scholarly journals Factors associated with neurodevelopment in preterm infants with systematic inflammation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eun Sun Lee ◽  
Ee-Kyung Kim ◽  
Seung han Shin ◽  
Young-Hun Choi ◽  
Young Hwa Jung ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
Systemic Inflammation ◽  
Head Circumference ◽  
Brain Mri ◽  
White Matter Injury ◽  
Social Emotional ◽  
Postmenstrual Age ◽  
Neurodevelopmental Impairment ◽  
Near Term

Abstract Background Several studies have suggested that adverse neurodevelopment could be induced by systemic inflammation in preterm infants. We aimed to investigate whether preterm infants with systemic inflammation would have impaired neurodevelopment and which biomarkers and neurophysiologic studies during inflammation are associated with poor neurodevelopment. Methods This prospective cohort study enrolled infants born before 30 weeks of gestation or with birth weight < 1250 g. Infants were grouped according to the presence of systemic inflammation: Control (no inflammation, n = 49), I (systemic inflammation, n = 45). Blood and cerebrospinal fluid samples for markers of brain injury and inflammation were collected and amplitude-integrated electroencephalography (aEEG) was performed within 4 h of septic workup. We evaluated aEEG at 35 weeks postmenstrual age (PMA), head circumference at 36 weeks PMA, and brain MRI at discharge. The Bayley Scales of Infant and Toddler Development III (Bayley-III) was performed at a corrected age (CA) of 18 months. Results The I group had more white matter injuries (2 vs. 26.7%, Control vs. I, respectively) at the time of discharge, lower brain functional maturation (9.5 vs. 8), and smaller head size (z-score − 1.45 vs. -2.12) at near-term age and poorer neurodevelopment at a CA of 18 months than the control (p < 0.05). Among the I group, the proportion of immature neutrophils (I/T ratios) and IL-1 beta levels in the CSF were associated with aEEG measures at the day of symptom onset (D0). Seizure spike on aEEG at D0 was significantly correlated with motor and social-emotional domains of Bayley-III (p < 0.05). The I/T ratio and CRP and TNF-α levels of blood at D0, white matter injury on MRI at discharge, head circumference and seizure spikes on aEEG at near-term age were associated with Bayley-III scores at a CA of 18 months. Conclusions Systemic inflammation induced by clinical infection and NEC are associated with neurodevelopmental impairment in preterm infants. The seizure spike on aEEG, elevated I/T ratio, CRP, and plasma TNF-alpha during inflammatory episodes are associated with poor neurodevelopment.

scholarly journals Window of Opportunity of Cerebral Hypothermia for Postischemic White Matter Injury in the Near-Term Fetal Sheep

2004 ◽  
Vol 24 (8) ◽  
pp. 877-886 ◽  
Author(s):  
Vincent Roelfsema ◽  
Laura Bennet ◽  
Sherly George ◽  
David Wu ◽  
Jian Guan ◽  
...  
Keyword(s):  
White Matter ◽  
Cerebral Ischemia ◽  
Caspase 3 ◽  
Basic Protein ◽  
White Matter Injury ◽  
Window Of Opportunity ◽  
Reactive Microglia ◽  
Fetal Sheep ◽  
Near Term ◽  
Protein Density

Postresuscitation cerebral hypothermia is consistently neuroprotective in experimental preparations; however, its effects on white matter injury are poorly understood. Using a model of reversible cerebral ischemia in unanesthetized near-term fetal sheep, we examined the effects of cerebral hypothermia (fetal extradural temperature reduced from 39.4±0.1°C to between 30 and 33°C), induced at different times after reperfusion and continued for 72 hours after ischemia, on injury in the parasagittal white matter 5 days after ischemia. Cooling started within 90 minutes of reperfusion was associated with a significant increase in bioactive oligodendrocytes in the intragyral white matter compared with sham cooling (41±20 vs 18±11 per field, P < 0.05), increased myelin basic protein density and reduced expression of activated caspase-3 (14±12 vs 91±51, P < 0.05). Reactive microglia were profoundly suppressed compared with sham cooling (4±6 vs 38±18 per field, P < 0.05) with no effect on numbers of astrocytes. When cooling was delayed until 5.5 hours after reperfusion there was no significant effect on loss of oligodendrocytes (24±12 per field). In conclusion, hypothermia can effectively protect white matter after ischemia, but only if initiated early after the insult. Protection was closely associated with reduced expression of both activated caspase-3 and of reactive microglia.

Neonatal Nucleated Red Blood Cells and the Prediction of Cerebral White Matter Injury in Preterm Infants

2006 ◽  
Vol 107 (3) ◽  
pp. 550-556 ◽  
Author(s):  
Anadir M. Silva ◽  
Randi N. Smith ◽  
Christoph U. Lehmann ◽  
Elizabeth A. Johnson ◽  
Cynthia J. Holcroft ◽  
...  
Keyword(s):  
White Matter ◽  
Red Blood Cells ◽  
Preterm Infants ◽  
Blood Cells ◽  
White Matter Injury ◽  
Cerebral White Matter ◽  
Nucleated Red Blood Cells

scholarly journals White matter injury but not germinal matrix hemorrhage induces elevated osteopontin expression in human preterm brains

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Gisela Nilsson ◽  
Ana A. Baburamani ◽  
Mary A. Rutherford ◽  
Changlian Zhu ◽  
Carina Mallard ◽  
...  
Keyword(s):  
Brain Injury ◽  
White Matter ◽  
Preterm Infants ◽  
Tissue Injury ◽  
White Matter Injury ◽  
Matricellular Protein ◽  
Perinatal Brain Injury ◽  
Germinal Matrix ◽  
Deep White Matter ◽  
Germinal Matrix Hemorrhage

AbstractOsteopontin (OPN) is a matricellular protein that mediates various physiological functions and is implicated in neuroinflammation, myelination, and perinatal brain injury. However, its expression in association with brain injury in preterm infants is unexplored. Here we examined the expression of OPN in postmortem brains of preterm infants and explored how this expression is affected in brain injury. We analyzed brain sections from cases with white matter injury (WMI) and cases with germinal matrix hemorrhage (GMH) and compared them to control cases having no brain injury. WMI cases displayed moderate to severe tissue injury in the periventricular and deep white matter that was accompanied by an increase of microglia with amoeboid morphology. Apart from visible hemorrhage in the germinal matrix, GMH cases displayed diffuse white matter injury in the periventricular and deep white matter. In non-injured preterm brains, OPN was expressed at low levels in microglia, astrocytes, and oligodendrocytes. OPN expression was significantly increased in regions with white matter injury in both WMI cases and GMH cases. The main cellular source of OPN in white matter injury areas was amoeboid microglia, although a significant increase was also observed in astrocytes in WMI cases. OPN was not expressed in the germinal matrix of any case, regardless of whether there was hemorrhage. In conclusion, preterm brain injury induces elevated OPN expression in microglia and astrocytes, and this increase is found in sites closely related to injury in the white matter regions but not with the hemorrhage site in the germinal matrix. Thus, it appears that OPN takes part in the inflammatory process in white matter injury in preterm infants, and these findings facilitate our understanding of OPN’s role under both physiological and pathological conditions in the human brain that may lead to greater elucidation of disease mechanisms and potentially better treatment strategies.

Neurodevelopmental Outcomes in Preterm Infants with White Matter Injury Using a New MRI Classification

Neonatology ◽  
2019 ◽  
Vol 116 (3) ◽  
pp. 227-235 ◽  
Author(s):  
Miriam Martinez-Biarge ◽  
Floris Groenendaal ◽  
Karina J. Kersbergen ◽  
Manon J.N.L. Benders ◽  
Francesca Foti ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
White Matter Injury ◽  
Neurodevelopmental Outcomes

663 The voiding pattern of preterm infants with serious periventricular white matter injury

2014 ◽  
Vol 13 (1) ◽  
pp. e663
Author(s):  
Y.L. Wang ◽  
J.G. Wen ◽  
Y.B. Wen ◽  
L. Xing ◽  
Y.S. Zhang ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
White Matter Injury ◽  
Periventricular White Matter ◽  
Voiding Pattern

Neuroradiological Mimics of Periventricular Leukomalacia

2021 ◽  
pp. 088307382110260
Author(s):  
Nihaal Reddy ◽  
Mary Doyle ◽  
Prasad Hanagandi ◽  
Ajay Taranath ◽  
Hisham Dahmoush ◽  
...  
Keyword(s):  
White Matter ◽  
Neurological Disorder ◽  
Clinical Presentation ◽  
Periventricular Leukomalacia ◽  
Brain Mri ◽  
White Matter Injury ◽  
Healthy Children ◽  
Imaging Features ◽  
Inherited Disorders ◽  
Radiological Criteria

Aim: Periventricular leukomalacia (PVL) is a term reserved to describe white matter injury in the premature brain. In this review article, the authors highlight the common and rare pathologies mimicking the chronic stage of PVL and propose practical clinico-radiological criteria that would aid in diagnosis and management. Methods and Results: The authors first describe the typical brain MRI (magnetic resonance imaging) features of PVL. Based on their clinical presentation, pathologic entities and their neuroimaging findings were clustered into distinct categories. Three clinical subgroups were identified: healthy children, children with stable/nonprogressive neurological disorder, and those with progressive neurological disorder. The neuroradiological discriminators are described in each subgroup with relevant differential diagnoses. The mimics were broadly classified into normal variants, acquired, and inherited disorders. Conclusions: The term “PVL” should be used appropriately as it reflects its pathomechanism. The phrase “white matter injury of prematurity” or “brain injury of prematurity” is more specific. Discrepancies in imaging and clinical presentation must be tread with caution and warrant further investigations to exclude other possibilities.

Apoptosis and White Matter Injury in Preterm Infants

2002 ◽  
Vol 5 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Sangkae Chamnanvanakij ◽  
Linda R. Margraf ◽  
Dennis Burns ◽  
Jeffrey M. Perlman
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
White Matter Injury
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