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Neurophysiologic Profiling of At-Risk Low and Very Low Birth-Weight Infants Using Magnetic Resonance Imaging

Ying Qi1, Jingni He2

  • 1Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.

Frontiers in Physiology
|April 9, 2021
PubMed

Insights

Low birth-weight newborns show significantly lower cerebral oxygen metabolism. Advanced MRI techniques identified these neonates at higher risk for brain injury, aiding early detection.

Area of Science:

  • Neonatal neuroscience
  • Medical imaging
  • Physiology

Background:

  • Low birth-weight (LBW) and very low birth-weight (VLBW) newborns face elevated risks for brain injuries, developmental delays, and future vascular diseases.
  • The precise neurobiological factors contributing to these vulnerabilities remain incompletely understood.

Purpose of the Study:

  • To investigate the neurobiologic underpinnings of pathophysiologic vulnerabilities in LBW-VLBW neonates.
  • To utilize advanced magnetic resonance imaging (MRI) techniques to quantify key cerebral physiological parameters.

Main Methods:

  • Employed T2-relaxation-under-spin-tagging (TRUST) and phase-contrast (PC) MRI to measure oxygen extraction fraction (OEF), global cerebral blood flow (CBF), and cerebral metabolic rate of oxygen (CMRO2).
  • Studied 50 neonates: 41 LBW-VLBW infants (stratified into those with (LBW-VLBW-a) and without (LBW-VLBW-n) structural MRI abnormalities) and 9 term controls.

Main Results:

  • LBW-VLBW neonates exhibited significantly lower CMRO2 compared to term controls (p=0.01).
  • Both LBW-VLBW-a and LBW-VLBW-n subgroups showed greater physiological deficits than term controls (p=0.03 and p=0.04, respectively).
  • Physiological parameters, particularly OEF, CBF, and CMRO2, demonstrated higher accuracy in distinguishing LBW-VLBW-a neonates compared to brain volume or body weight.

Conclusions:

  • Cerebral metabolic rate of oxygen (CMRO2) is significantly reduced in LBW-VLBW neonates, indicating impaired brain energy metabolism.
  • Physiological imaging using TRUST and PC MRI can effectively identify LBW-VLBW newborns at high risk for irreversible brain damage.
  • Distinct cerebral metabolic and hemodynamic alterations were observed in LBW-VLBW neonates with structural abnormalities, suggesting targeted interventions may be beneficial.

Keywords:
CBFCMRO2OEFPC MRITRUST MRIlow birth weight (LBW)very low birth weight (VLBW)

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