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Functional brain connectivity in ex utero premature infants compared to in utero fetuses.

ABSTRACT: Brain structural changes in premature infants appear before term age. Functional differences between premature infants and healthy fetuses during this period have yet to be explored. Here, we examined brain connectivity using resting state functional MRI in 25 very premature infants (VPT; gestational age at birth <32 weeks) and 25 healthy fetuses with structurally normal brain MRIs. Resting state data were evaluated using seed-based correlation analysis and network-based statistics using 23 regions of interest (ROIs) per hemisphere. Functional connectivity strength, the Pearson correlation between blood oxygenation level dependent signals over time across all ROIs, was compared between groups. In both cohorts, connectivity between homotopic ROIs showed a decreasing medial to lateral gradient. The cingulate cortex, medial temporal lobe and the basal ganglia shared the strongest connections. In premature infants, connections involving superior temporal, hippocampal, and occipital areas, among others, were stronger compared to fetuses. Premature infants showed stronger connectivity in sensory input and stress-related areas suggesting that extra-uterine environment exposure alters the development of select neural networks in the absence of structural brain injury.

SUBMITTER: De Asis-Cruz J

PROVIDER: S-EPMC7493786 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Functional brain connectivity in ex utero premature infants compared to in utero fetuses.

De Asis-Cruz Josepheen J Kapse Kushal K Basu Sudeepta K SK Said Mariam M Scheinost Dustin D Murnick Jonathan J Chang Taeun T du Plessis Adre A Limperopoulos Catherine C

NeuroImage 20200611

Brain structural changes in premature infants appear before term age. Functional differences between premature infants and healthy fetuses during this period have yet to be explored. Here, we examined brain connectivity using resting state functional MRI in 25 very premature infants (VPT; gestational age at birth <32 weeks) and 25 healthy fetuses with structurally normal brain MRIs. Resting state data were evaluated using seed-based correlation analysis and network-based statistics using 23 regi ...[more]

PMID: 32534962

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Project description:Non-syndromic clefts of the lip and/or palate (NSCLP) is the most common congenital anomaly in the craniofacial region. NSCLP is a highly gene-associated malformation. We speculate that pregnant women with NSCLP fetuses (pregnancies with NSCLP) may have specific brain changes during pregnancy. To explore characteristic brain function changes of pregnancies with NSCLP, we analyzed resting-state fMRI (rs-fMRI) data of 42 pregnant women (21 pregnancies with NSCLP and 21 pregnancies with normal fetuses) to compare intergroup differences of (fractional) amplitude of low frequency fluctuations (fALFF/ALFF), regional homogeneity (Reho), functional connectivity (FC) and network topological properties. Compared with the control group, increased ALFF in the left hippocampus, the right fusiform and the left anterior cingulate (ACG), increased Reho in left middle occipital gyrus (MOG) and right medial frontal gyrus (MFG) were found for pregnancies with NSCLP. Meanwhile, FC between the left supramarginal gyrus (SMG) and bilateral olfactory cortex (OLF), FC between left precentral gyrus (PreCG) and right MFG, FC between right inferior frontal gyrus (IFG) and left inferior temporal gyrus (ITG) were enhanced in pregnancies with NSCLP. Besides, FC between left PreCG and left amygdala, bilateral para-hippocampal gyrus, FC between left amygdala and left MFG, right IFG were decreased. Graph theory-based analysis explored increased degree centrality (DC), betweenness centrality (BC) and nodal efficiency (Ne) in the left ITG and left SMG for pregnancies with NSCLP. Pregnancies with NSCLP has widespread decreased FC within neural networks of speech and language, which indicated that they were more likely to be associated with defects in speech and language skills. At the same time, increased topological indices showed that speech and language related regions played dominant role in their brain networks. These findings may provide clues for early detection of NSCLP fetuses.

Project description:BACKGROUND:The use of functional connectivity magnetic resonance imaging (fcMRI) in research involving preterm infants is relatively new, and its feasibility in this population is not fully established. However, fcMRI images reveal functional neural connections that may be useful in establishing the mechanisms of neuroprotective interventions in preterm infants. OBJECTIVE:The aim of this study was to determine the feasibility of using fcMRI to measure differences in functional neural connections in nursing intervention studies. METHODS:A pilot study was conducted as part of a longitudinal, randomized controlled trial (RCT) testing the effect of a feeding intervention on neurodevelopmental and clinical outcomes of preterm infants randomly assigned to one of two groups: a patterned feeding experience (PFE) group and a usual feeding care (UFC) group. The fcMRIs were done at term-equivalent age. Visual, motor, and default mode networks were analyzed. RESULTS:Seven infants were studied (four were in the PFE group, and three were in the UFC group). Participants were selected sequentially from the parent RCT. Clear images were obtained from all participants. Differences were noted among PFE and UFC infants: Infants receiving PFE were hyperconnective in the default mode (caudate, anterior cingulate cortex, and precuneus) and motor networks (middle temporal and middle occipital areas) and hypoconnective in others areas of the default mode (hippocampal and lingual regions) and motor networks (precentral and superior frontal cortices) relative to UFC infants. No differences were noted in visual networks. DISCUSSION:The feasibility of using fcMRI at term-equivalent age in preterm infants who participated in an RCT on the effect of a nursing intervention was shown. Differences in connectivity among infants by group were detected. Further research is needed to show the benefit of fcMRI in studies of preterm infants given the costs of the procedure as well as the uncertain relationship of this early outcome measure to long-term neurodevelopment.

Project description:ImportancePrenatal maternal psychological distress can result in detrimental mother and child outcomes. Maternal stress increases with receipt of a prenatal diagnosis of fetal congenital heart disease (CHD); however, the association between maternal stress and the developing brain in fetuses with CHD is unknown.ObjectiveTo determine the association of maternal psychological distress with brain development in fetuses with CHD.Design, setting, and participantsThis longitudinal, prospective, case-control study consecutively recruited 48 pregnant women carrying fetuses with CHD and 92 healthy volunteers with low-risk pregnancies from the Children's National Health System between January 2016 and September 2018. Data were analyzed between January 2016 and June 2019.ExposuresFetal CHD and maternal stress, anxiety, and depression.Main outcomes and measuresMaternal stress, anxiety, and depression were measured using the Perceived Stress Scale, Spielberger State-Trait Anxiety Inventory, and Edinburgh Postnatal Depression Scale, respectively. Volumes of fetal total brain, cerebrum, left and right hippocampus, cerebellum, and brainstem were determined from 3-dimensionally reconstructed T2-weighted magnetic resonance imaging (MRI) scans.ResultsThis study included 223 MRI scans from 140 fetuses (74 MRIs from 48 fetuses with CHD and 149 MRIs from 92 healthy fetuses) between 21 and 40 weeks' gestation. Among 48 women carrying fetuses with CHD, 31 (65%) tested positive for stress, 21 (44%) for anxiety, and 14 (29%) for depression. Among 92 pregnant women carrying healthy fetuses, 25 (27%) tested positive for stress, 24 (26%) for anxiety, and 8 (9%) for depression. Depression scores were higher among 17 women carrying fetuses with single-ventricle CHD vs 31 women carrying fetuses with 2-ventricle CHD (3.8; 95% CI, 0.3 to 7.3). Maternal stress and anxiety were associated with smaller left hippocampal (stress: -0.003 cm3; 95% CI, -0.005 to -0.001 cm3), right hippocampal (stress: -0.004; 95% CI, -0.007 to -0.002; trait anxiety: -0.003; 95% CI, -0.005 to -0.001), and cerebellar (stress: -0.06; 95% CI, -0.09 to -0.02) volumes only among women with fetal CHD. Impaired hippocampal regions were noted in the medial aspect of left hippocampal head and inferior aspect of right hippocampal head and body. Impaired cerebellar regions were noted in the anterior superior aspect of vermal and paravermal regions and the left cerebellar lobe.Conclusions and relevanceThese findings suggested that psychological distress among women carrying fetuses with CHD is prevalent and is associated with impaired fetal cerebellar and hippocampal development. These data underscore the importance of universal screening for maternal psychological distress, integrated prenatal mental health support, and targeted early cognitive-behavioral interventions given that stress is a potentially modifiable risk factor in this high-risk population.

Dataset Information

Functional brain connectivity in ex utero premature infants compared to in utero fetuses.

Publications

Functional brain connectivity in ex utero premature infants compared to in utero fetuses.

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