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Child Neurology: Cortical Malformations in Preterm Infants: Case From a Prospective Cohort
Thiviya Selvanathan1, Mireille Guillot1, Helen M Branson1
1From the Department of Pediatrics (T.S., V.C., S.P.M.), The Hospital for Sick Children and University of Toronto, ON Department of Pediatrics (M.G.), Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec; Department of Diagnostic Imaging (H.M.B.), The Hospital for Sick Children and University of Toronto; Department of Pediatrics (E.N.K.), Mount Sinai Hospital and University of Toronto, ON Department of Pediatrics (S.P.M.), BC Children's Hospital and University of British Columbia, Vancouver, BC, Canada.
Insights
Malformations of cortical development (MCD) are rare brain disorders. This study details MCD findings in very preterm infants, noting incidental detection and long-term outcomes.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatric Neurology
Background:
- Malformations of cortical development (MCD) are rare, heterogeneous disorders affecting cerebral cortex development.
- Etiologies include genetic, metabolic, infectious, or vascular factors, classified by disrupted developmental stages.
- MCD are typically diagnosed via MRI in symptomatic infants, but early detection in preterm infants is less understood.
Purpose of the Study:
- To describe neuroimaging findings and neurodevelopmental outcomes of MCD in very preterm infants.
- To investigate the incidental detection of MCD in neonatal brain MRIs.
- To contribute to the limited literature on MCD in preterm populations.
Main Methods:
- Prospective longitudinal cohort study of 160 very preterm infants (<32 weeks' postmenstrual age).
- Incidental detection of MCD in neonatal research brain MRI scans.
- Follow-up neuroimaging from early life to term-equivalent age and assessment of childhood neurodevelopmental outcomes.
Main Results:
- Malformations of cortical development (MCD) were incidentally detected in 2 infants born very preterm.
- Detailed neuroimaging findings from neonatal period to term-equivalent age were documented.
- Childhood neurodevelopmental outcomes were assessed for these infants.
Conclusions:
- Malformations of cortical development (MCD) can be incidentally identified in very preterm infants via neonatal MRI.
- Longitudinal imaging and developmental assessments are crucial for understanding MCD evolution in this population.
- Further research is needed to characterize MCD in preterm infants due to its rarity and complexity.
Abstract:
Malformations of cortical development (MCD) are a rare group of disorders with heterogeneous clinical, neuroimaging, and genetic features. MCD consist of disruptions in the development of the cerebral cortex secondary to genetic, metabolic, infectious, or vascular etiologies. MCD are typically classified by stage of disrupted cortical development as secondary to abnormal: (1) neuronal proliferation or apoptosis, (2) neuronal migration, or (3) postmigrational cortical development. MCD are typically detected with brain MRI when an infant or child becomes symptomatic, presenting with seizures, developmental delay, or cerebral palsy. With recent advances in neuroimaging, cortical malformations can be detected using ultrasound or MRI during the fetal period or in the neonatal period. Of interest, preterm infants are born at a time when many cortical developmental processes are still occurring. However, there is a paucity of literature describing the neonatal imaging findings, clinical presentation, and evolution over time of cortical malformations in preterm infants. In this study, we present the neuroimaging findings from early life to term-equivalent age and childhood neurodevelopmental outcomes of an infant born very preterm (<32 weeks' postmenstrual age) with MCD detected incidentally on neonatal research brain MRI. These brain MRIs were performed as part of a prospective longitudinal cohort study of 160 very preterm infants; MCD were detected incidentally in 2 infants.
