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 near-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, 19 (63.3%) had grade I–II and 11 (36.7%) grade III–IV GMH-IVH; of these, 7 neonates (23%) underwent surgical interventions to divert cerebrospinal fluid (CSF). In infants with severe GMH-IVH, larger VV were significantly associated with decreased |sFC|. Our findings of increased VV and reduced sFC suggest that regional disruptions of ventricular size may impact the development of the underlying white matter. Hence, 3D cUS and fNIRS are promising bedside tools for monitoring the progression of GMH-IVH in preterm neonates.

Altered resting-state functional connectivity in newborns with hypoxic ischemic encephalopathy assessed using high-density functional near-infrared spectroscopy

“…fNIRS measures the amount of near-infrared light absorbed by hemoglobin, which is converted into concentration changes of oxygenated and deoxygenated hemoglobin (HbO and Hbr), respectively as an indirect measurement of neural activity 22 . RSFC derived from fNIRS and fMRI is comparable in several studies on adults 23 and a 1 month-old infant 24 . Less is known about the comparability between fNIRS and fMRI in the newborn period.…”

Altered resting state functional connectivity in newborns with hypoxic ischemic encephalopathy assessed using high-density functional near-infrared spectroscopy

“…In preterm-born neonates, altered FC was reported at term equivalent age compared to term-born neonates 22 . Lower FC on short-range and inter-hemispheric connections has also been reported in the preterm population 23 , associated with brain injury and larger ventricular volumes 24 . Few studies to date have examined RSFC using fNIRS to examine the impact of brain injuries after term birth.…”

A Wearable Fiber-Free Optical Sensor for Continuous Monitoring of Neonatal Cerebral Blood Flow and Oxygenation

“…There is an unmet need for continuous cerebral monitoring at the bedside in NICUs for timely diagnosis and day-to-day management of critically ill preterm infants at risk for brain injury. Portable NIRS/DCS technologies have been utilized for continuous monitoring of cerebral blood oxygenation/CBF variations in preterm infants 39,40 . However, most systems employ rigid fiber-optic probes for light delivering and detection, which constrain the subject’s movement.…”