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Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Published on: August 25, 2022
Altered structural brain networks at term-equivalent age in preterm infants with grade 1 intraventricular hemorrhage
Jong Ho Cha1, Yong-Ho Choi2, Jong-Min Lee2
1Department of Pediatrics, Hanyang University College of Medicine, Seoul, Hospital, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.
Insights
Grade 1 intraventricular hemorrhage in preterm infants may alter brain network development, enhancing local connections but potentially reducing global integration. This impacts information transfer and network segregation.
Area of Science:
- Neuroscience
- Medical Imaging
- Developmental Pediatrics
Background:
- Preterm infants face risks of disrupted brain connectivity due to perinatal complications.
- Understanding these disruptions is crucial for neurodevelopmental outcomes.
Purpose of the Study:
- To investigate brain connectivity development in preterm infants using diffusion tensor imaging (DTI).
- To assess the impact of grade 1 intraventricular hemorrhage (IVH) on brain network development at near-term age.
Main Methods:
- Diffusion MRI and connectomics were used on 86 infants (55 preterm, 24 full-term).
- Brain networks were analyzed using metrics like clustering coefficient, local efficiency, and global efficiency.
- Comparisons were made between preterm infants with and without grade 1 IVH using fractional anisotropy-weighted connectomes.
Main Results:
- Brain network connectivity in preterm infants without IVH was comparable to term infants.
- Preterm infants with grade 1 IVH showed increased clustering and local efficiency, suggesting enhanced segregation.
- These infants also exhibited longer path lengths and lower global efficiency, indicating reduced integration.
Conclusions:
- Grade 1 IVH in preterm infants may promote local information transfer and network segregation.
- This comes at the expense of global integration capacity in the developing brain.
- Findings highlight potential long-term implications for neurodevelopment in affected preterm infants.
Background:
Preterm infants are at risk for structural disruption of brain connectivity due to perinatal complications encountered during the fetal and neonatal periods. This study aimed to investigate the development of connectivity using diffusion tensor imaging at near-term age and the effect of grade 1 intraventricular hemorrhage on it.
Methods:
A total of 86 infants (55 preterm infants, 24 full-term infants) without apparent brain injury underwent diffusion magnetic resonance imaging (MRI) between 36 and 41 weeks post-menstrual age. The diffusion-MRI based connectomics were constructed from 64-segmented regions by using the Johns Hopkins University neonate atlas and were weighted with fractional anisotropy. The connectomes were quantified in the structural networks and investigated using network metrics, such as the clustering coefficient, local efficiency, characteristic path length, global efficiency, and small-worldness. We compared the differences in the brain networks of preterm infants with or without grade 1 intraventricular hemorrhage in binary and fractional anisotropy-weighted (wFA) connectomes.
Results:
The 55 preterm infants had a mean gestational age at birth of 29.3 ± 4.1 weeks and the 24 term-born infants, 38.1 ± 1.1 weeks. A total of 13 of the 55 preterm infants (23.6%) were diagnosed with grade 1 intraventricular hemorrhage. The development of connectivity of the brain network in preterm infants without intraventricular hemorrhage was comparable at near-term age to that in term infants. The preterm infants with germinal matrix hemorrhage exhibited higher clustering (0.093 ± 0.015 vs. 0.088 ± 0.007, p = 0.027) and local efficiency (0.151 ± 0.022 vs. 0.141 ± 0.010, p = 0.025), implying the potential for segregation. However, the preterm infants with intraventricular hemorrhage revealed a longer path length (0.291 ± 0.035 vs. 0.275 ± 0.019, p = 0.020) and lower global efficiency (3.998 ± 0.473 vs. 4.212 ± 0.281, p = 0.048), indicating a decreased integration in the wFA connectivity matrix than those without germinal matrix hemorrhage, after correcting for gestational age, sex, bronchopulmonary dysplasia, and age at scan.
Conclusion:
Grade 1 intraventricular hemorrhage in preterm infants may enhance the capacity for local information transfer and the relative reinforcement of the segregation of networks at the expense of global integration capacity.
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