3-D Echo Brain Volumes to Predict Neurodevelopmental Outcome in Infants: A Prospective Observational Follow-up Study
Maria Cristina Aisa1, Antonella Barbati2, Benito Cappuccini3
1Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy; GeBiSa, Research Foundation, Perugia, Italy; Centro Europeo per la Medicina e la Ricerca (CEMER), Perugia, Italy.
Insights
Reduced brain volumes in infants, measured by 3-D ultrasonography (3-DUS) shortly after birth, can predict long-term neurodevelopmental disorders. This early detection aids in identifying high-risk neonates for timely intervention.
Area of Science:
- Neonatal neuroimaging
- Developmental neuroscience
- Pediatric neurology
Background:
- Prematurity and intra-uterine growth restriction (IUGR) are linked to adverse neurodevelopmental outcomes.
- These conditions are associated with reduced regional brain volumes in infants.
- Early identification of at-risk neonates is crucial for intervention.
Purpose of the Study:
- To evaluate 3-D ultrasonography (3-DUS) brain volumes as early predictors of neurodevelopmental disorders.
- To assess whole brain, thalamus, frontal cortex, and cerebellum volumes at 30-40 days postnatally.
- To correlate early brain volumes with neurodevelopmental outcomes at two years of age.
Main Methods:
- A cohort of 334 neonates (full-term, preterm, IUGR, pre-IUGR) with diverse gestational ages (24-41 wk) and birth weights (860-4000 g) was studied.
- 3-D ultrasonography (3-DUS) was used to measure brain volumes at 30-40 days postnatally.
- Neurodevelopment was assessed at two years using the Griffiths III test.
Main Results:
- Significantly lower cerebral volumes were observed in infants with negative neurodevelopmental outcomes.
- 3-DUS brain volume measurements demonstrated excellent diagnostic accuracy for predicting adverse outcomes.
- Specific regions including the whole brain, thalamus, frontal cortex, and cerebellum showed predictive value.
Conclusions:
- 3-D ultrasonography (3-DUS) brain volumes measured in early infancy can serve as reliable early predictors of neurodevelopmental disorders.
- This non-invasive imaging technique aids in identifying neonates at high risk for future neurobehavioral issues.
- Early identification facilitates timely interventions to improve long-term outcomes for at-risk infants.
Abstract:
Prematurity and intra-uterine growth restriction (IUGR) are risk factors for long-term poor neurodevelopmental outcomes and are associated with reductions in regional brain volumes. In this study, the aim was to determine the possible role of 3-D ultrasonography (3-DUS) volumes of whole brain, thalamus, frontal cortex and cerebellum, measured at postnatal days 30-40, as early predictors of long-term risk for neurobehavioral disorders. To this purpose, a heterogeneous population of full-term, preterm, IUGR and preterm IUGR (pre-IUGR) born individuals (n = 334), characterized by gestational age and birth weight in the ranges 24-41 wk and 860-4000 g, respectively, was followed from postnatal days 30-40 to the second year of life. At enrollment, brain volumes were measured using 3-DUS, whereas neurodevelopment was assessed at 2 y using the Griffiths III test. Cerebral volumes were strictly and significantly lower in infants characterized by a negative outcome and had excellent diagnostic accuracy. The 3-DUS volume of whole brain, thalamus, frontal cortex or cerebellum may be an early predictor of neonates at major risk for neurobehavioral disorders in later life.
