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

Abstract

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.

Investigating Task-Free Functional Connectivity Patterns in Newborns Using functional Near-Infrared Spectroscopy

“…The copyright holder for this preprint this version posted September 6, 2023. ; https://doi.org/10.1101/2023.09.05.555980 doi: bioRxiv preprint the goal of monitoring these networks in a clinically relevant manner, particularly in neonates at risk of poor neurodevelopmental outcomes. fNIRS allows for studies of cortical hemodynamic brain activity analogous to fMRI but in a more practical and comfortable manner, making it suitable for use in newborns even in clinical settings 12 . With higher temporal resolution than fMRI, fNIRS enables the determination of changes in the concentrations of both oxy-(HbO) and deoxy-hemoglobin (HbR), providing valuable insights into neuronal activity.…”