Brain Structural and Vascular Anatomy Is Altered in Offspring of Pre-Eclamptic Pregnancies: A Pilot Study

Abstract

BACKGROUND AND PURPOSE:Pre-eclampsia is a serious clinical gestational disorder occurring in 3%-5% of all human pregnancies and characterized by endothelial dysfunction and vascular complications. Offspring born of pre-eclamptic pregnancies are reported to exhibit deficits in cognitive function, higher incidence of depression, and increased susceptibility to stroke. However, no brain imaging reports exist on these offspring. We aimed to assess brain structural and vascular anatomy in 7-to 10-year-old offspring of pre-eclamptic pregnancies compared with matched controls.

Diffusion Tensor Imaging of White Matter in Children Born from Preeclamptic Gestations

“…14 The independent DTI analyses identified differences in brain areas between the groups that corresponded with results from our previous analyses. For example, the larger brain anatomic areas described previously in PE-F1 (temporal lobe, right and left amygdalae) were coincident with a higher volume of bundles of white matter (superior longitudinal fasciculus and caudate nucleus) and also with higher values of FA (caudate nucleus).…”

“…20 The PE-F1 deviations of increased brain regional volumes or globally reduced vascular diameters suggest that the legacy impact of PE occurred in regions associated with memory and visual spatial processing. 14,16 Our previous findings that the temporal lobe and right and left amygdalae in PE-F1 are larger than in control children were coincident with the larger DTI volume of white matter in 2 ROIs: the caudate nucleus and superior longitudinal fasciculus (Table).…”

“…[5][6][7][8][9][10][11][12][13][14] The brain regions with statistically significant DTI differences were previously identified in an independent analysis as having anatomic variances in volume or global vessel width compared with children born from typical pregnancies.…”

“…In addition, reduced vascular radii were identified from time-of-flight MR angiography datasets in the occipital and parietal lobes. 14 These preliminary results…”

“…12,13 Recently, we conducted a pilot study to determine whether clinical cognitive function test outcomes and brain MR imaging findings differed between PE-F1s and typical 7-to 10-year-old children. 14 The hypothesis driving this research posits that the progressive dysregulation of angiokines that is clinically associated with maternal PE development reflects conditions occurring not only in placental but also in all fetal tissues and impacts fetal cerebrovascular development. This hypothesis 15 predicts that brain anatomy and function differ between PE-F1s and children born from normotensive mothers due to the use of common molecular pathways during vascular and neuronal cell differentiation (vascular endothelial growth factor pathways) and to the importance of cerebral blood flow for anatomic and functional brain development.…”