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Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption
Philippe Vo Van1, Marianne Alison2,3, Baptiste Morel4,5
1Department of Neonatology, Hospices Civils de Lyon, Femme Mère Enfant Hospital, 59 Boulevard Pinel, 69500 Bron, France.
Insights
Preterm birth impairs brain development, affecting microstructure and connectivity, leading to cognitive and behavioral issues. Early intervention and developmental care can help mitigate these negative effects on brain maturation.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Preterm birth disrupts fetal brain development, leading to microstructural alterations and cognitive deficits.
- These changes, including impaired myelination and disorganized brain networks, are often undetectable by conventional imaging.
- Cerebral plasticity, crucial for development, is negatively impacted by premature birth.
Purpose of the Study:
- To investigate the impact of preterm birth on brain microstructure and connectivity.
- To explore the potential of advanced neuroimaging techniques to detect these alterations.
- To understand how early life experiences and interventions can influence neurodevelopmental outcomes in preterm infants.
Main Methods:
- Utilizing advanced Magnetic Resonance Imaging (MRI) techniques, specifically diffusion tensor imaging (DTI) and functional MRI (fMRI).
- Employing tractography to visualize structural white matter connections and analyze functional networks.
- Assessing microstructural and macrostructural changes in the developing brain.
Main Results:
- Preterm birth significantly disrupts brain maturation, affecting myelination and white matter integrity.
- Advanced MRI techniques reveal disorganized structural and functional brain connectivity in preterm infants.
- These microstructural alterations correlate with potential for later cognitive and behavioral disorders.
Conclusions:
- Preterm birth causes early and significant disruptions to brain development, impacting microstructure and connectivity.
- Advanced neuroimaging, including DTI and fMRI, can detect these subtle cerebral alterations.
- Developmental neonatal care may offer a pathway to mitigate the adverse neurodevelopmental consequences of prematurity.
Abstract:
Preterm birth disrupts the in utero environment, preventing the brain from fully developing, thereby causing later cognitive and behavioral disorders. Such cerebral alteration occurs beneath an anatomical scale, and is therefore undetectable by conventional imagery. Prematurity impairs the microstructure and thus the histological process responsible for the maturation, including the myelination. Cerebral MRI diffusion tensor imaging sequences, based on water's motion into the brain, allows a representation of this maturation process. Similarly, the brain's connections become disorganized. The connectome gathers structural and anatomical white matter fibers, as well as functional networks referring to remote brain regions connected one over another. Structural and functional connectivity is illustrated by tractography and functional MRI, respectively. Their organizations consist of core nodes connected by edges. This basic distribution is already established in the fetal brain. It evolves greatly over time but is compromised by prematurity. Finally, cerebral plasticity is nurtured by a lifetime experience at microstructural and macrostructural scales. A preterm birth causes a negative and early disruption, though it can be partly mitigated by positive stimuli based on developmental neonatal care.
