Glutamate alterations in the premature infant brain during different gestational ages with glutamate chemical exchange saturation transfer imaging: a pilot study

Ren, Qingfa; Wan, Bin; Luo, Xunrong; Liu, Quanyuan; He, Guoqing; Li, Hao; Luo, Mingfang; Xu, Donghao; Liu, Pan; Wang, Jing; Yin, Zhijie; Li, Xianglin

doi:10.1007/s00330-022-09374-2

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…On the basis of any definition of FI, we included studies in which premature infants received pediatric Tui na to prevent or treat FI. We will identify prematurely born infants as per the definition of the World Health Organization (WHO); this includes infants born within 259 days from the first date of the mother’s last menstrual period or before 37 full weeks of gestation [ 39 ].…”

Section: Methodsmentioning

confidence: 99%

Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis

Bai,

Lyu,

Tang

et al. 2023

JMIR Res Protoc

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Background Feeding intolerance (FI), frequently resulting from gastrointestinal immaturity, is prevalent among premature infants. Current practices are gradually prioritizing nonpharmacological treatments, such as massage or “Tui na,” considering the potential side effects of prolonged medication use. Pediatric Tui na, a specialized massage therapy based on traditional Chinese medicine, has been widely studied for treating FI in premature infants. However, to our knowledge, no systematic review specifically focusing on the effectiveness and safety of traditional Chinese medicine–based pediatric Tui na for FI in premature infants has been published yet. Objective This study aims to develop a protocol for a systematic review and meta-analysis for evaluating the safety and efficacy of pediatric Tui na for premature infants with FI. Methods We will perform a comprehensive search in the following databases: Springer, Cochrane Library, Embase, MEDLINE, Clarivate Analytics, Physiotherapy Evidence Database (PEDro), CINAHL, PubMed, Scopus, World Health Organization (WHO) International Clinical Trials Registry Platform, and Chinese biomedical databases (Wanfang database, the China National Knowledge Infrastructure, Chinese Scientific Journals Database, and Chinese Biomedical Literature Databases), limited to studies published in Chinese and English languages between January 2000 and January 2023. The search strategy will use MeSH (Medical Subject Headings) terms and database-specific keywords. A total of 2 independent reviewers will initially screen the studies based on titles and abstracts, followed by a full-text evaluation of the eligible studies. Studies will include any nonrandomized controlled trials, nonrandomized clinical studies, randomized controlled trials, and quasi-experimental studies wherein the treatment group involves premature infants with FI given pediatric Tui na. Primary outcomes will be necrotizing enterocolitis, gastric residual volume, emesis, and stool blood. Secondary outcomes will be abdominal distension weight gain, time to achieve full enteral feeding, any adverse effects associated with pediatric Tui na, and length of hospital stay. The Cochrane Collaboration Risk of Bias Tool will be used to assess the risk of bias and methodological quality. Funnel plots will be used for evaluating publication bias. Meta-analysis will be conducted using the Review Manager software (version 5.4; Cochrane Collaboration). Subgroup analyses will be considered according to treatment received, country or setting, sex, and birth weight of premature infants (if heterogeneity is high, I2≥50%). Results This is a systematic review and meta-analysis protocol, so the results are not yet available. The protocol has been registered with PROSPERO (CRD42023390021). We are currently in the study selection phase. Results are expected to be completed by the end of 2023. Conclusions Following this protocol, a comprehensive and rigorous literature synthesis will be developed to assess the impact of pediatric Tui na treatment on premature infants with FI, enabling the determination of its efficacy and safety. Trial Registration PROSPERO CRD42023390021; https://tinyurl.com/bdf4kn23 International Registered Report Identifier (IRRID) PRR1-10.2196/46375

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Section: Methodsmentioning

confidence: 99%

Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis

Bai,

Lyu,

Tang

et al. 2023

JMIR Res Protoc

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Hippocampal Glutamate Levels and Their Correlation With Subregion Volume in School‐Aged Children With MRI‐Negative Epilepsy: A Preliminary Study

Xu,

Ren,

Liu

et al. 2024

Magnetic Resonance Imaging

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BackgroundAbnormal levels of glutamate constitute a key pathophysiologic mechanism in epilepsy. The use of glutamate chemical exchange saturation transfer (GluCEST) imaging to measure glutamate levels in pediatric epilepsy is rarely reported in research.PurposeTo investigate hippocampal glutamate level variations in pediatric epilepsy and the correlation between glutamate and hippocampal subregional volumes.Study TypeCross‐sectional, prospective.SubjectsA total of 38 school‐aged pediatric epilepsy patients with structurally normal MRI as determined by at least two independent radiologists (60% males; 8.7 ± 2.5 years; including 20 cases of focal pediatric epilepsy [FE] and 18 cases of generalized pediatric epilepsy [GE]) and 17 healthy controls (HC) (41% males; 9.0 ± 2.5 years).Field Strength/Sequence3.0 T; 3D magnetization prepared rapid gradient echo (MPRAGE) and 2D turbo spin echo GluCEST sequences.AssessmentThe relative concentration of glutamate was calculated through pixel‐wise magnetization transfer ratio asymmetry (MTRasym) analysis of the GluCEST data. Hippocampal subfield volumes were computed from MPRAGE data using FreeSurfer.Statistical TestsThis study used t tests, one‐way analysis of variance, Kruskal–Wallis tests, and Pearson correlation analysis. P < 0.05 was considered statistically significant.ResultsThe MTRasym values of both the left and right hippocampi were significantly elevated in GE (left: 2.51 ± 0.23 [GE] vs. 2.31 ± 0.12 [HCs], right: 2.50 ± 0.22 [GE] vs. 2.27 ± 0.22 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly elevated in FE (2.49 ± 0.28 [ipsilateral] vs. 2.29 ± 0.16 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly increased compared to the contralateral hippocampus in FE (2.49 ± 0.28 [ipsilateral] vs. 2.35 ± 0.34 [contralateral]). No significant differences in hippocampal volume were found between different groups (left hippocampus, P = 0.87; right hippocampus, P = 0.87).Data ConclusionGluCEST imaging have potential for the noninvasive measurement of glutamate levels in the brains of children with epilepsy.Level of Evidence2Technical EfficacyStage 1

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Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis (Preprint)

Bai¹,

Lyu²,

Tang³

et al. 2023

Preprint

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BACKGROUND Feeding intolerance (FI) is usually a consequence of gastrointestinal immaturity (GI) and commonly occurs in premature infants, and it affects lots of premature infants, many studies have investigated pediatric Tui na for treating FI in premature infants, but to our knowledge, no systematic review, meta-analysis, or review protocol relevant to TCM-based pediatric Tui na for premature infants with FI has been published thus far. OBJECTIVE To develop a protocol for a systematic review and meta-analysis for evaluating the safety and efficacy of pediatric Tui na for premature infants with feeding intolerance (FI) METHODS We will conduct a thorough electronic literature search of Embase, Clarivate Analytics, PubMed, Cochrane Library, MEDLINE, Scopus, Springer, CINAHL, Physiotherapy Evidence Database (PEDro), World Health Organization International Clinical Trials Registry Platform, and Chinese biomedical databases (Wanfang database, the China National Knowledge Infrastructure database, Chinese Biomedical Literature Database, and Chinese Scientific Journals Database). Two reviewers will independently screen the studies based on titles and abstracts, and full-text reading of the eligible studies will be performed thereafter. Studies include any non-randomized controlled trials, non-randomized clinical studies, randomized controlled trials, and quasi-experimental studies wherein the treatment group involves premature infants with FI given pediatric Tui na. Primary outcomes will be necrotizing enterocolitis, gastric residual volume, emesis, blood in the stool, and abdominal distension. Secondary outcomes will be weight gain, time to achieve full enteral feeding, any adverse events associated with pediatric Tui na, and length of hospital stay. The Cochrane Collaboration Risk of Bias Tool will be used for risk of bias and methodological quality assessments. A meta-analysis of the efficacy will be performed if the studies included are sufficient, and publication bias evaluation using funnel plots will be performed, if possible. Subgroup analyses will be performed if the studies are sufficient and show substantial heterogeneity. RESULTS We will initiate review database searches in January 2023 and expect to have some findings by July 2023. CONCLUSIONS This protocol will help establish a framework of a high-quality literature synthesis on the impact of pediatric Tui na treatment for premature infants with FI. The efficacy and safety of pediatric Tui na for premature infants with FI will be determined by the proposed review. CLINICALTRIAL PROSPERO CRD 42023390021.

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Glutamate alterations in the premature infant brain during different gestational ages with glutamate chemical exchange saturation transfer imaging: a pilot study

Cited by 3 publications

References 38 publications

Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis

Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis

Hippocampal Glutamate Levels and Their Correlation With Subregion Volume in School‐Aged Children With MRI‐Negative Epilepsy: A Preliminary Study

Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis (Preprint)

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