Evaluation of the frequency of neuroimaging findings in congenital infection by Zika virus and differences between computed tomography and magnetic resonance imaging in the detection of alterations
Abstract:Introduction: Congenital infection by the Zika virus (ZIKV) is responsible for severe abnormalities in the development of the central nervous system. The aim of this study was to evaluate and compare the ability of computed tomography (CT) and magnetic resonance (MR) to detect patterns of involvement of the central nervous system in congenital ZIKV syndrome. Methods: We retrospectively analyzed CT and MR images from 34 patients with congenital ZIKV syndrome and evaluated the differences between the two methods… Show more
“…In addition, a previous study conducted in a pediatric cohort (n=23) followed from birth until 36 months reported the development of postnatal microcephaly, mainly in children with severe brain abnormalities at birth 39 . Brain imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) showed calcifications, ventriculomegaly, and diffuse cortical atrophy, which are now part of the diagnostic criteria 31 , 35 , 40 - 42 . A multicenter study of 83 children born with microcephaly at the peak of the epidemic, recruited from 10 Brazilian states, highlighted a phenotype known as the fetal brain disruption sequence, which is rarely observed in other congenital infections 43 .…”
Section: Spectrum Of Congenital Zika Manifestationsmentioning
This review aimed to provide an update on the morphological and/or functional abnormalities related to congenital Zika virus (ZIKV) infection, based on primary data from studies conducted in Brazil since 2015. During the epidemic years (2015-2016), case series and pediatric cohort studies described several birth defects, including severe and/or disproportionate microcephaly, cranial bone overlap, skull collapse, congenital contractures (arthrogryposis and/or clubfoot), and visual and hearing abnormalities, as part of the spectrum of Congenital Zika Syndrome (CZS). Brain imaging abnormalities, mainly cortical atrophy, ventriculomegaly, and calcifications, serve as structural markers of CZS severity. Most case series and cohorts of microcephaly have reported the co-occurrence of epilepsy, dysphagia, orthopedic deformities, motor function impairment, cerebral palsy, and urological impairment. A previous large meta-analysis conducted in Brazil revealed that a confirmed ZIKV infection during pregnancy was associated with a 4% risk of microcephaly. Additionally, one-third of children showed at least one abnormality, predominantly identified in isolation. Studies examining antenatally ZIKV-exposed children without detectable abnormalities at birth reported conflicting neurodevelopmental results. Therefore, long-term follow-up studies involving pediatric cohorts with appropriate control groups are needed to address this knowledge gap. We recognize the crucial role of a national network of scientists collaborating with international research institutions in understanding the lifelong consequences of congenital ZIKV infection. Additionally, we highlight the need to provide sustainable resources for research and development to reduce the risk of future Zika outbreaks.
“…In addition, a previous study conducted in a pediatric cohort (n=23) followed from birth until 36 months reported the development of postnatal microcephaly, mainly in children with severe brain abnormalities at birth 39 . Brain imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) showed calcifications, ventriculomegaly, and diffuse cortical atrophy, which are now part of the diagnostic criteria 31 , 35 , 40 - 42 . A multicenter study of 83 children born with microcephaly at the peak of the epidemic, recruited from 10 Brazilian states, highlighted a phenotype known as the fetal brain disruption sequence, which is rarely observed in other congenital infections 43 .…”
Section: Spectrum Of Congenital Zika Manifestationsmentioning
This review aimed to provide an update on the morphological and/or functional abnormalities related to congenital Zika virus (ZIKV) infection, based on primary data from studies conducted in Brazil since 2015. During the epidemic years (2015-2016), case series and pediatric cohort studies described several birth defects, including severe and/or disproportionate microcephaly, cranial bone overlap, skull collapse, congenital contractures (arthrogryposis and/or clubfoot), and visual and hearing abnormalities, as part of the spectrum of Congenital Zika Syndrome (CZS). Brain imaging abnormalities, mainly cortical atrophy, ventriculomegaly, and calcifications, serve as structural markers of CZS severity. Most case series and cohorts of microcephaly have reported the co-occurrence of epilepsy, dysphagia, orthopedic deformities, motor function impairment, cerebral palsy, and urological impairment. A previous large meta-analysis conducted in Brazil revealed that a confirmed ZIKV infection during pregnancy was associated with a 4% risk of microcephaly. Additionally, one-third of children showed at least one abnormality, predominantly identified in isolation. Studies examining antenatally ZIKV-exposed children without detectable abnormalities at birth reported conflicting neurodevelopmental results. Therefore, long-term follow-up studies involving pediatric cohorts with appropriate control groups are needed to address this knowledge gap. We recognize the crucial role of a national network of scientists collaborating with international research institutions in understanding the lifelong consequences of congenital ZIKV infection. Additionally, we highlight the need to provide sustainable resources for research and development to reduce the risk of future Zika outbreaks.
“…Since the initial reports and observations of ZIKV affecting development, it has become clear that there is variation in the extent to which exposure to ZIKV during fetal development [herein, for brevity referred to as fetal ZIKV (fZIKV)] affects the developing brain and that children born with normal-sized heads and brains may also be affected. Children with congenital ZIKV syndrome (CZS), which presents both with and without microcephaly, have a myriad of neurological symptoms, including ventriculomegaly, lissencephaly, areas of calcification and cysts throughout the brain, and cortical malformations (2)(3)(4)(5)(6)(7). Children with CZS can present smaller in size and weight (8)(9)(10) and may exhibit muscle weakness, loss of reflexes, dyspnea, hypertonia, spasticity, arthrogryposis, epilepsy, and developmental delays and may have severe learning disabilities [for a review, see (11)].…”
There is enormous variation in the extent to which fetal Zika virus (fZIKV) infection affects the developing brain. Despite the neural consequences of fZIKV infection observed in people and animal models, many open questions about the relationship between infection dynamics and fetal and infant development remain. To further understand how ZIKV affects the developing nervous system and the behavioral consequences of prenatal infection, we adopted a nonhuman primate model of fZIKV infection in which we inoculated pregnant rhesus macaques and their fetuses with ZIKV in the early second trimester of fetal development. We then tracked their health across gestation and characterized infant development across the first month of life. ZIKV-infected pregnant mothers had long periods of viremia and mild changes to their hematological profiles. ZIKV RNA concentrations, an indicator of infection magnitude, were higher in mothers whose fetuses were male, and the magnitude of ZIKV RNA in the mothers’ plasma or amniotic fluid predicted infant outcomes. The magnitude of ZIKV RNA was negatively associated with infant growth across the first month of life, affecting males’ growth more than females’ growth, although for most metrics, both males and females evidenced slower growth rates as compared with control animals whose mothers were not ZIKV inoculated. Compared with control infants, fZIKV infants also spent more time with their mothers during the first month of life, a social behavior difference that may have long-lasting consequences on psychosocial development during childhood.
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