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Pinto CR, Duarte JV, Dinis A, Duarte IC, Castelhano J, Pinto J, Oliveira G, Castelo-Branco M. Functional neuroimaging of responses to multiple sensory stimulations in newborns with perinatal asphyxia. Transl Pediatr 2023; 12:1646-1658. [PMID: 37814708 PMCID: PMC10560353 DOI: 10.21037/tp-23-135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/21/2023] [Indexed: 10/11/2023] Open
Abstract
Background Functional neuroimaging can provide pathophysiological information in perinatal asphyxia (PA). However, fundamental unresolved questions remain related to the influence of neurovascular coupling (NVC) maturation on functional responses in early development. We aimed to probe the feasibility and compare the responses to multiple sensory stimulations in newborns with PA using functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy (fNIRS). Methods Responses to visual, auditory, and sensorimotor passive stimulation were measured with fMRI and fNIRS and compared in 18 term newborns with PA and six controls. Results Most newborns exhibited a positive fMRI response during visual and sensorimotor stimulation, higher in the sensorimotor. An asymmetric pattern (negative in the left hemisphere) was observed in auditory stimulation. The fNIRS response most resembling the adult pattern (positive) in PA occurred during auditory stimulation, in which oxyhemoglobin (HbO) increased, and deoxyhemoglobin (HbR) decreased. Significative differences were found in the HbO and HbR profiles in newborns with PA compared to the controls, more evident in auditory stimulation. Positive correlations between the fMRI BOLD signal and at least one fNIRS channel (HbO) in all stimuli in newborns with PA were identified: the strongest was in the auditory (r=0.704) and the weakest in the sensorimotor (r=0.544); in more fNIRS channels, in the visual. Conclusions Both techniques are feasible physiological assessment tools, suggesting a distinctive level of maturation in sensory and motor areas. Differences in fNIRS profiles in newborns with PA and controls and the fMRI-fNIRS relationship observed can encourage the fNIRS as a clinically emergent valuable tool.
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Affiliation(s)
- Carla R. Pinto
- Pediatric Intensive Care Unit, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, Portugal
- University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT) and Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - João V. Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT) and Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Alexandra Dinis
- Pediatric Intensive Care Unit, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Isabel C. Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT) and Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Castelhano
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT) and Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joana Pinto
- Neuroradiology Unit, Medical Imaging Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Guiomar Oliveira
- University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT) and Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Child Developmental Center, Research and Clinical Training Center, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT) and Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Botondi V, Pirra A, Strozzi M, Perrotta M, Gavilanes DAW, Di Ricco L, Spagnuolo C, Maconi A, Rocchetti A, Mazzucco L, Balbo V, Schena F, Stellitano G, Oddi A, Dotta A, Bersani I, Sannia A, Peila C, Bertino E, Bianco I, Gambi A, Mangifesta R, Gazzolo D. Perinatal asphyxia partly affects presepsin urine levels in non-infected term infants. Clin Chem Lab Med 2022; 60:793-799. [PMID: 35112525 DOI: 10.1515/cclm-2022-0027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/14/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Standard of care sepsis biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT) can be affected by several perinatal factors, among which perinatal asphyxia (PA) has a significant role. In this light, new early sepsis biomarkers such as presepsin (P-SEP) are needed to enact therapeutic strategies at a stage when clinical and laboratory patterns are still silent or unavailable. We aimed at investigating the potential effects of PA on longitudinal P-SEP urine levels. METHODS We conducted an observational case-control study in 76 term infants, 38 with PA and 38 controls. Standard clinical, laboratory, radiological monitoring procedures and P-SEP urine measurement were performed at four time-points (first void, 24, 48, 96 h) after birth. RESULTS Higher (p<0.05) CRP and PCT blood levels at T1-T3 were observed in PA than control infants whilst no differences (p>0.05, for all) at T0 were observed between groups. P-SEP urine levels were higher (p<0.05) in PA at first void and at 24 h while no differences (p>0.05) at 48 and 96 h were observed. No significant correlations were found (p>0.05) between P-SEP and urea (R=0.11) and creatinine (R=0.02) blood levels, respectively. CONCLUSIONS The present results, showed that PA effects on P-SEP were limited up to the first 24 h following birth in absence of any kidney function bias. Data open the way to further investigations aimed at validating P-SEP assessment in non-invasive biological fluids as a reliable tool for early EOS and LOS detection in high-risk infants.
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Affiliation(s)
- Valentina Botondi
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Alice Pirra
- Neonatal Intensive Care Unit, S. Croce and Carle Hospital, Cuneo, Italy
| | - Mariachiara Strozzi
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Marika Perrotta
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Danilo A W Gavilanes
- Department of Pediatrics and Neonatology, Maastricht University, Maastricht, The Netherlands
| | - Laura Di Ricco
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Cynzia Spagnuolo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Antonio Maconi
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Andrea Rocchetti
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Laura Mazzucco
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Valeria Balbo
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Federico Schena
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Giuseppina Stellitano
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Arianna Oddi
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, Alessandria, Italy
| | - Andrea Dotta
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Iliana Bersani
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Andrea Sannia
- Neonatal Intensive Care Unit, S. Croce and Carle Hospital, Cuneo, Italy
| | - Chiara Peila
- Complex Structure Neonatology Unit, Department of Public Health and Pediatric, University of Turin, Turin, Italy
| | - Enrico Bertino
- Complex Structure Neonatology Unit, Department of Public Health and Pediatric, University of Turin, Turin, Italy
| | - Ines Bianco
- Laboratory of Clinical Pathology, SS Annunziata Hospital, Chieti, Italy
| | - Alessandra Gambi
- Laboratory of Clinical Pathology, SS Annunziata Hospital, Chieti, Italy
| | | | - Diego Gazzolo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
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