Neonatal Functional and Structural Connectivity Are Associated with Cerebral Palsy at Two Years of Age

Merhar, Stephanie L.; Gozdas, Elveda; Tkach, Jean A.; Parikh, Nehal A.; Kline‐Fath, Beth M.; He, Lili; Yuan, Weihong; Altaye, Mekibib; Leach, James; Holland, Scott K.

doi:10.1055/s-0039-1683874

Cited by 8 publications

(5 citation statements)

References 40 publications

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“…Although the literature on fMRI in newborns with brain injury is still scarce, these findings are supported by a study performed on newborns with perinatal brain lesions, including NE due to presumed PA, which concluded that the CP group had reduced functional connectivity from the right supplementary motor areas when compared with the non-CP group [33]. However, they did not find any difference between the groups in brain activation during a motor task like the one used in our study.…”

Section: Discussionsupporting

confidence: 82%

The role of early functional neuroimaging in predicting neurodevelopmental outcomes in neonatal encephalopathy

et al. 2023

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Reliably assessing the early neurodevelopmental outcomes in infants with neonatal encephalopathy (NE) is of utmost importance to advise parents and implement early and personalized interventions. We aimed to evaluate the accuracy of neuroimaging modalities, including functional magnetic resonance imaging (fMRI) in predicting neurodevelopmental outcomes in NE. Eighteen newborns with NE due to presumed perinatal asphyxia (PA) were included in the study, 16 of whom underwent therapeutic hypothermia. Structural magnetic resonance imaging (MRI), and fMRI during passive visual, auditory, and sensorimotor stimulation were acquired between the 10th and 14th day of age. Clinical follow-up protocol included visual and auditory evoked potentials and a detailed neurodevelopmental evaluation at 12 and 18 months of age. Infants were divided according to sensory and neurodevelopmental outcome: severe, moderate disability, or normal. Structural MRI findings were the best predictor of severe disability with an AUC close to 1.0. There were no good predictors to discriminate between moderate disability versus normal outcome. Nevertheless, structural MRI measures showed a significant correlation with the scores of neurodevelopmental assessments. During sensorimotor stimulation, the fMRI signal in the right hemisphere had an AUC of 0.9 to predict absence of cerebral palsy (CP). fMRI measures during auditory and visual stimulation did not predict sensorineural hearing loss or cerebral visual impairment.Conclusion: In addition to structural MRI, fMRI with sensorimotor stimulation may open the gate to improve the knowledge of neurodevelopmental/motor prognosis if proven in a larger cohort of newborns with NE. What is Known: • Establishing an early, accurate neurodevelopmental prognosis in neonatal encephalopathy remains challenging. • Although structural MRI has a central role in neonatal encephalopathy, advanced MRI modalities are gradually being explored to optimize neurodevelopmental outcome knowledge. What is New: • Newborns who later developed cerebral palsy had a trend towards lower fMRI measures in the right sensorimotor area during sensorimotor stimulation. • These preliminary fMRI results may improve future early delineation of motor prognosis in neonatal encephalopathy.

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Section: Discussionsupporting

confidence: 82%

The role of early functional neuroimaging in predicting neurodevelopmental outcomes in neonatal encephalopathy

et al. 2023

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“…Since our study was conducted on u-HCC, which is a different subject from the previous study, a new cutoff value needs to be established. CV ≥ 0.22, the median value for all patients, was applied in this study as a cutoff, as in previous studies [ 28 , 29 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of Efficacy for Atezolizumab/Bevacizumab in Unresectable Hepatocellular Carcinoma with Hepatobiliary-Phase Gadolinium Ethoxybenzyl-Diethylenetriaminepentaacetic Acid MRI

Kunichika,

Minamiguchi,

Tachiiri

et al. 2024

Cancers

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Background: This study aimed to examine whether the coefficient of variation (CV) in the hepatobiliary-phase (HBP) of Gd-EOB-DTPA-MRI could be an independent predictive factor for tumor progression. Methods: Patients who underwent Gd-EOB-DTPA-MRI before Atezolizumab/bevacizumab therapy at six affiliated institutions between 2018 and 2022 were included. CV for each patient was calculated as the mean value for up to five tumors larger than 10 mm, and CV of the whole tumor was calculated using LIFEx software. The tumor response was evaluated within 6–10 weeks. The primary endpoint was to investigate the predictive factors, including CV, related to tumor progression using logistic regression analysis. The secondary endpoints were tumor response rate and progression-free survival (PFS) based on CV. Results: Of the 46 enrolled patients, 13 (28.3%) underwent early progressive disease. Multivariate analysis revealed that a high CV (≥0.22) was an independent predictive factor for tumor progression (p = 0.043). Patients with a high CV had significantly frequent PD than those with a low CV (43.5 vs. 13.0%, p = 0.047). Patients with a high CV tended to have shorter PFS than those with a low CV (3.5 vs. 6.7 months, p = 0.071). Conclusion: Quantitative analysis using CV in the HBP of Gd-EOB-DTPA-MRI may be useful for predicting tumor progression for atezolizumab/bevacizumab therapy.

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“…This suggests that term-born children with PVL may have a more diffuse injury of white matter when compared to preterm children with PVL [14]. In both term and preterm infants, perinatal brain injury is the primary cause of cerebral palsy [19]. Structural MRI is the standard used to evaluate for brain injury in term and preterm infants with suspected brain injury apparent on ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“…Structural MRI is the standard used to evaluate for brain injury in term and preterm infants with suspected brain injury apparent on ultrasound. It was found that Diffusion Tensor Imaging (DTI) and functional MRI obtained soon after birth are potential biomarkers to help predict CP in newborns with perinatal brain injury, thus facilitating early intervention to improve motor outcomes in infants at risk of CP [19]. Infants with perinatal brain injury and CP were shown to have reduced structural and functional connectivity within motor networks during the neonatal period when compared to infants with perinatal brain injury and normal motor outcomes [19].…”

Section: Discussionmentioning

confidence: 99%

Management of spastic diplegic cerebral palsy and periventricular leukomalacia in a preterm 2-year-old: A case report and review of the literature

Rahman¹,

Palin²,

Murphy³

et al. 2022

J Clin Images Med Case Rep

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Periventricular Leukomalacia (PVL) is the most frequent brain injury to be associated with Cerebral Palsy (CP), especially in preterm infants. Spastic diplegia, a movement disorder commonly seen in CP, is characterized by increased muscle tone and spasticity in the lower extremities. The authors present a case of a 2-year-old child with mild PVL and spastic diplegia CP, with identifying factors including preterm birth history, his present age, and increasing severity of symptoms overtime. Magnetic resonance imaging was significant for an abnormally increased periventricular signal consistent with mild PVL. Due to worsening symptoms of toe-walking, increased gait width, and spasticity of lower extremities, interventions were recommended. This case demonstrates the neurodevelopmental consequences of PVL and ischemic brain injury in a preterm infant, resulting in spastic diplegic CP. A comprehensive and up-to-date review of the literature on PVL and spastic diplegia associated with CP is explored. Keywords: Cerebral palsy; Preterm; Spasticity; Hypoxic-ischemic encephalopathy; Magnetic resonance imaging.

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Neonatal Functional and Structural Connectivity Are Associated with Cerebral Palsy at Two Years of Age

Cited by 8 publications

References 40 publications

The role of early functional neuroimaging in predicting neurodevelopmental outcomes in neonatal encephalopathy

The role of early functional neuroimaging in predicting neurodevelopmental outcomes in neonatal encephalopathy

Prediction of Efficacy for Atezolizumab/Bevacizumab in Unresectable Hepatocellular Carcinoma with Hepatobiliary-Phase Gadolinium Ethoxybenzyl-Diethylenetriaminepentaacetic Acid MRI

Management of spastic diplegic cerebral palsy and periventricular leukomalacia in a preterm 2-year-old: A case report and review of the literature

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