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Neuroimaging of structural and functional connectivity in preterm infants with intraventricular hemorrhage
Regina L Triplett1, Christopher D Smyser2
1Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
Insights
Infants with intraventricular hemorrhage (IVH) experience poor neurodevelopmental outcomes due to altered brain connectivity. Neuroimaging reveals these changes, guiding future interventions to improve outcomes.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Medical Imaging
Background:
- Intraventricular hemorrhage (IVH) in preterm infants is linked to severe neurodevelopmental deficits.
- Brain structure and function disruptions are increasingly recognized as key contributors to these poor outcomes.
Purpose of the Study:
- To review neuroimaging techniques for assessing brain connectivity in infants with IVH.
- To explore the relationship between IVH, altered brain connectivity, and neurodevelopmental outcomes.
- To identify future research directions for improving outcomes in this population.
Main Methods:
- Review of studies utilizing diffusion MRI and resting-state functional MRI (fMRI) to assess structural and functional brain connectivity.
- Analysis of the impact of IVH severity and location on connectivity patterns.
- Correlation of infant connectivity findings with early childhood neurodevelopmental assessments.
Main Results:
- Neuroimaging techniques like diffusion MRI and fMRI are crucial for understanding brain alterations in IVH.
- IVH severity and location significantly influence structural and functional connectivity disruptions.
- Altered connectivity in infancy predicts later neurodevelopmental challenges in early childhood.
Conclusions:
- Neuroimaging provides critical insights into the mechanisms underlying poor neurodevelopmental outcomes after IVH.
- Understanding connectivity alterations is essential for developing targeted interventions.
- Future research should focus on prospective and interventional studies to mitigate these disruptions and improve infant neurodevelopment.
Abstract:
Preterm infants with intraventricular hemorrhage (IVH) are known to have some of the worst neurodevelopmental outcomes in all of neonatal medicine, with a growing body of evidence relating these outcomes to underlying disruptions in brain structure and function. This review begins by summarizing state-of-the-art neuroimaging techniques delineating structural and functional connectivity (diffusion and resting state functional MRI) and their application in infants with IVH, including unique technical challenges and emerging methods. We then review studies of altered structural and functional connectivity, highlighting the role of IVH severity and location. We subsequently detail investigations linking structural and functional findings in infancy to later outcomes in early childhood. We conclude with future directions including methodologic considerations for prospective and potentially interventional studies designed to mitigate disruptions to underlying structural and functional connections and improve neurodevelopmental outcomes in this high-risk population.
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