Altered structural brain networks at term-equivalent age in preterm infants with grade 1 intraventricular hemorrhage

Utility of Diffusion Tensor Imaging in Preterm Infants with Germinal Matrix Hemorrhage and Intraventricular Hemorrhage: A Systematic Review

OBJECTIVE

Intraventricular hemorrhage (IVH) and germinal matrix hemorrhage (GMH) are the most common brain injuries in preterm infants. Neonates with these injuries are at greater risk of impaired neurodevelopmental outcome. Current guidelines recommend screening infants with cranial ultrasound (CUS); however, this is prone to missing subtle injury patterns, particularly within the posterior fossa. The present report sought to discuss the utility of diffusion tensor imaging (DTI) in preterm infants.

METHODS

A systematic review of PubMed, Ovid MEDLINE, and Ovid EMBASE was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included manuscripts were methodically scrutinized for quality, DTI use, and neurologic outcome.

RESULTS

Twenty studies with 1574 infants who underwent DTI were included. There were 574 preterm infants with GMH-IVH on DTI. Twelve studies documented decreased fractional anisotropy, whereas 6 demonstrated structural segregation and asymmetrical white matter myelination in these infants. Seven studies documented concurrent CUS use with 2 studies comparing DTI findings with CUS findings. In both studies, DTI more accurately detected presence of GMH, especially within the cerebellum. Among GMH-IVH preterm infants, 58.5% demonstrated cognitive, intellectual, and language delays at follow-up (mean, 32.4 months). Additionally, lower fractional anisotropy values on initial DTI were associated with cognitive, language, and motor delays.

CONCLUSIONS

Although DTI is more sensitive for picking up subtle injury patterns, CUS remains the standard of care when screening for injuries that would necessitate surgical intervention. DTI offers a refined understanding of the sequelae of GMH-IVH with microstructural changes found on DTI being associated with childhood motor and cognitive outcomes.

Altered functional connectivity in preterm neonates with intraventricular hemorrhage assessed using functional near-infrared spectroscopy

Intraventricular hemorrhage (IVH) is a common neurological injury following very preterm birth. Resting-state functional connectivity (RSFC) using functional magnetic resonance imaging (fMRI) is associated with injury severity; yet, fMRI is impractical for use in intensive care settings. Functional near-infrared spectroscopy (fNIRS) measures RSFC through cerebral hemodynamics and has greater bedside accessibility than fMRI. We evaluated RSFC in preterm neonates with IVH using fNIRS and fMRI at term-equivalent age, and compared fNIRS connectivity between healthy newborns and those with IVH. Sixteen very preterm born neonates were scanned with fMRI and fNIRS. Additionally, fifteen healthy newborns were scanned with fNIRS. In preterms with IVH, fNIRS and fMRI connectivity maps were compared using Euclidean and Jaccard distances. The severity of IVH in relation to fNIRS-RSFC strength was examined using generalized linear models. fNIRS and fMRI RSFC maps showed good correspondence. Connectivity strength was significantly lower in healthy newborns (p-value = 0.023) and preterm infants with mild IVH (p-value = 0.026) compared to infants with moderate/severe IVH. fNIRS has potential to be a new bedside tool for assessing brain injury and monitoring cerebral hemodynamics, as well as a promising biomarker for IVH severity in very preterm born infants.

Neuroimaging of structural and functional connectivity in preterm infants with intraventricular hemorrhage

Preterm infants with intraventricular hemorrhage (IVH) are known to have some of the worst neurodevelopmental outcomes in all of neonatal medicine, with a growing body of evidence relating these outcomes to underlying disruptions in brain structure and function. This review begins by summarizing state-of-the-art neuroimaging techniques delineating structural and functional connectivity (diffusion and resting state functional MRI) and their application in infants with IVH, including unique technical challenges and emerging methods. We then review studies of altered structural and functional connectivity, highlighting the role of IVH severity and location. We subsequently detail investigations linking structural and functional findings in infancy to later outcomes in early childhood. We conclude with future directions including methodologic considerations for prospective and potentially interventional studies designed to mitigate disruptions to underlying structural and functional connections and improve neurodevelopmental outcomes in this high-risk population.

Examining the effect of online advertisement cues on human responses using eye-tracking, EEG, and MRI

This study sought to emphasize how disciplines such as neuroscience and marketing can be applied in advertising and consumer behavior. The application of neuroscience methods in analyzing and understanding human behavior related to the Elaboration Likelihood Model (ELM) and brain activity has recently garnered attention. This study examines brain processes while participants attempted to elicit preferences for a product, and demonstrates factors that influence consumer behavior using eye-tracking, electroencephalography (EEG), and magnetic resonance imaging (MRI) from a neuroscience approach. We planned two conditions of online advertising, namely, peripheral cues without argument and central cues with argument strength. Thirty respondents participated in the experiment, consisting of eye-tracking, EEG, and MRI instruments to explore brain activity in central cue conditions. We investigated whether diffusion tensor imaging (DTI) analysis could detect regional brain changes. Using eye-tracking, we found that the responses were mainly in the mean fixation duration, number of fixations, mean saccade duration, and number of saccade durations for the central cue condition. Moreover, the findings show that the fusiform gyrus and frontal cortex are significantly associated with building a relationship by inferring central cues in the EEG assay. The MRI images show that the fusiform gyrus and frontal cortex are significantly active in the central cue condition. DTI analysis indicates that the corpus callosum has changed in the central cue condition. We used eye-tracking, EEG, MRI, and DTI to understand that these connections may apprehend responses when viewing advertisements, especially in the fusiform gyrus, frontal cortex, and corpus callosum.