The fetal brain shows accelerated growth in the latter half of gestation, and these changes can be captured by 2D and 3D biometry measurements. The aim of this study was to quantify brain growth in normal fetuses using Magnetic Resonance Imaging (MRI) and to produce reference biometry data and a freely available centile calculator (https://www.developingbrain.co.uk/fetalcentiles/). A total of 127 MRI examinations (1.5 T) of fetuses with a normal brain appearance (21–38 gestational weeks) were included in this study. 2D and 3D biometric parameters were measured from slice-to-volume reconstructed images, including 3D measurements of supratentorial brain tissue, lateral ventricles, cortex, cerebellum and extra-cerebral CSF and 2D measurements of brain biparietal diameter and fronto-occipital length, skull biparietal diameter and occipitofrontal diameter, head circumference, transverse cerebellar diameter, extra-cerebral CSF, ventricular atrial diameter, and vermis height, width, and area. Centiles were constructed for each measurement. All participants were invited for developmental follow-up. All 2D and 3D measurements, except for atrial diameter, showed a significant positive correlation with gestational age. There was a sex effect on left and total lateral ventricular volumes and the degree of ventricular asymmetry. The 5th, 50th, and 95th centiles and a centile calculator were produced. Developmental follow-up was available for 73.1% of cases [mean chronological age 27.4 (±10.2) months]. We present normative reference charts for fetal brain MRI biometry at 21–38 gestational weeks. Developing growth trajectories will aid in the better understanding of normal fetal brain growth and subsequently of deviations from typical development in high-risk pregnancies or following premature delivery.Electronic supplementary materialThe online version of this article (doi:10.1007/s00429-016-1342-6) contains supplementary material, which is available to authorized users.

HighlightsDS fetal and neonatal brains show deviations from typical development.Whole brain and cerebellar volumes are smaller in DS from 21 weeks gestation.Cortical volumes in DS appear to deviate around the third trimester.Structural abnormalities are likely substrates for later neurocognitive impairment.

In this study, we construct a spatio-temporal surface atlas of the developing cerebral cortex, which is an important tool for analysing and understanding normal and abnormal cortical development. In utero Magnetic Resonance Imaging (MRI) of 80 healthy fetuses was performed, with a gestational age range of 21.7 to 38.9 weeks. Topologically correct cortical surface models were extracted from reconstructed 3D MRI volumes. Accurate correspondences were obtained by applying a joint spectral analysis to cortices for sets of subjects close to a specific age. Sulcal alignment was found to be accurate in comparison to spherical demons, a state of the art registration technique for aligning 2D cortical representations (average Fréchet distance≈0.4 mm at 30 weeks). We construct consistent, unbiased average cortical surface templates, for each week of gestation, from age-matched groups of surfaces by applying kernel regression in the spectral domain. These were found to accurately capture the average cortical shape of individuals within the cohort, suggesting a good alignment of cortical geometry. Each spectral embedding and its corresponding cortical surface template provide a dual reference space where cortical geometry is aligned and a vertex-wise morphometric analysis can be undertaken.

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Down syndrome is the most common genetic developmental disorder in humans and is caused by partial or complete triplication of human chromosome 21 (trisomy 21). It is a complex condition which results in multiple lifelong health problems, including varying degrees of intellectual disability and delays in speech, memory, and learning. As both length and quality of life are improving for individuals with Down syndrome, attention is now being directed to understanding and potentially treating the associated cognitive difficulties and their underlying biological substrates. These have included imaging and postmortem studies which have identified decreased regional brain volumes and histological anomalies that accompany early onset dementia. In addition, advances in genome‐wide analysis and Down syndrome mouse models are providing valuable insight into potential targets for intervention that could improve neurogenesis and long‐term cognition. As little is known about early brain development in human Down syndrome, we review recent advances in magnetic resonance imaging that allow non‐invasive visualization of brain macro‐ and microstructure, even in utero. It is hoped that together these advances may enable Down syndrome to become one of the first genetic disorders to be targeted by antenatal treatments designed to ‘normalize’ brain development. What this paper adds Magnetic resonance imaging can provide non‐invasive characterization of early brain development in Down syndrome. Down syndrome mouse models enable study of underlying pathology and potential intervention strategies. Potential therapies could modify brain structure and improve early cognitive levels. Down syndrome may be the first genetic disorder to have targeted therapies which alter antenatal brain development.

Highlights Fetuses that subsequently deliver very preterm have a reduction in cortical and extra cerebrospinal fluid volumes. If such alterations commence antenatally this suggests a role for earlier administration of neuroprotective agents.

Down syndrome (DS) occurs with triplication of human chromosome 21 and is associated with deviations in cortical development evidenced by simplified gyral appearance and reduced cortical surface area. Radial glia are neuronal and glial progenitors that also create a scaffolding structure essential for migrating neurons to reach cortical targets and therefore play a critical role in cortical development. The aim of this study was to characterise radial glial expression pattern and morphology in the frontal lobe of the developing human fetal brain with DS and age-matched controls. Secondly, we investigated whether microstructural information from in vivo magnetic resonance imaging (MRI) could reflect histological findings from human brain tissue samples. Immunohistochemistry was performed on paraffin-embedded human post-mortem brain tissue from nine fetuses and neonates with DS (15-39 gestational weeks (GW)) and nine euploid age-matched brains (18-39 GW). Radial glia markers CRYAB, HOPX, SOX2, GFAP and Vimentin were assessed in the Ventricular Zone, Subventricular Zone and Intermediate Zone. In vivo diffusion MRI was used to assess microstructure in these regions in one DS (21 GW) and one control (22 GW) fetal brain. We found a significant reduction in radial glial progenitor SOX2 and subtle deviations in radial glia expression (GFAP and Vimentin) prior to 24 GW in DS. In vivo, fetal MRI demonstrates underlying radial projections consistent with immunohistopathology. Radial glial alterations may contribute to the subsequent simplified gyral patterns and decreased cortical volumes observed in the DS brain. Recent advances in fetal MRI acquisition and analysis could provide non-invasive imaging-based biomarkers of early developmental deviations.

Highlights A consideration of the causes of individual differences in Down syndrome, at the level of genes, epigenetics, brain, and behaviour, linking potential differences in early development with elevated risk for Alzheimer’s disease. Evaluation of environmental (socioeconomic status) and genetic (chromosome 19 apolipoprotein APOE genotype, modulating risk for AD in adulthood) predictors of individual differences in early vocabulary development in a sample of 84 infants and young children with DS. Neither predictor accounted for significant amounts of variance, leaving the wide variability unexplained and likely arising from complex individual effects of the DS genotype. There was weak evidence that early development was faster for the APOE genotype conferring greater AD risk (ε4 carriers) consistent with recent observations in infant attention ( D’Souza, Mason et al., 2020 ) Proof of principle that prenatal and neonatal magnetic resonance imaging methods may be used to test the predictive power of measures of early brain structure for variation in DS infant cognitive development. Early brain development represents the concerted effect of the DS genotype. The article argues for the importance of a multi-level, lifespan developmental approach to explore the origins of individual differences in DS cognition. It hypothesises that in this framework, dementia itself may be considered as a developmental disorder ( Karmiloff-Smith et al., 2016 ).