VP39.01: Assessment of the time course of postmortem fetal brain changes by DWI after radiofrequency ablation for fetal reduction in monochorionic pregnancies

Objective: Acute anorexia nervosa (AN) leads to reduced gray (GM) and white matter (WM) volume in the brain, which however improves again upon restoration of weight. Yet little is known about the extent and clinical correlates of these brain changes, nor do we know much about the time-course and completeness of their recovery. Methods: We conducted a meta-analysis and a qualitative review of all magnetic resonance imaging studies involving volume analyses of the brain in both acute and recovered AN. Results: We identified structural neuroimaging studies with a total of 214 acute AN patients and 177 weight-recovered AN patients. In acute AN, GM was reduced by 5.6% and WM by 3.8% compared to healthy controls (HC). Short-term weight recovery 2–5 months after admission resulted in restitution of about half of the GM aberrations and almost full WM recovery. After 2–8 years of remission GM and WM were nearly normalized, and differences to HC (GM: –1.0%, WM: –0.7%) were no longer significant, although small residual changes could not be ruled out. In the qualitative review some studies found GM volume loss to be associated with cognitive deficits and clinical prognosis. Conclusions: GM and WM were strongly reduced in acute AN. The completeness of brain volume rehabilitation remained equivocal.

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Effect of residual slow pathway function on the time course of recurrences of atrioventricular nodal reentrant tachycardia after radiofrequency ablation of the slow pathway

The American Journal of Cardiology ◽

10.1016/s0002-9149(99)80634-1 ◽

1995 ◽

Vol 75 (8) ◽

pp. 628-630 ◽

Cited By ~ 28

Author(s):

John D. Hummel ◽

S. Adam Strickberger ◽

Brian D. Williamson ◽

K. Ching Man ◽

Emile Daoud ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Time Course ◽

Slow Pathway ◽

Atrioventricular Nodal Reentrant Tachycardia ◽

Reentrant Tachycardia ◽

Pathway Function

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Time Course of Nicotinamide Adenine Dinucleotide Diaphorase Staining after Renal Radiofrequency Ablation Influences Viability Assessment

Journal of Endourology ◽

10.1089/end.2005.1128 ◽

2007 ◽

Vol 21 (2) ◽

pp. 223-227 ◽

Cited By ~ 41

Author(s):

J. Kyle Anderson ◽

Meredith Baker ◽

Omar Jaffers ◽

Margaret S. Pearle ◽

Guy L. Lindberg ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Nicotinamide Adenine Dinucleotide ◽

Time Course ◽

Nicotinamide Adenine ◽

Viability Assessment

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Fetal and Postnatal Brain Imaging for the Detection of ZIKV Encephalopathy in the Fetus/Newborn

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.055 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S22-S22

Author(s):

Sarah Mulkey ◽

Gilbert Vezina ◽

Yamil Fourzali ◽

Dorothy Bulas ◽

Margarita Arroyave-Wessel ◽

...

Keyword(s):

Pregnant Women ◽

Imaging Modality ◽

Brain Mri ◽

Cerebellar Atrophy ◽

Fetal Brain ◽

Fetal Mri ◽

Zikv Infection ◽

Chiari Ii ◽

Brain Changes ◽

Prospective Longitudinal

Abstract Background Up to 15% of pregnancies complicated by maternal ZIKV infection result in Zika-virus associated brain abnormalities in the fetus/newborn. Fetal ultrasound (feUS) is the standard imaging modality for the evaluation of fetal anatomy and for brain changes from congenital infection. Fetal MRI (feMRI) may be a useful adjunct. Methods We performed a prospective longitudinal neuroimaging study of fetuses/newborns of pregnant women with clinical and/or lab confirmed (RT-PCR and/or IgM/PRNT) diagnosis of Zika infection in Barranquilla, Colombia (endemic) and in Washington, DC, USA (travel-related). Gestational age (GA) at exposure and timing between ZIKV exposure/symptoms and imaging was documented. Subjects had one to two feMRIs and feUS, depending upon GA at enrollment. The feMRI and feUS protocols were standardized between sites and studies were centrally interpreted at Children’s National. Postnatally, infants received an unsedated brain MRI and head US. Results Forty-eight, ZIKV exposed/infected in first or second trimester pregnant women were enrolled (46 Colombia, 2 USA). Subjects had symptoms of ZIKV infection at mean of 8.4±5.7 week GA. The first feMRI and feUS were performed at 25.1±6.3 week GA. Thirty-six infants had a second feMRI and feUS at 31.1±4.2 week GA. Three of 48 (6%) cases had an abnormal feMRI: (1) heterotopias and abnormal cortical indent; (2) parietal encephalocele and Chiari II; (3) thin corpus callosum, dysplastic brainstem, temporal cysts, subependymal heterotopias, and generalized cerebral/cerebellar atrophy. FeUS in these three cases found (1) normal study; (2) parietal encephalocele and Chiari II; (3) significant ventriculomegaly with decreasing percentiles of head circumference from 32 to 36 week GA (38% to 3.6%). Postnatal head US revealed findings not seen on feUS: choroid plexus or germinal matrix cysts in nine infants and lenticulostriate vasculopathy in one infant. Conclusion FeMRI and feUS provide complimentary information in the assessment of fetal brain changes in ZIKV. In cases of abnormal brain structure, feMRI reveals more extensive areas of brain damage than is seen by US. Further studies are needed to determine whether cystic changes on postnatal head US are related to ZIKV infection, or are incidental findings. Disclosures All authors: No reported disclosures.

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