippocampal function is built on a sensorimotor foundation and that this foundation is especially evident early in development. Moreover, at those ages when the hippocampus is first establishing functional connectivity with distant sensory and motor structures, that connectivity is preferentially expressed during periods of active (or REM) sleep. These findings reinforce the notion that sleep, as the predominant state of early infancy, provides a critical context for sensorimotor development, including development of the hippocampus and its associated network.
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Affiliation(s)
| | - Mark S Blumberg
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA.,Iowa Neuroscience Institute, University of Iowa, Iowa City, Iowa, USA
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20
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Loukas S, Lordier L, Meskaldji DE, Filippa M, Sa de Almeida J, Van De Ville D, Hüppi PS. Musical memories in newborns: A resting-state functional connectivity study. Hum Brain Mapp 2022; 43:647-664. [PMID: 34738276 PMCID: PMC8720188 DOI: 10.1002/hbm.25677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/28/2022] Open
Abstract
Music is known to induce emotions and activate associated memories, including musical memories. In adults, it is well known that music activates both working memory and limbic networks. We have recently discovered that as early as during the newborn period, familiar music is processed differently from unfamiliar music. The present study evaluates music listening effects at the brain level in newborns, by exploring the impact of familiar or first‐time music listening on the subsequent resting‐state functional connectivity in the brain. Using a connectome‐based framework, we describe resting‐state functional connectivity (RS‐FC) modulation after music listening in three groups of newborn infants, in preterm infants exposed to music during their neonatal‐intensive‐care‐unit (NICU) stay, in control preterm, and full‐term infants. We observed modulation of the RS‐FC between brain regions known to be implicated in music and emotions processing, immediately following music listening in all newborn infants. In the music exposed group, we found increased RS‐FC between brain regions known to be implicated in familiar and emotionally arousing music and multisensory processing, and therefore implying memory retrieval and associative memory. We demonstrate a positive correlation between the occurrence of the prior music exposure and increased RS‐FC in brain regions implicated in multisensory and emotional processing, indicating strong engagement of musical memories; and a negative correlation with the Default Mode Network, indicating disengagement due to the aforementioned cognitive processing. Our results describe the modulatory effect of music listening on brain RS‐FC that can be linked to brain correlates of musical memory engrams in preterm infants.
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Affiliation(s)
- Serafeim Loukas
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland.,Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Lara Lordier
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Djalel-Eddine Meskaldji
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland.,Institute of Mathematics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Manuela Filippa
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Joana Sa de Almeida
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
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21
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Hermans T, Thewissen L, Gewillig M, Cools B, Jansen K, Pillay K, De Vos M, Van Huffel S, Naulaers G, Dereymaeker A. Functional brain maturation and sleep organisation in neonates with congenital heart disease. Eur J Paediatr Neurol 2022; 36:115-122. [PMID: 34954621 DOI: 10.1016/j.ejpn.2021.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/23/2021] [Accepted: 12/11/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Neonates with Congenital Heart Disease (CHD) have structural delays in brain development. To evaluate whether functional brain maturation and sleep-wake physiology is also disturbed, the Functional Brain Age (FBA) and sleep organisation on EEG during the neonatal period is investigated. METHODS We compared 15 neonates with CHD who underwent multichannel EEG with healthy term newborns of the same postmenstrual age, including subgroup analysis for d-Transposition of the Great Arteries (d-TGA) (n = 8). To estimate FBA, a prediction tool using quantitative EEG features as input, was applied. Second, the EEG was automatically classified into the 4 neonatal sleep stages. Neonates with CHD underwent neurodevelopmental testing using the Bayley Scale of Infant Development-III at 24 months. RESULTS Preoperatively, the FBA was delayed in CHD infants and more so in d-TGA infants. The FBA was positively correlated with motor scores. Sleep organisation was significantly altered in neonates with CHD. The duration of the sleep cycle and the proportion of Active Sleep Stage 1 was decreased, again more marked in the d-TGA infants. Neonates with d-TGA spent less time in High Voltage Slow Wave Sleep and more in Tracé Alternant compared to healthy terms. Both FBA and sleep organisation normalised postoperatively. The duration of High Voltage Slow Wave Sleep remained positively correlated with motor scores in d-TGA infants. INTERPRETATION Altered early brain function and sleep is present in neonates with CHD. These results are intruiging, as inefficient neonatal sleep has been linked with adverse long-term outcome. Identifying how these rapid alterations in brain function are mitigated through improvements in cerebral oxygenation, surgery, drugs and nutrition may have relevance for clinical practice and outcome.
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Affiliation(s)
- Tim Hermans
- Division STADIUS, Department of Electrical Engineering (ESAT), KU Leuven (University of Leuven), Leuven, Belgium
| | - Liesbeth Thewissen
- Department of Development and Regeneration, Neonatal Intensive Care Unit, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Marc Gewillig
- Department of Cardiovascular Science, Paediatric Cardiology, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Bjorn Cools
- Department of Cardiovascular Science, Paediatric Cardiology, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Child Neurology, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Kirubin Pillay
- Department of Paediatrics, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Maarten De Vos
- Division STADIUS, Department of Electrical Engineering (ESAT), KU Leuven (University of Leuven), Leuven, Belgium
| | - Sabine Van Huffel
- Division STADIUS, Department of Electrical Engineering (ESAT), KU Leuven (University of Leuven), Leuven, Belgium
| | - Gunnar Naulaers
- Department of Development and Regeneration, Neonatal Intensive Care Unit, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Anneleen Dereymaeker
- Department of Development and Regeneration, Neonatal Intensive Care Unit, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium.
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22
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Rajagopalan V, Deoni S, Panigrahy A, Thomason ME. Is fetal MRI ready for neuroimaging prime time? An examination of progress and remaining areas for development. Dev Cogn Neurosci 2021; 51:100999. [PMID: 34391003 PMCID: PMC8365463 DOI: 10.1016/j.dcn.2021.100999] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/08/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022] Open
Abstract
A major challenge in designing large-scale, multi-site studies is developing a core, scalable protocol that retains the innovation of scientific advances while also lending itself to the variability in experience and resources across sites. In the development of a common Healthy Brain and Child Development (HBCD) protocol, one of the chief questions is "is fetal MRI ready for prime-time?" While there is agreement about the value of prenatal data obtained non-invasively through MRI, questions about practicality abound. There has been rapid progress over the past years in fetal and placental MRI methodology but there is uncertainty about whether the gains afforded outweigh the challenges in supporting fetal MRI protocols at scale. Here, we will define challenges inherent in building a common protocol across sites with variable expertise and will propose a tentative framework for evaluation of design decisions. We will compare and contrast various design considerations for both normative and high-risk populations, in the setting of the post-COVID era. We will conclude with articulation of the benefits of overcoming these challenges and would lend to the primary questions articulated in the HBCD initiative.
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Affiliation(s)
- Vidya Rajagopalan
- Department of Radiology, Keck School of Medicine, University of Southern California and Childrens Hospital of Los Angeles, United States.
| | - Sean Deoni
- Department of Pediatrics, Memorial Hospital of Rhode Island, United States
| | - Ashok Panigrahy
- Department of Radiology, University of Pittsburgh Medical School and Children's Hospital of Pittsburgh, United States
| | - Moriah E Thomason
- Departments of Child and Adolescent Psychiatry and Population Health, Hassenfeld Children's Hospital at NYU Langone, United States
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23
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Tokariev A, Breakspear M, Videman M, Stjerna S, Scholtens LH, van den Heuvel MP, Cocchi L, Vanhatalo S. Impact of In Utero Exposure to Antiepileptic Drugs on Neonatal Brain Function. Cereb Cortex 2021; 32:2385-2397. [PMID: 34585721 PMCID: PMC9157298 DOI: 10.1093/cercor/bhab338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 12/27/2022] Open
Abstract
In utero brain development underpins brain health across the lifespan but is vulnerable to physiological and pharmacological perturbation. Here, we show that antiepileptic medication during pregnancy impacts on cortical activity during neonatal sleep, a potent indicator of newborn brain health. These effects are evident in frequency-specific functional brain networks and carry prognostic information for later neurodevelopment. Notably, such effects differ between different antiepileptic drugs that suggest neurodevelopmental adversity from exposure to antiepileptic drugs and not maternal epilepsy per se. This work provides translatable bedside metrics of brain health that are sensitive to the effects of antiepileptic drugs on postnatal neurodevelopment and carry direct prognostic value.
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Affiliation(s)
- Anton Tokariev
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Michael Breakspear
- School of Psychology, College of Engineering, Science and the Environment, University of Newcastle, Callaghan, New South Wales, Australia.,School of Medicine and Public Health, College of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Mari Videman
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Department of Pediatric Neurology, New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Susanna Stjerna
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Lianne H Scholtens
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Martijn P van den Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Child Psychiatry, Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Luca Cocchi
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sampsa Vanhatalo
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
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24
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Mojtahedi N, Kovalchuk Y, Böttcher A, Garaschuk O. Stable behavioral state-specific large scale activity patterns in the developing cortex of neonates. Cell Calcium 2021; 98:102448. [PMID: 34375923 DOI: 10.1016/j.ceca.2021.102448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 01/31/2023]
Abstract
Intrinsic neuronal activity is a hallmark of the developing brain. In rodents, a handful of such activities were described in different cortical areas but the unifying macroscopic perspective is still lacking. Here we combined large-scale in vivo Ca2+ imaging of the dorsal cortex in non-anesthetized neonatal mice with mathematical analyses to reveal unique behavioral state-specific maps of intrinsic activity. These maps were remarkably stable over time within and across experiments and used patches of correlated activity with little hemispheric symmetry as well as stationary and propagating waves as building blocks. Importantly, the maps recorded during motion and rest were almost inverse, with frontoparietal areas active during motion and posterior-lateral areas active at rest. The retrosplenial cortex engaged in both resting- and motion-related activities via functional long-range connections with respective cortical areas. The data obtained bind different region-specific activity patterns described so far into a single consistent picture and set the stage for future inactivation studies, probing the exact function of this complex activity pattern for cortical wiring in neonates.
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Affiliation(s)
- Nima Mojtahedi
- Institute of Physiology, Department of Neurophysiology, Eberhard Karls University of Tübingen, 72074 Tübingen, Germany
| | - Yury Kovalchuk
- Institute of Physiology, Department of Neurophysiology, Eberhard Karls University of Tübingen, 72074 Tübingen, Germany
| | - Alexander Böttcher
- Werner Reichardt Centre for Integrative Neuroscience, University of Tübingen, 72076 Tübingen, Germany
| | - Olga Garaschuk
- Institute of Physiology, Department of Neurophysiology, Eberhard Karls University of Tübingen, 72074 Tübingen, Germany.
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25
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Martini FJ, Guillamón-Vivancos T, Moreno-Juan V, Valdeolmillos M, López-Bendito G. Spontaneous activity in developing thalamic and cortical sensory networks. Neuron 2021; 109:2519-2534. [PMID: 34293296 DOI: 10.1016/j.neuron.2021.06.026] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/05/2021] [Accepted: 06/23/2021] [Indexed: 11/19/2022]
Abstract
Developing sensory circuits exhibit different patterns of spontaneous activity, patterns that are related to the construction and refinement of functional networks. During the development of different sensory modalities, spontaneous activity originates in the immature peripheral sensory structures and in the higher-order central structures, such as the thalamus and cortex. Certainly, the perinatal thalamus exhibits spontaneous calcium waves, a pattern of activity that is fundamental for the formation of sensory maps and for circuit plasticity. Here, we review our current understanding of the maturation of early (including embryonic) patterns of spontaneous activity and their influence on the assembly of thalamic and cortical sensory networks. Overall, the data currently available suggest similarities between the developmental trajectory of brain activity in experimental models and humans, which in the future may help to improve the early diagnosis of developmental disorders.
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Affiliation(s)
- Francisco J Martini
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas (UMH-CSIC), Sant Joan d'Alacant, Spain.
| | - Teresa Guillamón-Vivancos
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas (UMH-CSIC), Sant Joan d'Alacant, Spain
| | - Verónica Moreno-Juan
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas (UMH-CSIC), Sant Joan d'Alacant, Spain
| | - Miguel Valdeolmillos
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas (UMH-CSIC), Sant Joan d'Alacant, Spain
| | - Guillermina López-Bendito
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas (UMH-CSIC), Sant Joan d'Alacant, Spain.
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26
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Dubois J, Alison M, Counsell SJ, Hertz‐Pannier L, Hüppi PS, Benders MJ. MRI of the Neonatal Brain: A Review of Methodological Challenges and Neuroscientific Advances. J Magn Reson Imaging 2021; 53:1318-1343. [PMID: 32420684 PMCID: PMC8247362 DOI: 10.1002/jmri.27192] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 01/04/2023] Open
Abstract
In recent years, exploration of the developing brain has become a major focus for researchers and clinicians in an attempt to understand what allows children to acquire amazing and unique abilities, as well as the impact of early disruptions (eg, prematurity, neonatal insults) that can lead to a wide range of neurodevelopmental disorders. Noninvasive neuroimaging methods such as MRI are essential to establish links between the brain and behavioral changes in newborns and infants. In this review article, we aim to highlight recent and representative studies using the various techniques available: anatomical MRI, quantitative MRI (relaxometry, diffusion MRI), multiparametric approaches, and functional MRI. Today, protocols use 1.5 or 3T MRI scanners, and specialized methodologies have been put in place for data acquisition and processing to address the methodological challenges specific to this population, such as sensitivity to motion. MR sequences must be adapted to the brains of newborns and infants to obtain relevant good soft-tissue contrast, given the small size of the cerebral structures and the incomplete maturation of tissues. The use of age-specific image postprocessing tools is also essential, as signal and contrast differ from the adult brain. Appropriate methodologies then make it possible to explore multiple neurodevelopmental mechanisms in a precise way, and assess changes with age or differences between groups of subjects, particularly through large-scale projects. Although MRI measurements only indirectly reflect the complex series of dynamic processes observed throughout development at the molecular and cellular levels, this technique can provide information on brain morphology, structural connectivity, microstructural properties of gray and white matter, and on the functional architecture. Finally, MRI measures related to clinical, behavioral, and electrophysiological markers have a key role to play from a diagnostic and prognostic perspective in the implementation of early interventions to avoid long-term disabilities in children. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Jessica Dubois
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Marianne Alison
- University of ParisNeuroDiderot, INSERM,ParisFrance
- Department of Pediatric RadiologyAPHP, Robert‐Debré HospitalParisFrance
| | - Serena J. Counsell
- Centre for the Developing BrainSchool of Biomedical Engineering & Imaging Sciences, King's College LondonLondonUK
| | - Lucie Hertz‐Pannier
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Petra S. Hüppi
- Division of Development and Growth, Department of Woman, Child and AdolescentUniversity Hospitals of GenevaGenevaSwitzerland
| | - Manon J.N.L. Benders
- Department of NeonatologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
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27
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Aita M, De Clifford Faugère G, Lavallée A, Feeley N, Stremler R, Rioux É, Proulx MH. Effectiveness of interventions on early neurodevelopment of preterm infants: a systematic review and meta-analysis. BMC Pediatr 2021; 21:210. [PMID: 33926417 PMCID: PMC8082967 DOI: 10.1186/s12887-021-02559-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As preterm infants' neurodevelopment is shaped by NICU-related factors during their hospitalization, it is essential to evaluate which interventions are more beneficial for their neurodevelopment at this specific time. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of interventions initiated during NICU hospitalization on preterm infants' early neurodevelopment during their hospitalization and up to two weeks corrected age (CA). METHODS This systematic review referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines and was registered in PROSPERO (CRD42017047072). We searched CINAHL, MEDLINE, PubMed, EMBASE (OVID), Cochrane Systematic Reviews, CENTRAL, and Web of Science from 2002 to February 2020 and included randomized controlled/clinical trials conducted with preterm infants born between 24 and 366/7 weeks of gestation. All types of interventions instigated during NICU hospitalization were included. Two independent reviewers performed the study selection, data extraction, assessment of risks of bias and quality of evidence. RESULTS Findings of 12 studies involving 901 preterm infants were synthesized. We combined three studies in a meta-analysis showing that compared to standard care, the NIDCAP intervention is effective in improving preterm infants' neurobehavioral and neurological development at two weeks CA. We also combined two other studies in a meta-analysis indicating that parental participation did not significantly improve preterm infants' neurobehavioral development during NICU hospitalization. For all other interventions (i.e., developmental care, sensory stimulation, music and physical therapy), the synthesis of results shows that compared to standard care or other types of comparators, the effectiveness was either controversial or partially effective. CONCLUSIONS The overall quality of evidence was rated low to very low. Future studies are needed to identify interventions that are the most effective in promoting preterm infants' early neurodevelopment during NICU hospitalization or close to term age. Interventions should be appropriately designed to allow comparison with previous studies and a combination of different instruments could provide a more global assessment of preterm infants' neurodevelopment and thus allow for comparisons across studies. TRIAL REGISTRATION Prospero CRD42017047072 .
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Affiliation(s)
- Marilyn Aita
- Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, Montréal, QC, H3C 3J7, Canada.
- CHU Sainte-Justine Research Centre, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.
- Quebec Network on Nursing Intervention Research, PO Box 6128, Centre-ville, Montréal, QC, H3C 3J7, Canada.
| | - Gwenaëlle De Clifford Faugère
- Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, Montréal, QC, H3C 3J7, Canada
- CHU Sainte-Justine Research Centre, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, Montréal, QC, H3C 3J7, Canada
- CHU Sainte-Justine Research Centre, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Nancy Feeley
- Quebec Network on Nursing Intervention Research, PO Box 6128, Centre-ville, Montréal, QC, H3C 3J7, Canada
- Ingram School of Nursing, McGill University, 680 Rue Sherbrooke Ouest #1800, Montréal, QC, H3A 2M7, Canada
- Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada
- Hospital for Sick Children (SickKids), 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Émilie Rioux
- Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, Montréal, QC, H3C 3J7, Canada
- Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada
| | - Marie-Hélène Proulx
- Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, Montréal, QC, H3C 3J7, Canada
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28
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De Asis-Cruz J, Andersen N, Kapse K, Khrisnamurthy D, Quistorff J, Lopez C, Vezina G, Limperopoulos C. Global Network Organization of the Fetal Functional Connectome. Cereb Cortex 2021; 31:3034-3046. [PMID: 33558873 DOI: 10.1093/cercor/bhaa410] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/11/2020] [Accepted: 12/11/2020] [Indexed: 12/21/2022] Open
Abstract
Recent advances in brain imaging have enabled non-invasive in vivo assessment of the fetal brain. Characterizing brain development in healthy fetuses provides baseline measures for identifying deviations in brain function in high-risk clinical groups. We examined 110 resting state MRI data sets from fetuses at 19 to 40 weeks' gestation. Using graph-theoretic techniques, we characterized global organizational features of the fetal functional connectome and their prenatal trajectories. Topological features related to network integration (i.e., global efficiency) and segregation (i.e., clustering) were assessed. Fetal networks exhibited small-world topology, showing high clustering and short average path length relative to reference networks. Likewise, fetal networks' quantitative small world indices met criteria for small-worldness (σ > 1, ω = [-0.5 0.5]). Along with this, fetal networks demonstrated global and local efficiency, economy, and modularity. A right-tailed degree distribution, suggesting the presence of central areas that are more highly connected to other regions, was also observed. Metrics, however, were not static during gestation; measures associated with segregation-local efficiency and modularity-decreased with advancing gestational age. Altogether, these suggest that the neural circuitry underpinning the brain's ability to segregate and integrate information exists as early as the late 2nd trimester of pregnancy and reorganizes during the prenatal period. Significance statement. Mounting evidence for the fetal origins of some neurodevelopmental disorders underscores the importance of identifying features of healthy fetal brain functional development. Alterations in prenatal brain connectomics may serve as early markers for identifying fetal-onset neurodevelopmental disorders, which in turn provide improved surveillance of at-risk fetuses and support the initiation of early interventions.
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Affiliation(s)
- Josepheen De Asis-Cruz
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Nicole Andersen
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Kushal Kapse
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | | | - Jessica Quistorff
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Catherine Lopez
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, 111 Michigan Ave NW, Washington DC 20010
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29
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Relationship Between Early Functional and Structural Brain Developments and Brain Injury in Preterm Infants. THE CEREBELLUM 2021; 20:556-568. [PMID: 33532923 PMCID: PMC8360868 DOI: 10.1007/s12311-021-01232-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/07/2021] [Indexed: 02/07/2023]
Abstract
Background Recent studies explored the relationship between early brain function and brain morphology, based on the hypothesis that increased brain activity can positively affect structural brain development and that excitatory neuronal activity stimulates myelination. Objective To investigate the relationship between maturational features from early and serial aEEGs after premature birth and MRI metrics characterizing structural brain development and injury, measured around 30weeks postmenstrual age (PMA) and at term. Moreover, we aimed to verify whether previously developed maturational EEG features are related with PMA. Design/Methods One hundred six extremely preterm infants received bedside aEEGs during the first 72h and weekly until week 5. 3T-MRIs were performed at 30weeks PMA and at term. Specific features were extracted to assess EEG maturation: (1) the spectral content, (2) the continuity [percentage of spontaneous activity transients (SAT%) and the interburst interval (IBI)], and (3) the complexity. Automatic MRI segmentation to assess volumes and MRI score was performed. The relationship between the maturational EEG features and MRI measures was investigated. Results Both SAT% and EEG complexity were correlated with PMA. IBI was inversely associated with PMA. Complexity features had a positive correlation with the cerebellar size at 30weeks, while event-based measures were related to the cerebellar size at term. Cerebellar width, cortical grey matter, and total brain volume at term were inversely correlated with the relative power in the higher frequency bands. Conclusions The continuity and complexity of the EEG steadily increase with increasing postnatal age. Increasing complexity and event-based features are associated with cerebellar size, a structure with enormous development during preterm life. Brain activity is important for later structural brain development. Supplementary Information The online version contains supplementary material available at 10.1007/s12311-021-01232-z.
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Kidokoro H. Delta brushes are not just a hallmark of EEG in human preterm infants. Pediatr Int 2021; 63:130-136. [PMID: 32749014 DOI: 10.1111/ped.14420] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 07/28/2020] [Indexed: 02/02/2023]
Abstract
The delta brush, a well-known characteristic waveform of the human preterm electroencephalogram, represents spontaneous electrical activity. Recent experimental animal model evidence suggests that delta brushes are not only spontaneous intrinsic activity but are also evoked by external sensory stimulation or spontaneous movement. They are also likely to reflect the activity of subplate neurons, which play an important role in early brain development and network organization. Here, evidence about delta brushes in human preterm electroencephalogram is provided along with future perspectives.
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Affiliation(s)
- Hiroyuki Kidokoro
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Luhmann HJ, Fukuda A. Can we understand human brain development from experimental studies in rodents? Pediatr Int 2020; 62:1139-1144. [PMID: 32531857 DOI: 10.1111/ped.14339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/05/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022]
Abstract
Animal models are needed to gain an understanding of the genetic, molecular, cellular, and network mechanisms of human brain development. In rodents, a large spectrum of in vitro and in vivo approaches allows detailed analyses and specific experimental manipulations for studying the sequence of developmental steps in corticogenesis. Neurogenesis, neuronal migration, cellular differentiation, programmed cell death, synaptogenesis, and myelination are surprisingly similar in the rodent cortex and the human cortex. Spontaneous EEG activity in the pre- and early postnatal human cortex resembles the activity patterns recorded with intracortical multi-electrode arrays in newborn rodents. This early activity is generated by thalamic activation of a subplate-driven local network coupled via gap junctions, which controls the development of cortical columns and the spatio-temporal pattern of apoptosis. Disturbances of this activity may induce disturbances in cortical structure and function leading to neurological and psychiatric disorders.
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Affiliation(s)
- Heiko J Luhmann
- Institute of Physiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Atsuo Fukuda
- Department of Physiology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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Sun H, Gonzalez F, McQuillen PS. Caffeine Restores Background EEG Activity Independent of Infarct Reduction after Neonatal Hypoxic Ischemic Brain Injury. Dev Neurosci 2020; 42:72-82. [PMID: 32810862 DOI: 10.1159/000509365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/10/2020] [Indexed: 12/19/2022] Open
Abstract
In human preterm newborns, caffeine increases brain activity and improves neurodevelopmental outcomes. In animal models of hypoxic ischemic brain injury, caffeine pretreatment reduces infarct volume. We studied the relationship between tissue neuroprotection and brain activity after injury to further understand caffeine neuroprotection. Rat dams received caffeine prior to birth or on postnatal day 3 (P3) through P16. Caffeine-treated and -untreated pups underwent the Vannucci procedure (unilateral carotid ligation, global hypoxia) on P2. A subset had EEG recordings. Brain hemispheric infarct volume was measured on P16. P2 hypoxic ischemia (HI) results in histologic brain injury (mean ± standard deviation infarct volume 10.3 ± 4.6%) and transient suppression of EEG activity. Caffeine pretreatment reduces brain injury (mean ± standard deviation infarct volume 1.6 ± 4.5%, p < 0.001) and improves amplitude-integrated EEG (aEEG) and EEG burst duration and amplitude. Caffeine treatment after HI does not reduce infarct volume (mean ± standard deviation 8.3 ± 4.1%, p = 1.0). However, caffeine posttreatment was equally effective at restoring aEEG amplitude and EEG burst duration and amplitude. Thus, caffeine supports brain background electrical activity independent of tissue neuroprotection.
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Affiliation(s)
- Haiyan Sun
- Institute of Pediatrics, Xuzhou Medical University, Xuzhou, China
| | - Fernando Gonzalez
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Patrick S McQuillen
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA,
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Fleiss B, Gressens P, Stolp HB. Cortical Gray Matter Injury in Encephalopathy of Prematurity: Link to Neurodevelopmental Disorders. Front Neurol 2020; 11:575. [PMID: 32765390 PMCID: PMC7381224 DOI: 10.3389/fneur.2020.00575] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/19/2020] [Indexed: 12/16/2022] Open
Abstract
Preterm-born infants frequently suffer from an array of neurological damage, collectively termed encephalopathy of prematurity (EoP). They also have an increased risk of presenting with a neurodevelopmental disorder (e.g., autism spectrum disorder; attention deficit hyperactivity disorder) later in life. It is hypothesized that it is the gray matter injury to the cortex, in addition to white matter injury, in EoP that is responsible for the altered behavior and cognition in these individuals. However, although it is established that gray matter injury occurs in infants following preterm birth, the exact nature of these changes is not fully elucidated. Here we will review the current state of knowledge in this field, amalgamating data from both clinical and preclinical studies. This will be placed in the context of normal processes of developmental biology and the known pathophysiology of neurodevelopmental disorders. Novel diagnostic and therapeutic tactics required integration of this information so that in the future we can combine mechanism-based approaches with patient stratification to ensure the most efficacious and cost-effective clinical practice.
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Affiliation(s)
- Bobbi Fleiss
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
- Université de Paris, NeuroDiderot, Inserm, Paris, France
- PremUP, Paris, France
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Pierre Gressens
- Université de Paris, NeuroDiderot, Inserm, Paris, France
- PremUP, Paris, France
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Helen B. Stolp
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
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Thomason ME. Development of Brain Networks In Utero: Relevance for Common Neural Disorders. Biol Psychiatry 2020; 88:40-50. [PMID: 32305217 PMCID: PMC7808399 DOI: 10.1016/j.biopsych.2020.02.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/05/2020] [Accepted: 02/05/2020] [Indexed: 01/27/2023]
Abstract
Magnetic resonance imaging, histological, and gene analysis approaches in living and nonliving human fetuses and in prematurely born neonates have provided insight into the staged processes of prenatal brain development. Increased understanding of micro- and macroscale brain network development before birth has spurred interest in understanding the relevance of prenatal brain development to common neurological diseases. Questions abound as to the sensitivity of the intrauterine brain to environmental programming, to windows of plasticity, and to the prenatal origin of disorders of childhood that involve disruptions in large-scale network connectivity. Much of the available literature on human prenatal neural development comes from cross-sectional or case studies that are not able to resolve the longitudinal consequences of individual variation in brain development before birth. This review will 1) detail specific methodologies for studying the human prenatal brain, 2) summarize large-scale human prenatal neural network development, integrating findings from across a variety of experimental approaches, 3) explore the plasticity of the early developing brain as well as potential sex differences in prenatal susceptibility, and 4) evaluate opportunities to link specific prenatal brain developmental processes to the forms of aberrant neural connectivity that underlie common neurological disorders of childhood.
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Affiliation(s)
- Moriah E Thomason
- Department of Child and Adolescent Psychiatry, Department of Population Health, and Neuroscience Institute, New York University Langone Health, New York, New York.
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35
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Stevenson NJ, Oberdorfer L, Tataranno ML, Breakspear M, Colditz PB, de Vries LS, Benders MJNL, Klebermass-Schrehof K, Vanhatalo S, Roberts JA. Automated cot-side tracking of functional brain age in preterm infants. Ann Clin Transl Neurol 2020; 7:891-902. [PMID: 32368863 PMCID: PMC7318094 DOI: 10.1002/acn3.51043] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/20/2020] [Indexed: 12/14/2022] Open
Abstract
Objective A major challenge in the care of preterm infants is the early identification of compromised neurological development. While several measures are routinely used to track anatomical growth, there is a striking lack of reliable and objective tools for tracking maturation of early brain function; a cornerstone of lifelong neurological health. We present a cot‐side method for measuring the functional maturity of the newborn brain based on routinely available neurological monitoring with electroencephalography (EEG). Methods We used a dataset of 177 EEG recordings from 65 preterm infants to train a multivariable prediction of functional brain age (FBA) from EEG. The FBA was validated on an independent set of 99 EEG recordings from 42 preterm infants. The difference between FBA and postmenstrual age (PMA) was evaluated as a predictor for neurodevelopmental outcome. Results The FBA correlated strongly with the PMA of an infant, with a median prediction error of less than 1 week. Moreover, individual babies follow well‐defined individual trajectories. The accuracy of the FBA applied to the validation set was statistically equivalent to the training set accuracy. In a subgroup of infants with repeated EEG recordings, a persistently negative predicted age difference was associated with poor neurodevelopmental outcome. Interpretation The FBA enables the tracking of functional neurodevelopment in preterm infants. This establishes proof of principle for growth charts for brain function, a new tool to assist clinical management and identify infants who will benefit most from early intervention.
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Affiliation(s)
- Nathan J Stevenson
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Lisa Oberdorfer
- Department of Pediatrics, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - Maria-Luisa Tataranno
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michael Breakspear
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia.,Priority Research Center for Mind and Brain, University of Newcastle, Newcastle, NSW, 2305, Australia
| | - Paul B Colditz
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD, 4029, Australia
| | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Katrin Klebermass-Schrehof
- Department of Pediatrics, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - Sampsa Vanhatalo
- Department of Children's Clinical Neurophysiology, BABA Center, Pediatric Research Center, Children's Hospital, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Finland
| | - James A Roberts
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
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Tataranno ML, Gui L, Hellström-Westas L, Toet M, Groenendaal F, Claessens NHP, Schuurmans J, Fellman V, Sävman K, de Vries LS, Huppi P, Benders MJNL. Morphine affects brain activity and volumes in preterms: An observational multi-center study. Early Hum Dev 2020; 144:104970. [PMID: 32276190 DOI: 10.1016/j.earlhumdev.2020.104970] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We hypothesized that morphine has a depressing effect on early brain activity, assessed using quantitative aEEG/EEG parameter and depressed activity will be associated with brain volumes at term in extremely preterm infants. STUDY DESIGN 174 preterm infants were enrolled in 3 European tertiary NICUs (mean GA:26 ± 1wks) and monitored during the first 72 h after birth with continuous 2 channel aEEG. Six epochs of aEEG recordings were selected and minimum amplitude of aEEG (min aEEG), percentage of time amplitude <5 μV (% of time < 5 μV), spontaneous activity transients (SATrate) and interSAT interval (ISI) were calculated. For infants receiving morphine, the cumulative morphine dosage was calculated. In a subgroup of 58 infants, good quality MRI at term equivalent age (TEA) and the cumulative morphine dose until TEA were available. The effects of morphine administration and cumulative dose on aEEG/EEG measures and on brain volumes were investigated. RESULTS Morphine administration had a significant effect on all quantitative aEEG/EEG measures, causing depression of early brain activity [longer ISI (β 2.900), reduced SAT rate (β -1.386), decreased min aEEG (β -0.782), and increased % of time < 5 μV (β 14.802)] in all epochs. A significant effect of GA and postnatal age on aEEG/EEG measures was observed. Cumulative morphine dose until TEA had a significant negative effect on total brain volume (TBV) (β -8.066) and cerebellar volume (β -1.080). CONCLUSIONS Administration of sedative drugs should be considered when interpreting aEEG/EEG together with the negative dose dependent morphine impact on brain development.
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Affiliation(s)
- M L Tataranno
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - L Gui
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - L Hellström-Westas
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - M Toet
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - F Groenendaal
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - N H P Claessens
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - J Schuurmans
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - V Fellman
- Lund University, Department of Clinical Sciences, Lund, Pediatrics, Skåne University Hospital, Lund, Sweden
| | - K Sävman
- Department of Pediatrics, Perinatal Center, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - L S de Vries
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - P Huppi
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - M J N L Benders
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands.
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Mayer M, Arrizabalaga O, Ciba M, Schroeder IS, Ritter S, Thielemann C. Novel in vitro assay to investigate radiation induced changes in the functionality of human embryonic stem cell-derived neurospheres. Neurotoxicology 2020; 79:40-47. [PMID: 32320710 DOI: 10.1016/j.neuro.2020.04.003] [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: 08/12/2019] [Revised: 03/31/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
Ionizing radiation (IR) is increasingly used for diagnostics and therapy of severe brain diseases. However, IR also has adverse effects on the healthy brain tissue, particularly on the neuronal network. This is true for adults but even more pronounced in the developing brain of unborn and pediatric patients. Epidemiological studies on children receiving radiotherapy showed an increased risk for cognitive decline ranging from mild deficits in academic functioning to severe late effects in intellectual ability and language as a consequence of altered neuronal development and connectivity. To provide a comprehensive approach for the analysis of radiation-induced alterations in human neuronal functionality, we developed an in vitro assay by combining microelectrode array (MEA) analyses and human embryonic stem cell (hESC) derived three-dimensional neurospheres (NS). In our proof of principle study, we irradiated hESC with 1 Gy X-rays and let them spontaneously differentiate into neurons within NS. After the onset of neuronal activity, we recorded and analyzed the activity pattern of the developing neuronal networks. The network activity in NS derived from irradiated hESC was significantly reduced, whereas no differences in molecular endpoints such as cell proliferation and transcript or protein expression analyses were found. Thus, the combination of MEA analysis with a 3D model for neuronal functionality revealed radiation sequela that otherwise would not have been detected. We therefore strongly suggest combining traditional biomolecular methods with the new functional assay presented in this work to improve the risk assessment for IR-induced effects on the developing brain.
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Affiliation(s)
- Margot Mayer
- TH Aschaffenburg University of Applied Sciences, BioMEMS Lab, Aschaffenburg, Germany.
| | - Onetsine Arrizabalaga
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Division, Darmstadt, Germany.
| | - Manuel Ciba
- TH Aschaffenburg University of Applied Sciences, BioMEMS Lab, Aschaffenburg, Germany.
| | - Insa S Schroeder
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Division, Darmstadt, Germany.
| | - Sylvia Ritter
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Division, Darmstadt, Germany.
| | - Christiane Thielemann
- TH Aschaffenburg University of Applied Sciences, BioMEMS Lab, Aschaffenburg, Germany.
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Del Rio-Bermudez C, Kim J, Sokoloff G, Blumberg MS. Active Sleep Promotes Coherent Oscillatory Activity in the Cortico-Hippocampal System of Infant Rats. Cereb Cortex 2020; 30:2070-2082. [PMID: 31922194 PMCID: PMC7175014 DOI: 10.1093/cercor/bhz223] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 08/09/2019] [Accepted: 08/28/2019] [Indexed: 12/12/2022] Open
Abstract
Active sleep (AS) provides a unique developmental context for synchronizing neural activity within and between cortical and subcortical structures. In week-old rats, sensory feedback from myoclonic twitches, the phasic motor activity that characterizes AS, promotes coherent theta oscillations (4-8 Hz) in the hippocampus and red nucleus, a midbrain motor structure. Sensory feedback from twitches also triggers rhythmic activity in sensorimotor cortex in the form of spindle bursts, which are brief oscillatory events composed of rhythmic components in the theta, alpha/beta (8-20 Hz), and beta2 (20-30 Hz) bands. Here we ask whether one or more of these spindle-burst components are communicated from sensorimotor cortex to hippocampus. By recording simultaneously from whisker barrel cortex and dorsal hippocampus in 8-day-old rats, we show that AS, but not other behavioral states, promotes cortico-hippocampal coherence specifically in the beta2 band. By cutting the infraorbital nerve to prevent the conveyance of sensory feedback from whisker twitches, cortical-hippocampal beta2 coherence during AS was substantially reduced. These results demonstrate the necessity of sensory input, particularly during AS, for coordinating rhythmic activity between these two developing forebrain structures.
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Affiliation(s)
- Carlos Del Rio-Bermudez
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Jangjin Kim
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Greta Sokoloff
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, USA
| | - Mark S Blumberg
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, USA
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA 52245, USA
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Andreoli E, Petrenko V, Constanthin PE, Contestabile A, Bocchi R, Egervari K, Quairiaux C, Salmon P, Kiss JZ. Transplanted Embryonic Neurons Improve Functional Recovery by Increasing Activity in Injured Cortical Circuits. Cereb Cortex 2020; 30:4708-4725. [PMID: 32266929 DOI: 10.1093/cercor/bhaa075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/07/2020] [Accepted: 03/06/2020] [Indexed: 12/11/2022] Open
Abstract
Transplantation of appropriate neuronal precursors after injury is a promising strategy to reconstruct cortical circuits, but the efficiency of these approaches remains limited. Here, we applied targeted apoptosis to selectively ablate layer II/III pyramidal neurons in the rat juvenile cerebral cortex and attempted to replace lost neurons with their appropriate embryonic precursors by transplantation. We demonstrate that grafted precursors do not migrate to replace lost neurons but form vascularized clusters establishing reciprocal synaptic contacts with host networks and show functional integration. These heterotopic neuronal clusters significantly enhance the activity of the host circuits without causing epileptic seizures and attenuate the apoptotic injury-induced functional deficits in electrophysiological and behavioral tests. Chemogenetic activation of grafted neurons further improved functional recovery, and the persistence of the graft was necessary for maintaining restored functions in adult animals. Thus, implanting neuronal precursors capable to form synaptically integrated neuronal clusters combined with activation-based approaches represents a useful strategy for helping long-term functional recovery following brain injury.
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Affiliation(s)
- Evgenia Andreoli
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Volodymyr Petrenko
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Paul Eugène Constanthin
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Alessandro Contestabile
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Riccardo Bocchi
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Kristof Egervari
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Charles Quairiaux
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Patrick Salmon
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Jozsef Zoltan Kiss
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
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Jannesari M, Saeedi A, Zare M, Ortiz-Mantilla S, Plenz D, Benasich AA. Stability of neuronal avalanches and long-range temporal correlations during the first year of life in human infants. Brain Struct Funct 2020; 225:1169-1183. [PMID: 32095901 PMCID: PMC7166209 DOI: 10.1007/s00429-019-02014-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 06/26/2019] [Indexed: 11/27/2022]
Abstract
During infancy, the human brain rapidly expands in size and complexity as neural networks mature and new information is incorporated at an accelerating pace. Recently, it was shown that single-electrode EEG in preterms at birth exhibits scale-invariant intermittent bursts. Yet, it is currently not known whether the normal infant brain, in particular, the cortex, maintains a distinct dynamical state during development that is characterized by scale-invariant spatial as well as temporal aspects. Here we employ dense-array EEG recordings acquired from the same infants at 6 and 12 months of age to characterize brain activity during an auditory odd-ball task. We show that suprathreshold events organize as spatiotemporal clusters whose size and duration are power-law distributed, the hallmark of neuronal avalanches. Time series of local suprathreshold EEG events display significant long-range temporal correlations (LRTCs). No differences were found between 6 and 12 months, demonstrating stability of avalanche dynamics and LRTCs during the first year after birth. These findings demonstrate that the infant brain is characterized by distinct spatiotemporal dynamical aspects that are in line with expectations of a critical cortical state. We suggest that critical state dynamics, which theory and experiments have shown to be beneficial for numerous aspects of information processing, are maintained by the infant brain to process an increasingly complex environment during development.
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Affiliation(s)
- Mostafa Jannesari
- School of Computer Science, Institute for Research in Fundamental Sciences (IPM), 70 Lavasani Avenue, Tehran, 19395, Iran
| | - Alireza Saeedi
- Department of Physiology of Cognitive Processes, Max-Planck-Institute for Biological Cybernetics, 72076, Tübingen, Germany
| | - Marzieh Zare
- School of Computer Science, Institute for Research in Fundamental Sciences (IPM), 70 Lavasani Avenue, Tehran, 19395, Iran.
| | - Silvia Ortiz-Mantilla
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, 197 University Avenue, Newark, NJ, 07102, USA
| | - Dietmar Plenz
- Section on Critical Brain Dynamics, Laboratory of Systems Neuroscience, National Institute of Mental Health, Porter Neuroscience Research Center, MSC 3735, Bethesda, MD, 20892, USA
| | - April A Benasich
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, 197 University Avenue, Newark, NJ, 07102, USA
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Altered Cortical Gyrification in Adults Who Were Born Very Preterm and Its Associations With Cognition and Mental Health. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:640-650. [PMID: 32198001 DOI: 10.1016/j.bpsc.2020.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND The last trimester of pregnancy is a critical period for the establishment of cortical gyrification, and altered folding patterns have been reported following very preterm birth (< 33 weeks of gestation) in childhood and adolescence. However, research is scant on the persistence of such alterations in adulthood and their associations with cognitive and psychiatric outcomes. METHODS We studied 79 very preterm and 81 age-matched full-term control adults. T1-weighted magnetic resonance images were used to measure a local gyrification index (LGI), indicating the degree of folding across multiple vertices of the reconstructed cortical surface. Group and group-by-sex LGI differences were assessed by means of per-vertex adjustment for cortical thickness and overall intracranial volume. Within-group correlations were also computed between LGI and functional outcomes, including general intelligence (IQ) and psychopathology. RESULTS Very preterm adults had significantly reduced LGI in extensive cortical regions encompassing the frontal, anterior temporal, and occipitoparietal lobes. Alterations in lateral fronto-temporal-parietal and medial occipitoparietal regions were present in both men and women, although men showed more extensive alterations. In both very preterm and control adults, higher LGI was associated with higher IQ and lower psychopathology scores, with the spatial distribution of these associations substantially differing between the two groups. CONCLUSIONS Very preterm adults' brains are characterized by significant and widespread local hypogyria, and these alterations might be implicated in cognitive and psychiatric outcomes. Gyrification reflects an early developmental process and provides a fingerprint for very preterm birth.
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Ansari AH, De Wel O, Pillay K, Dereymaeker A, Jansen K, Van Huffel S, Naulaers G, De Vos M. A convolutional neural network outperforming state-of-the-art sleep staging algorithms for both preterm and term infants. J Neural Eng 2020; 17:016028. [PMID: 31689694 DOI: 10.1088/1741-2552/ab5469] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To classify sleep states using electroencephalogram (EEG) that reliably works over a wide range of preterm ages, as well as term age. APPROACH A convolutional neural network is developed to perform 2- and 4-class sleep classification in neonates. The network takes as input an 8-channel 30 s EEG segment and outputs the sleep state probabilities. Apart from simple downsampling of the input and smoothing of the output, the suggested network is an end-to-end algorithm that avoids the need for hand-crafted feature selection or complex pre/post processing steps. To train and test this method, 113 EEG recordings from 42 infants are used. MAIN RESULTS For quiet sleep detection (the 2-class problem), mean kappa between the network estimate and the ground truth annotated by EEG human experts is 0.76. The sensitivity and specificity are 90% and 88%, respectively. For 4-class classification, mean kappa is 0.64. The averaged sensitivity and specificity (1 versus all) respectively equal 72% and 91%. The results outperform current state-of-the-art methods for which kappa ranges from 0.66 to 0.70 in preterm and from 0.51 to 0.61 in term infants, based on training and testing using the same database. SIGNIFICANCE The proposed method has the highest reported accuracy for EEG sleep state classification for both preterm and term age neonates.
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Affiliation(s)
- Amir H Ansari
- Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Belgium. imec, Leuven, Belgium
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Al Hajjar Y, Al Hajjar AESA, Daya B, Chauvet P. Intelligent Models to Predict the Prognosis of Premature Neonates According to Their EEG Signals. COGNITIVE ANALYTICS 2020:830-840. [DOI: 10.4018/978-1-7998-2460-2.ch043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
The aim of this paper is to find the best intelligent model that allows predicting the future of premature newborns according to their electroencephalogram (EEG). EEG is a signal that measures the electrical activity of the brain. In this paper, the authors used a dataset of 397 EEG records detected at birth of premature newborns and their classification by doctors two years later: normal, sick or risky. They executed machine learning on this dataset using several intelligent models such as multiple linear regression, linear discriminant analysis, artificial neural network and decision tree. They used 14 parameters concerning characteristics extracted from EEG records that affect the prognosis of the newborn. Then, they presented a complete comparative study between these models in order to find who gives best results. Finally, they found that decision tree gave best result with performance of 100% for sick records, 76.9% for risky and 69.1% for normal ones.
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Feldmann M, Rousson V, Nguyen TD, Bernet V, Hagmann C, Latal B, Natalucci G. Cognitive outcome of early school-aged children born very preterm is not predicted by early short-term amplitude-integrated electroencephalography. Acta Paediatr 2020; 109:78-84. [PMID: 31254357 DOI: 10.1111/apa.14919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 02/06/2023]
Abstract
AIM We investigated the association between early amplitude-integrated electroencephalography (aEEG) and cognitive outcome in very preterm infants at early school-age. METHODS This prospective cohort study, conducted in the Department of Neonatology, University Hospital Zurich, Switzerland, from 2009 to 2012, comprised of infants born at <32 weeks of gestation, who underwent continuous aEEG recording during the first 4 days of life. Cognitive outcome was assessed with the Kaufman-Assessment Battery for Children at 5 years. Univariate and multivariate logistic regressions were calculated between aEEG parameters and normal cognitive outcome, defined as an intelligence quotient (IQ) of at least 85. RESULTS The 118 (52.5% male) infants were born at a mean gestational age of 29.9 weeks and a mean birth weight of 1235 ± 363 g. We followed up 89 children at the age of five, and they had a mean IQ of 97.8 ± 12.7 with 21.3% under 85-and 2.2% had cerebral palsy. Univariate analyses found associations between aEEG measures and normal cognitive outcome, but these were no longer significant after adjustment for confounders. Socioeconomic status and neonatal morbidity were independent predictors of cognitive outcome. CONCLUSION Early short-term aEEG did not predict later cognitive outcome in our cohort of very preterm infants.
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Affiliation(s)
- Maria Feldmann
- Child Development Centre University Children's Hospital Zurich Zurich Switzerland
- Children's Research Centre University Children's Hospital Zurich Zurich Switzerland
| | - Valentin Rousson
- Institute for Social and Preventive Medicine, Statistical Unit Lausanne University Hospital Lausanne Switzerland
| | - Thi Dao Nguyen
- Department of Neonatology University of Zurich and University Hospital Zurich Zurich Switzerland
| | - Vera Bernet
- Department of Neonatology and Paediatric Intensive care University Children's Hospital Zurich Zurich Switzerland
| | - Cornelia Hagmann
- Children's Research Centre University Children's Hospital Zurich Zurich Switzerland
- Department of Neonatology and Paediatric Intensive care University Children's Hospital Zurich Zurich Switzerland
| | - Beatrice Latal
- Child Development Centre University Children's Hospital Zurich Zurich Switzerland
- Children's Research Centre University Children's Hospital Zurich Zurich Switzerland
| | - Giancarlo Natalucci
- Child Development Centre University Children's Hospital Zurich Zurich Switzerland
- Department of Neonatology University of Zurich and University Hospital Zurich Zurich Switzerland
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Filippa M, Lordier L, De Almeida JS, Monaci MG, Adam-Darque A, Grandjean D, Kuhn P, Hüppi PS. Early vocal contact and music in the NICU: new insights into preventive interventions. Pediatr Res 2020; 87:249-264. [PMID: 31266053 DOI: 10.1038/s41390-019-0490-9] [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] [Received: 06/04/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022]
Abstract
It is now clearly established that the environment and the sensory stimuli, particularly during the perinatal period, have an impact on infant's development. During the last trimester of gestation, activity-dependent plasticity shapes the fetal brain, and prematurity has been shown to alter the typical developmental trajectories. In this delicate period, preventive interventions aiming at modulating these developmental trajectories through activity-inducing interventions are currently underway to be tested. The purpose of this review paper is to describe the potentialities of early vocal contact and music on the preterm infant's brain development, and their potential beneficial effect on early development. Scientific evidence supports a behavioral orientation of the newborn to organized sounds, such as those of voice and music, and recent neuroimaging studies further confirm full cerebral processing of music as multisensory stimuli. However, the impact of long-term effects of music exposure and early vocal contact on preterm infants' long-term neurodevelopment needs be further investigated. To conclude, it is necessary to establish the neuroscientific bases of the early perception and the long-term effects of music and early vocal contact on the premature newborns' development. Scientific projects are currently on the way to fill this gap in knowledge.
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Affiliation(s)
- Manuela Filippa
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland. .,University of Valle d'Aosta, Aosta, Italy. .,Neuroscience of Emotion and Affective Dynamics, Swiss Center for Affective Sciences, and Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
| | - Lara Lordier
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
| | - Joana Sa De Almeida
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
| | | | - Alexandra Adam-Darque
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neuroscience, Division of Neurorehabilitation, University Hospital of Geneva and University of Geneva, Geneva, Switzerland
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics, Swiss Center for Affective Sciences, and Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Pierre Kuhn
- Service de Médecine et réanimation du nouveau-né, Hôpital de Hautepierre, CHU Strasbourg, Strasbourg, France
| | - Petra S Hüppi
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
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Jannesari M, Saeedi A, Zare M, Ortiz-Mantilla S, Plenz D, Benasich AA. Stability of neuronal avalanches and long-range temporal correlations during the first year of life in human infant. Brain Struct Funct 2019; 224:2453-2465. [PMID: 31267171 PMCID: PMC6698269 DOI: 10.1007/s00429-019-01918-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 06/26/2019] [Indexed: 11/29/2022]
Abstract
During infancy, the human brain rapidly expands in size and complexity as neural networks mature and new information is incorporated at an accelerating pace. Recently, it was shown that single electrode EEG in preterms at birth exhibits scale-invariant intermittent bursts. Yet, it is currently not known whether the normal infant brain, in particular, the cortex maintains a distinct dynamical state during development that is characterized by scale-invariant spatial as well as temporal aspects. Here we employ dense-array EEG recordings acquired from the same infants at 6 and 12 months of age to characterize brain activity during an auditory oddball task. We show that suprathreshold events organize as spatiotemporal clusters whose size and duration are power-law distributed, the hallmark of neuronal avalanches. Time series of local suprathreshold EEG events display significant long-range temporal correlations (LRTCs). No differences were found between 6 and 12 months, demonstrating stability of avalanche dynamics and LRTCs during the first year after birth. These findings demonstrate that the infant brain is characterized by distinct spatiotemporal dynamical aspects that are in line with expectations of a critical cortical state. We suggest that critical state dynamics, which theory and experiments have shown to be beneficial for numerous aspects of information processing, are maintained by the infant brain to process an increasingly complex environment during development.
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Affiliation(s)
- Mostafa Jannesari
- School of Computer Science, Institute for Research in Fundamental Sciences (IPM), 70 Lavasani Avenue, Tehran, 19395, Iran
| | - Alireza Saeedi
- Department of Physiology of Cognitive Processes, Max-Planck-Institute for Biological Cybernetics, Tübingen, 72076, Germany
| | - Marzieh Zare
- School of Computer Science, Institute for Research in Fundamental Sciences (IPM), 70 Lavasani Avenue, Tehran, 19395, Iran.
| | - Silvia Ortiz-Mantilla
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, 197 University Avenue, Newark, NJ, 07102, USA
| | - Dietmar Plenz
- Section on Critical Brain Dynamics, Laboratory of Systems Neuroscience, National Institute of Mental Health, Porter Neuroscience Research Center, MSC 3735, Bethesda, MD, 20892, USA
| | - April A Benasich
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, 197 University Avenue, Newark, NJ, 07102, USA
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Vasung L, Rezayev A, Yun HJ, Song JW, van der Kouwe A, Stewart N, Palani A, Shiohama T, Chouinard-Decorte F, Levman J, Takahashi E. Structural and Diffusion MRI Analyses With Histological Observations in Patients With Lissencephaly. Front Cell Dev Biol 2019; 7:124. [PMID: 31355197 PMCID: PMC6637974 DOI: 10.3389/fcell.2019.00124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/26/2019] [Indexed: 12/11/2022] Open
Abstract
The development of cortical convolutions, gyri and sulci, is a complex process that takes place during prenatal development. Lissencephaly, a rare genetic condition characterized by the lack of cortical convolutions, offers a model to look into biological processes that lead to the development of convolutions. Retrospective, qualitative, and quantitative analyses of structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were performed in patients with lissencephaly (N = 10) and age-/sex-matched controls (N = 10). In order to identify microstructural correlates of structural MRI and DTI findings, postmortem brains of patients with lissencephaly (N = 4) and age-matched controls (N = 4) were also examined with histology. Patients with lissencephaly had significantly smaller gyrification index and volumes of hemispheric white and gray matter, compared to the age-/sex-matched control group. However, there was no significant difference between groups in the subcortical gray matter volumes. Although the majority of patients with lissencephaly had a preserved normal-like appearance of major fissures and primary sulci, the spatial distribution of agyric cortical regions was different in patients with lissencephaly-1 (LIS1) and doublecortin (DCX) mutations. Lastly, in patients with lissencephaly, the spatiotemporal distribution of projection pathways was preserved while short- to medium-range cortico-cortical pathways were absent or fewer in number. Our results indicate that in the patients with lissencephaly cortical system is affected more than the subcortical one.
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Affiliation(s)
- Lana Vasung
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
| | - Arthur Rezayev
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
| | - Hyuk Jin Yun
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
| | - Jae W. Song
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Andre van der Kouwe
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Natalie Stewart
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
| | - Arthi Palani
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
| | - Tadashi Shiohama
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Francois Chouinard-Decorte
- Ludmer Centre for Neuroinformatics, McGill Centre for Integrative Neuroscience, Department of Biomedical Engineering, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jacob Levman
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
- Department of Mathematics, Statistics, and Computer Science, St. Francis Xavier University, Antigonish, NS, Canada
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston, MA, United States
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Abstract
Preterm babies are cared for in neonatal intensive care units (NICU), which are busy places with a lot of mechanical noise increasingly recognized to disrupt normal brain development. NICUs therefore invest in developmental care procedures, with music for example, but neurobiological evidence for these interventions is missing. We present results from a clinical trial to study the effects of a music intervention on preterm infants’ brain development. Based on resting-state fMRI, we provide evidence that music enhanced connectivity in a brain circuitry involving the salience network with regions implicated in sensory and higher-order cognitive functions, previously found to be altered in preterm infants. To our knowledge, this study is unique in observing an impact of music on brain development in preterm newborns. Neonatal intensive care units are willing to apply environmental enrichment via music for preterm newborns. However, no evidence of an effect of music on preterm brain development has been reported to date. Using resting-state fMRI, we characterized a circuitry of interest consisting of three network modules interconnected by the salience network that displays reduced network coupling in preterm compared with full-term newborns. Interestingly, preterm infants exposed to music in the neonatal intensive care units have significantly increased coupling between brain networks previously shown to be decreased in premature infants: the salience network with the superior frontal, auditory, and sensorimotor networks, and the salience network with the thalamus and precuneus networks. Therefore, music exposure leads to functional brain architectures that are more similar to those of full-term newborns, providing evidence for a beneficial effect of music on the preterm brain.
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Kanold PO, Deng R, Meng X. The Integrative Function of Silent Synapses on Subplate Neurons in Cortical Development and Dysfunction. Front Neuroanat 2019; 13:41. [PMID: 31040772 PMCID: PMC6476909 DOI: 10.3389/fnana.2019.00041] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/26/2019] [Indexed: 12/20/2022] Open
Abstract
The thalamocortical circuit is of central importance in relaying information to the cortex. In development, subplate neurons (SPNs) form an integral part of the thalamocortical pathway. These early born cortical neurons are the first neurons to receive thalamic inputs and excite neurons in the cortical plate. This feed-forward circuit topology of SPNs supports the role of SPNs in shaping the formation and plasticity of thalamocortical connections. Recently it has been shown that SPNs also receive inputs from the developing cortical plate and project to the thalamus. The cortical inputs to SPNs in early ages are mediated by N-methyl-D-aspartate (NMDA)-receptor only containing synapses while at later ages α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-receptors are present. Thus, SPNs perform a changing integrative function over development. NMDA-receptor only synapses are crucially influenced by the resting potential and thus insults to the developing brain that causes depolarizations, e.g., hypoxia, can influence the integrative function of SPNs. Since such insults in humans cause symptoms of neurodevelopmental disorders, NMDA-receptor only synapses on SPNs might provide a crucial link between early injuries and later circuit dysfunction. We thus here review subplate associated circuits, their changing functions, and discuss possible roles in development and disease.
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Affiliation(s)
- Patrick O Kanold
- Department of Biology, University of Maryland, College Park, MD, United States
| | - Rongkang Deng
- Department of Biology, University of Maryland, College Park, MD, United States
| | - Xiangying Meng
- Department of Biology, University of Maryland, College Park, MD, United States
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Carrasco M, Stafstrom CE. How Early Can a Seizure Happen? Pathophysiological Considerations of Extremely Premature Infant Brain Development. Dev Neurosci 2019; 40:417-436. [PMID: 30947192 DOI: 10.1159/000497471] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/04/2019] [Indexed: 11/19/2022] Open
Abstract
Seizures in neonates represent a neurologic emergency requiring prompt recognition, determination of etiology, and treatment. Yet, the definition and identification of neonatal seizures remain challenging and controversial, in part due to the unique physiology of brain development at this life stage. These issues are compounded when considering seizures in premature infants, in whom the complexities of brain development may engender different clinical and electrographic seizure features at different points in neuronal maturation. In extremely premature infants (< 28 weeks gestational age), seizure pathophysiology has not been explored in detail. This review discusses the physiological and structural development of the brain in this developmental window, focusing on factors that may lead to seizures and their consequences at this early time point. We hypothesize that the clinical and electrographic phenomenology of seizures in extremely preterm infants reflects the specific pathophysiology of brain development in that age window.
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Affiliation(s)
- Melisa Carrasco
- Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carl E Stafstrom
- Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,
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