Cerebral gray matter injuries in infants with intraventricular hemorrhage

Sharma, Deep; Agyemang, Alex Adusei; Ballabh, Praveen

doi:10.1016/j.semperi.2022.151595

Cited by 9 publications

(8 citation statements)

References 93 publications

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“…We observed an inverse relation between |sFC| and large VV: increases in VV were associated with decreases in |sFC|. Our findings of increased ventricle volume in preterm neonates and reduced fNIRS-based functional connectivity suggest that regional disruptions of ventricular size may impact the development of the underlying grey matter 53 . These results bear clinical significance given that the neonate's brain is rapidly growing and at risk for injury 54 .…”

Section: Discussionmentioning

confidence: 59%

“…Our findings suggest that increasing ventricular dilatation is associated with reduced |sFC| in preterm infants with GMH-IVH. To put this into context, the larger the ventricles, the more likely sFC will be impaired 53 . While GMH, especially when severe, is known to cause pathological and functional consequences based on the extent of white matter injury 55 , 56 , we did observe similar findings in our study, more so in the group with severe ventriculomegaly needing CSF diversion.…”

Section: Discussionmentioning

confidence: 99%

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Three-dimensional cranial ultrasound and functional near-infrared spectroscopy for bedside monitoring of intraventricular hemorrhage in preterm neonates

Kebaya

Stubbs²,

Lo³

et al. 2023

Sci Rep

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Germinal Matrix-Intraventricular Hemorrhage (GMH-IVH) remains a significant cause of adverse neurodevelopment in preterm infants. Current management relies on 2-dimensional cranial ultrasound (2D cUS) ventricular measurements. Reliable biomarkers are needed to aid in the early detection of posthemorrhagic ventricular dilatation (PHVD) and subsequent neurodevelopment. In a prospective cohort study, we incorporated 3-dimensional (3D) cUS and functional near-infrared spectroscopy (fNIRS) to monitor neonates with GMH-IVH. Preterm neonates (≤ 32 weeks' gestation) were enrolled following a GMH-IVH diagnosis. Neonates underwent sequential measurements: 3D cUS images were manually segmented using in-house software, and the ventricle volumes (VV) were extracted. Multichannel fNIRS data were acquired using a high-density system, and spontaneous functional connectivity (sFC) was calculated. Of the 30 neonates enrolled in the study, 19 (63.3%) had grade I–II and 11 (36.7%) grade III–IV GMH-IVH; of these, 7 neonates (23%) underwent surgical interventions to divert cerebrospinal fluid (CSF). In infants with severe GMH-IVH, larger VV were significantly associated with decreased |sFC|. Our findings of increased VV and reduced sFC suggest that regional disruptions of ventricular size may impact the development of the underlying white matter. Hence, 3D cUS and fNIRS are promising bedside tools for monitoring the progression of GMH-IVH in preterm neonates.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Three-dimensional cranial ultrasound and functional near-infrared spectroscopy for bedside monitoring of intraventricular hemorrhage in preterm neonates

Kebaya

Stubbs²,

Lo³

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Our study findings are not surprising, given that the pathological and functional consequences of GMH-IVH depend on its severity. (57) Previous resting-state FC fMRI studies have reported similar findings, showing resting state networks development was affected depending on WMI severity and location. (60, 61) In addition, in a recent study, Tortora et al showed regional impairment of cortical and regional grey matter perfusion in preterm infants with mild GMH-IVH.…”

Section: Discussionmentioning

confidence: 65%

“…Our findings of increased ventricular volume in preterm neonates and reduced fNIRS-based functional connectivity suggest that regional disruptions of ventricular size may impact the development of the underlying grey matter. (57) These results bear clinical significance given that the preterm neonate’s brain is rapidly growing and at risk for injury. (58, 59) Furthermore, severe GMH-IVH and PHVD have been linked to adverse ND outcomes.…”

Section: Discussionmentioning

confidence: 94%

Three-dimensional cranial ultrasound and functional near infrared spectroscopy for bedside monitoring of intraventricular hemorrhage in preterm neonates

Kebaya

Stubbs

et al. 2022

Preprint

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Germinal Matrix-Intraventricular hemorrhage (GMH-IVH) remains a significant cause of adverse neurodevelopment in preterm infants. Current management relies on 2-dimensional cranial ultrasound (2D cUS) ventricular measurements. Reliable biomarkers are needed to aid in the early detection of posthemorrhagic ventricular dilatation (PHVD) and subsequent neurodevelopment. In a prospective cohort study, we incorporated 3-dimensional (3D) cUS and functional infrared spectroscopy (fNIRS) to monitor neonates with GMH-IVH. Preterm neonates (<32 weeks' gestation) were enrolled following a GMH-IVH diagnosis. Neonates underwent sequential measurements: 3D cUS images were manually segmented using in-house software, and the ventricle volumes (VV) were extracted. Multichannel fNIRS data were acquired using a high-density system, and spontaneous functional connectivity (sFC) was calculated. Of the 30 neonates enrolled in the study, 21 (70%) had grade I-II and 12 (40%) grade III-IV GMH-IVH, and 23 neonates (77%) underwent surgical interventions to divert cerebrospinal fluid (CSF). Infants with severe GMH-IVH who underwent CSF diversion had larger VV and significantly decreased sFC (p<0.001). Our findings of increased VV and reduced sFC suggest that regional disruptions of ventricular size may impact the development of the underlying grey matter. Hence, 3D cUS and fNIRS are promising bedside tools for monitoring the progression of GMH-IVH in preterm neonates.

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“…Brain injury is a common complication of preterm infants, including Intraventricular hemorrhage, periventricular leukomalacia, and diffuse white matter injury (WMI) 10 . In very low birth weight preterm infants, the germinal stroma blood vessels are immature and the tissue blood vessels are poorly supported, making the lateral ventricle particularly susceptible to intraventricular hemorrhage, white matter coagulation, and necrosis 11,12 . As the most common form of preterm brain injury, periventricular WMI or periventricular leukomalacia often occurs in infants between 24 and 32 weeks of gestational age, which may be accompanied by reduced cortical volume, thalamus, and basal ganglia volume 13 .…”

Section: Overview Of Preterm Brain Injurymentioning

confidence: 99%

Treatment of preterm brain injury via gut‐microbiota–metabolite–brain axis

Li,

Liu,

Shi

2023

CNS Neurosci Ther

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BackgroundBrain injury in preterm infants potentially disrupts critical structural and functional connective networks in the brain. It is a major cause of neurological sequelae and developmental deficits in preterm infants. Interesting findings suggest that the gut microbiota (GM) and their metabolites contribute to the programming of the central nervous system (CNS) during developmental stages and may exert structural and functional effects throughout the lifespan.AimTo summarize the existing knowledge of the potential mechanisms related to immune, endocrine, neural, and blood–brain barrier (BBB) mediated by GM and its metabolites in neural development and function.MethodsWe review the recent literature and included 150 articles to summarize the mechanisms through which GM and their metabolites work on the nervous system. Potential health benefits and challenges of relevant treatments are also discussed.ResultsThis review discusses the direct and indirect ways through which the GM may act on the nervous system. Treatment of preterm brain injury with GM or related derivatives, including probiotics, prebiotics, synbiotics, dietary interventions, and fecal transplants are also included.ConclusionThis review summarizes mechanisms underlying microbiota‐gut‐brain axis and novel therapeutic opportunities for neurological sequelae in preterm infants. Optimizing the initial colonization and microbiota development in preterm infants may represent a novel therapy to promote brain development and reduce long‐term sequelae.

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Cerebral gray matter injuries in infants with intraventricular hemorrhage

Cited by 9 publications

References 93 publications

Three-dimensional cranial ultrasound and functional near-infrared spectroscopy for bedside monitoring of intraventricular hemorrhage in preterm neonates

Three-dimensional cranial ultrasound and functional near-infrared spectroscopy for bedside monitoring of intraventricular hemorrhage in preterm neonates

Three-dimensional cranial ultrasound and functional near infrared spectroscopy for bedside monitoring of intraventricular hemorrhage in preterm neonates

Treatment of preterm brain injury via gut‐microbiota–metabolite–brain axis

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