Display omitted
► We propose a fully automatic method for the segmentation of neonatal brain MRI. ► It segments brain parts and tissues essential for evaluating early brain development. ► It uses ...high-level brain morphology priors, and needs no atlas or manual intervention. ► Priors concern tissue structure, connectivity and relative positions. ► Results are visually accurate and show high overlap with expert manual segmentation.
The segmentation of MR images of the neonatal brain is an essential step in the study and evaluation of infant brain development. State-of-the-art methods for adult brain MRI segmentation are not applicable to the neonatal brain, due to large differences in structure and tissue properties between newborn and adult brains. Existing newborn brain MRI segmentation methods either rely on manual interaction or require the use of atlases or templates, which unavoidably introduces a bias of the results towards the population that was used to derive the atlases. We propose a different approach for the segmentation of neonatal brain MRI, based on the infusion of high-level brain morphology knowledge, regarding relative tissue location, connectivity and structure. Our method does not require manual interaction, or the use of an atlas, and the generality of its priors makes it applicable to different neonatal populations, while avoiding atlas-related bias. The proposed algorithm segments the brain both globally (intracranial cavity, cerebellum, brainstem and the two hemispheres) and at tissue level (cortical and subcortical gray matter, myelinated and unmyelinated white matter, and cerebrospinal fluid). We validate our algorithm through visual inspection by medical experts, as well as by quantitative comparisons that demonstrate good agreement with expert manual segmentations. The algorithm’s robustness is verified by testing on variable quality images acquired on different machines, and on subjects with variable anatomy (enlarged ventricles, preterm- vs. term-born).
The main aim of the present study was to investigate the effects of the COVID-19 pandemic on the mothers' postnatal depression, stress, and attachment during their stay in the Neonatal Intensive Care ...Unit (NICU). Twenty mothers of very premature infants born before 32weeks of gestational age were recruited at the Geneva University Hospital between January 2018 and February 2020 before the COVID-19 pandemic started. Mothers were screened for postnatal depression after their preterm infant's birth (Edinburgh Postnatal Depression Scale, EPDS), then for stress (Parental Stressor Scale: Neonatal Intensive Care Unit, PSS:NICU), and attachment (Maternal Postnatal Attachment Scale, MPAS) at infant's term-equivalent age. Data were compared with 14 mothers recruited between November 2020 and June 2021 during the COVID-19 pandemic. No significant differences were found in the scores for depression, stress, and attachment between the two groups. However, a non-statistically significant trend showed a general increase of depression symptoms in mothers during the COVID-19 pandemic, which significantly correlated to the attachment and stress scores. Moreover, the PSS:NICU Sights and Sounds score was significantly positively correlated with EPDS scores and negatively with the MPAS score only in the During-COVID group. To conclude, we discussed a possible dampened effect of the several protective family-based actions that have been adopted in the Geneva University Hospital during the health crisis, and we discussed the most appropriate interventions to support parents in this traumatic period during the COVID-19 pandemic.
The hippocampus is known to be vulnerable to hypoxia, stress, and undernutrition, all likely to be present in fetal intrauterine growth restriction (IUGR). The effect of IUGR in preterm infants on ...the hippocampus was studied using 3D magnetic resonance imaging at term-equivalent age Thirteen preterm infants born with IUGR after placental insufficiency were compared with 13 infants with normal intrauterine growth age matched for gestational age. The hippocampal structural differences were defined using voxel-based morphometry and manual segmentation. The specific neurobehavioral function was evaluated by the Assessment of Preterm Infants' Behavior at term and at 24 mo of corrected age by a Bayley Scales of Infant and Toddler Development. Voxel-based morphometry detected significant gray matter volume differences in the hippocampus between the two groups. This finding was confirmed by manual segmentation of the hippocampus with a reduction of hippocampal volume after IUGR. The hippocampal volume reduction was further associated with functional behavioral differences at term-equivalent age in all six subdomains of the Assessment of Preterm Infants' Behavior but not at 24 mo of corrected age. We conclude that hippocampal development in IUGR is altered and might result from a combination of maternal corticosteroid hormone exposure, hypoxemia, and micronutrient deficiency.
Among executive functions (EFs), research has highlighted specific inhibition difficulties in preterm children. The present paper reviews and classifies the studies that assessed response inhibition ...and interference control abilities in preterm children and adolescents aged 3 to 16 years. Most behavioral studies agree on a developmental delay at early school age in inhibition abilities and a catch-up before adolescence, with lesser response inhibition difficulties at pre-adolescence. However, persisting interference control difficulties have been reported into early adulthood. These results are discussed, along with functional magnetic resonance imaging (fMRI) findings. Finally, this paper outlines methodological issues that need to be overcome in order to define the developmental trajectory of inhibition abilities in the preterm population.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Magnetic resonance imaging has proved to be suitable and efficient for in vivo investigation of the early process of brain gyrification in fetuses and preterm newborns but the question remains as to ...whether cortical-related measurements derived from both cases are comparable or not. Indeed, the developmental folding trajectories drawn up from both populations have not been compared so far, neither from cross-sectional nor from longitudinal datasets. The present study aimed to compare features of cortical folding between healthy fetuses and early imaged preterm newborns on a cross-sectional basis, over a developmental period critical for the folding process (21-36 weeks of gestational age GA). A particular attention was carried out to reduce the methodological biases between the 2 populations. To provide an accurate group comparison, several global parameters characterizing the cortical morphometry were derived. In both groups, those metrics provided good proxies for the dramatic brain growth and cortical folding over this developmental period. Except for the cortical volume and the rate of sulci appearance, they depicted different trajectories in both groups suggesting that the transition from into ex utero has a visible impact on cortical morphology that is at least dependent on the GA at birth in preterm newborns.
Aim
This study assessed predictive values of fidgety movement assessment (FMA) in a large sample of infants born very preterm for developmental abnormalities, in particular for cerebral palsy (CP) at ...2 years in an everyday clinical setting.
Method
This is a multicentre study of infants born preterm with gestational age lower than 32.0 weeks. FMA was performed at 3 months corrected age; neurodevelopment (Bayley Scales of Infant Development, 2nd edition) and neurological abnormalities were assessed at 2 years. Predictive values of FMA for the development of CP were calculated and combined with abnormalities at cerebral ultrasound.
Results
Five hundred and thirty‐five infants (gestational age 28.2wks standard deviation 1.3wks) were included. Eighty‐one percent showed normal fidgety movements and 19% atypical (82 absent, 21 abnormal) fidgety movements. Absent fidgety movements predicted CP at 2 years with an odds ratio (OR) of 8.9 (95% confidence interval CI 4.1–17.0), a combination of atypical fidgety movements and major brain lesion on cerebral ultrasound predicted it with an OR of 17.8 (95% CI 5.2–61.6). Mean mental developmental index of infants with absent fidgety movements was significantly lower (p=0.012) than with normal fidgety movements.
Interpretation
Detection of infants at risk for later CP through FMA was good, but less robust when performed in a routine clinical setting; prediction improved when combined with neonatal cerebral ultrasound.
What this paper adds
Fidgety movement assessment (FMA) in infants born very preterm is practicable in a clinical setting.
Clinical results of FMA are less robust than when performed in academic settings.
A combination of FMA and cerebral ultrasound appears to improve prognostic information.
FMA at 3 months can help to identify infants at risk for cognitive dysfunction.
This article is commented on by Zuk on page 568 of this issue.
Immature cognition is susceptible to interference from competing information, and particularly in affectively charged situations. Several studies have reported activation in the anterior cingulate ...cortex, prefrontal cortex and amygdala associated with emotional conflict processing in adults but literature is lacking regarding children. Moreover, studies in children and adolescents still disagree regarding the functional activation of amygdala related to facial stimuli. In the purpose of investigating both the effect of socio-emotional stimuli and its interaction with interference control, we designed a flanker task associated with an event-related fMRI paradigm in 30 healthy children ages 9–11. In addition to happy, angry and neutral faces, we presented scrambled stimuli to examine a potential effect of faces. Regarding both brain and behavior results, no effect of emotional valence was observed. However, both results evidenced an emotional effect of faces compared with scrambled stimuli. This was expressed by faster RTs associated with increased amygdala activity and activation of the ventral ACC, in congruent trials only. When scrambled were inversely compared to faces, increased activity was observed within the lateral prefrontal cortex. Regarding the amygdala, the results suggest that in late school age children, activity in the amygdala seemed to underlie the socio-emotional effect induced by faces but not the emotional conflict. Studying brain regions involved in emotion regulation is important to further understand neurodevelopmental disorders and psychopathologies, particularly in late childhood and adolescence.
•We used a socio-emotional flanker task and fMRI in children.•Amygdala activity underlay a main effect of faces stimuli in non-conflict conditions.•Ventral ACC activity underlay a main effect of faces stimuli in non-conflict conditions.•Increased amygdala activity was associated with faster RTs in non-conflict conditions.
In the human brain, the appearance of cortical sulci is a complex process that takes place mostly during the second half of pregnancy, with a relatively stable temporal sequence across individuals. ...Since deviant gyrification patterns have been observed in many neurodevelopmental disorders, mapping cortical development in vivo from the early stages on is an essential step to uncover new markers for diagnosis or prognosis. Recently this has been made possible by MRI combined with post-processing tools, but the reported results are still fragmented. Here we aimed to characterize the typical folding progression ex utero from the pre- to the post-term period, by considering 58 healthy preterm and full-term newborns and infants imaged between 27 and 62 weeks of post-menstrual age. Using a method of spectral analysis of gyrification (SPANGY), we detailed the spatial-frequency structure of cortical patterns in a quantitative way. The modeling of developmental trajectories revealed three successive waves that might correspond to primary, secondary and tertiary folding. Some deviations were further detected in 10 premature infants without apparent neurological impairment and imaged at term equivalent age, suggesting that our approach is sensitive enough to highlight the subtle impact of preterm birth and extra-uterine life on folding.
Display omitted
•The progression of cortical folding was studied from the pre- to post-term period.•SPANGY provided a quantitative spectral and spatial analysis of cortical patterns.•We showed three successive folding waves with different characteristic age points.•This approach suggested deviations in primary folding in premature infants at TEA.
Erythropoietin (EPO), the hypoxia-inducible hematopoietic hormone, has well-established neuroprotective/neurotrophic roles in the developing central nervous system and the therapeutic potential of ...EPO has been widely explored in clinical studies for the treatment of perinatal hypoxic brain lesion, as well as prematurity. Here, we reveal that both EPO and Epo receptor (EPOR) are expressed in the developing rat somatosensory cortex during radial migration and laminar positioning of granular and supragranular neurons. Experimental deregulation of EPO signaling using genetic approaches results in aberrant migration, as well as permanent neuronal misplacement leading to abnormal network activity and protracted sensory behavioral deficits. We identify ERK as the downstream effector of the EPO signaling pathway for neuronal migration. These findings reveal a crucial role for endogenous EPO signaling in neuronal migration, and offer important insights for understanding how the temporary deregulation of EPO could result in migration defects that lead to abnormal behavior in the adult.
PDF
