TY - JOUR
T1 - MR diffusion changes in the perimeter of the lateral ventricles demonstrate periventricular injury in post-hemorrhagic hydrocephalus of prematurity
AU - Isaacs, Albert M.
AU - Smyser, Christopher D.
AU - Lean, Rachel E.
AU - Alexopoulos, Dimitrios
AU - Han, Rowland H.
AU - Neil, Jeffrey J.
AU - Zimbalist, Sophia A.
AU - Rogers, Cynthia E.
AU - Yan, Yan
AU - Shimony, Joshua S.
AU - Limbrick, David D.
N1 - Funding Information:
We thank Dr. Joseph N. Paulson ( Genentech , San Francisco, CA. USA) for his help with the statistical analyses; Ms. Karen Lukas, Mr. Anthony Barton, and Ms. Jessica Perkins for study coordination; Ms. Tara Smyser and Ms. Jeanette Kenley for their help with many aspects of data acquisition and analyses; IDDRC at Washington University for assistance with data collection; and the children and their families for participating in the study. We appreciate the support of our funding agencies including the National Institutes of Health, Child Neurology Foundation, Cerebral Palsy International Research Foundation, Dana Foundation, March of Dimes Prematurity Research Center at Washington University, Doris Duke Charitable Foundation, Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health. The funding sources had no involvement in study design, data analysis, writing the report, or the decision to submit the article for publication.
Funding Information:
Funding: This work was supported by the Vanier Canada Graduate Scholarship[grant number 396212]; National Institutes of Health [grant numbers K02 NS089852, K23 NS075151, K23 MH105179, TL1 TR002344, P30 NS098577, R01 MH113570, R01 HD061619, and R01 HD057098]; Child Neurology Foundation; Cerebral Palsy International Research Foundation; The Dana Foundation; March of Dimes Prematurity Research Center at Washington University; The Doris Duke Charitable Foundation; and the Eunice Kennedy Shriver National Institute of Child Health& Human Development of the National Institutes of Health [grant number U54 HD087011]. None of the organizations listed had any role in the study design, data collection, data analysis, data interpretation, writing or decision to submit the report for publication.
Publisher Copyright:
© 2019 The Authors
PY - 2019
Y1 - 2019
N2 - Objectives: Injury to the preterm lateral ventricular perimeter (LVP), which contains the neural stem cells responsible for brain development, may contribute to the neurological sequelae of intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus of prematurity (PHH). This study utilizes diffusion MRI (dMRI) to characterize the microstructural effects of IVH/PHH on the LVP and segmented frontal-occipital horn perimeters (FOHP). Study design: Prospective study of 56 full-term infants, 72 very preterm infants without brain injury (VPT), 17 VPT infants with high-grade IVH without hydrocephalus (HG-IVH), and 13 VPT infants with PHH who underwent dMRI at term equivalent. LVP and FOHP dMRI measures and ventricular size-dMRI correlations were assessed. Results: In the LVP, PHH had consistently lower FA and higher MD and RD than FT and VPT (p<.050). However, while PHH FA was lower, and PHH RD was higher than their respective HG-IVH measures (p<.050), the MD and AD values did not differ. In the FOHP, PHH infants had lower FA and higher RD than FT and VPT (p<.010), and a lower FA than the HG-IVH group (p<.001). While the magnitude of AD in both the LVP and FOHP were consistently less in the PHH group on pairwise comparisons to the other groups, the differences were not significant (p>.050). Ventricular size correlated negatively with FA, and positively with MD and RD (p<.001) in both the LVP and FOHP. In the PHH group, FA was lower in the FOHP than in the LVP, which was contrary to the observed findings in the healthy infants (p<.001). Nevertheless, there were no regional differences in AD, MD, and RD in the PHH group. Conclusion: HG-IVH and PHH results in aberrant LVP/FOHP microstructure, with prominent abnormalities among the PHH group, most notably in the FOHP. Larger ventricular size was associated with greater magnitude of abnormality. LVP/FOHP dMRI measures may provide valuable biomarkers for future studies directed at improving the management and neurological outcomes of IVH/PHH.
AB - Objectives: Injury to the preterm lateral ventricular perimeter (LVP), which contains the neural stem cells responsible for brain development, may contribute to the neurological sequelae of intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus of prematurity (PHH). This study utilizes diffusion MRI (dMRI) to characterize the microstructural effects of IVH/PHH on the LVP and segmented frontal-occipital horn perimeters (FOHP). Study design: Prospective study of 56 full-term infants, 72 very preterm infants without brain injury (VPT), 17 VPT infants with high-grade IVH without hydrocephalus (HG-IVH), and 13 VPT infants with PHH who underwent dMRI at term equivalent. LVP and FOHP dMRI measures and ventricular size-dMRI correlations were assessed. Results: In the LVP, PHH had consistently lower FA and higher MD and RD than FT and VPT (p<.050). However, while PHH FA was lower, and PHH RD was higher than their respective HG-IVH measures (p<.050), the MD and AD values did not differ. In the FOHP, PHH infants had lower FA and higher RD than FT and VPT (p<.010), and a lower FA than the HG-IVH group (p<.001). While the magnitude of AD in both the LVP and FOHP were consistently less in the PHH group on pairwise comparisons to the other groups, the differences were not significant (p>.050). Ventricular size correlated negatively with FA, and positively with MD and RD (p<.001) in both the LVP and FOHP. In the PHH group, FA was lower in the FOHP than in the LVP, which was contrary to the observed findings in the healthy infants (p<.001). Nevertheless, there were no regional differences in AD, MD, and RD in the PHH group. Conclusion: HG-IVH and PHH results in aberrant LVP/FOHP microstructure, with prominent abnormalities among the PHH group, most notably in the FOHP. Larger ventricular size was associated with greater magnitude of abnormality. LVP/FOHP dMRI measures may provide valuable biomarkers for future studies directed at improving the management and neurological outcomes of IVH/PHH.
KW - Intraventricular hemorrhage
KW - Periventricular white matter
KW - Subventricular zone
KW - Ventricular zone
UR - http://www.scopus.com/inward/record.url?scp=85075564970&partnerID=8YFLogxK
U2 - 10.1016/j.nicl.2019.102031
DO - 10.1016/j.nicl.2019.102031
M3 - Article
C2 - 31795043
AN - SCOPUS:85075564970
SN - 2213-1582
VL - 24
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
M1 - 102031
ER -