Is Brain Maturation Comparable in Fetuses and Premature Neonates at Term Equivalent Age?

Viola, Angèle; Confort‐Gouny, S.; Schneider, J; Fur, Yann Le; Viout, Patrick; Chapon, F.; Pineau, S.; Cozzone, Patrick J.; Girard, Nadine

doi:10.3174/ajnr.a2555

Cited by 20 publications

(15 citation statements)

References 48 publications

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“…Our study showed that this assumption may not be valid as Cr as significantly different in the two cohorts. However, our observations are generally consistent with a study where metabolism of near term in utero fetuses was compared with premature neonates imaged at equivalent PC age [25]. Higher levels of NAA and Cr were observed in premature neonates compared with fetuses.…”

Section: Discussionsupporting

confidence: 91%

“…These patterns of developmental lag have been most robustly demonstrated in the most extreme preterm cohorts and in preterm infants with severe injury visualized on conventional imaging [11], [12]. Yet, even in studies where preterm infants with documented injury have been excluded, it has been suggested that WM maturation still lags, documented as decreased WM volume and abnormal microstructure [22], [23] albeit there has been variability as a more recent study reported an early onset of WM maturation in preterm infants [24], [25]. Studies of GM maturation in preterm infants have revealed a decrease in GM volume [19] and differences in tissue microstructure [26], [27].…”

Section: Discussionmentioning

confidence: 99%

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Metabolic Maturation of White Matter Is Altered in Preterm Infants

et al. 2014

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Significant physiological switches occur at birth such as the transition from fetal parallel blood flow to a two-circuit serial system with increased arterial oxygenation of blood delivered to all organs including the brain. In addition, the extra-uterine environment exposes premature infants to a host of stimuli. These events could conceivably alter the trajectory of brain development in premature infants. We used in vivo magnetic resonance spectroscopy to measure absolute brain metabolite concentrations in term and premature-born infants without evidence of brain injury at equivalent post-conceptional age. Prematurity altered the developmental time courses of N-acetyl-aspartate, a marker for axonal and neuronal development, creatine, an energy metabolite, and choline, a membrane metabolite, in parietal white matter. Specifically, at term-equivalency, metabolic maturation in preterm infants preceded development in term infants, but then progressed at a slower pace and trajectories merged at ≈340–370 post-conceptional days. In parieto/occipital grey matter similar trends were noticed but statistical significance was not reached. The timing of white matter development and synchronization of white matter and grey matter maturation in premature-born infants is disturbed. This may contribute to the greater risk of long-term neurological problems of premature infants and to their higher risk for white matter injury.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Metabolic Maturation of White Matter Is Altered in Preterm Infants

et al. 2014

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“…How premature extrauterine life may affect these processes is not yet fully understood. In a previous study, we reported microstructural and metabolic differences between fetuses and preterm neonates around term, suggesting advanced brain maturation in the neonates born premature [46]. Here, we compared brain maturation in premature neonates and term neonates around term.…”

Section: Discussionmentioning

confidence: 91%

“…The finding of large differences in both Y 0 and apparent T 2 values between PN and TN suggests that the difference in signal intensity between these groups reflects differences in taurine concentration and T 2 . Differences in metabolite T 2 relaxation times may indicate differences in metabolite intracellular environment such as viscosity and metabolite-protein binding [46]. This aminoacid is a major osmolyte involved in cell volume regulation, neurotransmission, ion channel modulation, and neuroprotection [47–49].…”

Section: Discussionmentioning

confidence: 99%

Creatine, Glutamine plus Glutamate, and Macromolecules Are Decreased in the Central White Matter of Premature Neonates around Term

et al. 2016

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Preterm birth represents a high risk of neurodevelopmental disabilities when associated with white-matter damage. Recent studies have reported cognitive deficits in children born preterm without brain injury on MRI at term-equivalent age. Understanding the microstructural and metabolic underpinnings of these deficits is essential for their early detection. Here, we used diffusion-weighted imaging and single-voxel 1H magnetic resonance spectroscopy (MRS) to compare brain maturation at term-equivalent age in premature neonates with no evidence of white matter injury on conventional MRI except diffuse excessive high-signal intensity, and normal term neonates. Thirty-two infants, 16 term neonates (mean post-conceptional age at scan: 39.8±1 weeks) and 16 premature neonates (mean gestational age at birth: 29.1±2 weeks, mean post-conceptional age at scan: 39.2±1 weeks) were investigated. The MRI/MRS protocol performed at 1.5T involved diffusion-weighted MRI and localized 1H-MRS with the Point RESolved Spectroscopy (PRESS) sequence. Preterm neonates showed significantly higher ADC values in the temporal white matter (P<0.05), the occipital white matter (P<0.005) and the thalamus (P<0.05). The proton spectrum of the centrum semiovale was characterized by significantly lower taurine/H2O and macromolecules/H2O ratios (P<0.05) at a TE of 30 ms, and reduced (creatine+phosphocreatine)/H2O and (glutamine+glutamate)/H2O ratios (P<0.05) at a TE of 135 ms in the preterm neonates than in full-term neonates. Our findings indicate that premature neonates with normal conventional MRI present a delay in brain maturation affecting the white matter and the thalamus. Their brain metabolic profile is characterized by lower levels of creatine, glutamine plus glutamate, and macromolecules in the centrum semiovale, a finding suggesting altered energy metabolism and protein synthesis.

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“…Our findings suggest that even in the absence of structural brain injury, the developmental trajectory of the preterm brain is altered over the third trimester. Evidence of clinical 4 .01 * 14.17 ± 1.6 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] 13.91 ± 2.7 [8][9][10][11][12][13][14][15][16][17][18][19][20] .66…”

Section: Discussionmentioning

confidence: 99%

Third Trimester Brain Growth in Preterm Infants Compared With In Utero Healthy Fetuses

et al. 2016

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BACKGROUND AND OBJECTIVES:Compared with term infants, preterm infants have impaired brain development at term-equivalent age, even in the absence of structural brain injury. However, details regarding the onset and progression of impaired preterm brain development over the third trimester are unknown. Our primary objective was to compare third-trimester brain volumes and brain growth trajectories in ex utero preterm infants without structural brain injury and in healthy in utero fetuses. As a secondary objective, we examined risk factors associated with brain volumes in preterm infants over the thirdtrimester postconception.

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Is Brain Maturation Comparable in Fetuses and Premature Neonates at Term Equivalent Age?

Cited by 20 publications

References 48 publications

Metabolic Maturation of White Matter Is Altered in Preterm Infants

Metabolic Maturation of White Matter Is Altered in Preterm Infants

Creatine, Glutamine plus Glutamate, and Macromolecules Are Decreased in the Central White Matter of Premature Neonates around Term

Third Trimester Brain Growth in Preterm Infants Compared With In Utero Healthy Fetuses

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