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Updated: May 24, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome
Ashok Panigrahy1, Jessica L Wisnowski, Andre Furtado
1Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA, USA. Ashok.Panigrahy@chp.edu
Insights
Neuroimaging aids in diagnosing and managing preterm infant brain injuries. Advanced techniques like MRI offer insights into brain development, aiding long-term outcome prediction and interventions.
Area of Science:
- Neonatal neuroscience
- Developmental neurology
- Medical imaging
Background:
- Preterm infants face high risks of brain injury and neurodevelopmental disabilities due to interrupted brain maturation.
- Neuroimaging is crucial for diagnosing and managing brain development and injury in preterm infants.
Purpose of the Study:
- To evaluate the role of neuroimaging in assessing preterm infant brain development and injury.
- To explore the utility of conventional and advanced imaging techniques for diagnosis, prognosis, and intervention.
Main Methods:
- Utilized cranial ultrasound (US) for intraventricular hemorrhage (IVH) detection and prognostic information for cerebral palsy.
- Employed conventional magnetic resonance imaging (MRI) for evaluating periventricular leukomalacia (PVL) and other preterm brain injuries.
- Discussed the potential of advanced MR techniques (volumetric, diffusion tensor, spectroscopy, functional connectivity) and connectomics.
Main Results:
- Cranial US is sensitive for IVH and provides prognostic data for cerebral palsy.
- MRI shows promise for diagnosing PVL and other injuries under specific clinical conditions.
- Advanced MR techniques and connectomics are essential for understanding preterm brain development and function.
Conclusions:
- Neuroimaging, combining conventional and advanced techniques, is vital for preterm infant brain assessment.
- Future applications include biomarkers for neurodevelopmental outcomes, efficacy assessment of neuroprotective agents, and selection for developmental interventions.
Abstract:
For typically developing infants, the last trimester of fetal development extending into the first post-natal months is a period of rapid brain development. Infants who are born premature face significant risk of brain injury (e.g., intraventricular or germinal matrix hemorrhage and periventricular leukomalacia) from complications in the perinatal period and also potential long-term neurodevelopmental disabilities because these early injuries can interrupt normal brain maturation. Neuroimaging has played an important role in the diagnosis and management of the preterm infant. Both cranial US and conventional MRI techniques are useful in diagnostic and prognostic evaluation of preterm brain development and injury. Cranial US is highly sensitive for intraventricular hemorrhage (IVH) and provides prognostic information regarding cerebral palsy. Data are limited regarding the utility of MRI as a routine screening instrument for brain injury for all preterm infants. However, MRI might provide diagnostic or prognostic information regarding PVL and other types of preterm brain injury in the setting of specific clinical indications and risk factors. Further development of advanced MR techniques like volumetric MR imaging, diffusion tensor imaging, metabolic imaging (MR spectroscopy) and functional connectivity are necessary to provide additional insight into the molecular, cellular and systems processes that underlie brain development and outcome in the preterm infant. The adult concept of the "connectome" is also relevant in understanding brain networks that underlie the preterm brain. Knowledge of the preterm connectome will provide a framework for understanding preterm brain function and dysfunction, and potentially even a roadmap for brain plasticity. By combining conventional imaging techniques with more advanced techniques, neuroimaging findings will likely be used not only as diagnostic and prognostic tools, but also as biomarkers for long-term neurodevelopmental outcomes, instruments to assess the efficacy of neuroprotective agents and maneuvers in the NICU, and as screening instruments to appropriately select infants for longitudinal developmental interventions.
