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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Inflammatory pathogenesis of cortical polymicrogyria: an autopsy study
P Toti1, C De Felice, M L Palmeri
1Institute of Pathology, University of Siena, Italy.
Abstract:
Polymicrogyria, a cortical abnormality usually classified among neuron migration disorders, is characterized by different etiologies and pathogeneses. Recently, it has been proposed that polymicrogyria could be acquired as a consequence of a lasting damage to the developing brain. In this study, we test the hypothesis that an infection in the fetal adnexa may give rise to distant brain defects and eventually polymicrogyria. Thirty-two fetuses spontaneously aborted for extensive ascending chorioamnionitis at 15-26 wk of gestation were evaluated. Control subjects were represented by 8 fetuses aborted at 15-24 wk of gestation. A complete autopsy was carried out between 4 and 12 h after fetal expulsion. We found different histologic alterations in the primitive cortical architecture, both isolated and combined (undulation of the cortical ribbon, untimely cortical folding/molecular layer fusion, and neuronal loss). A total of 25 cases presented one or more of the above-described morphologic alterations in the brain (78%). On the contrary, similar alterations were never observed in any of the control brains (p=0.019). Our findings indicate that chorioamnionitis significantly impairs brain cortex morphogenesis. Such neuron damage may be caused by an unspecific, indirect mechanism of injury to the developing cortex involving hypoxia and free radical generation. The reported brain abnormalities may even evolve into polymicrogyria in surviving fetuses.
Insights
Fetal infection, specifically chorioamnionitis, can cause brain damage and developmental abnormalities like polymicrogyria. This study links infection to histological changes in fetal brain cortex development.
Area of Science:
- Neuroscience
- Developmental Biology
- Pathology
Background:
- Polymicrogyria is a cortical malformation often categorized with neuron migration disorders.
- Recent theories suggest polymicrogyria can be acquired due to developmental brain injury.
- This study investigates if fetal adnexal infections lead to brain defects and polymicrogyria.
Observation:
- Thirty-two fetuses with ascending chorioamnionitis (15-26 weeks gestation) and 8 controls were examined.
- Histological analysis revealed cortical architecture alterations in 78% of affected fetuses.
- Observed changes included cortical ribbon undulation, premature folding, and neuronal loss.
Findings:
- Ascending chorioamnionitis significantly impacts fetal brain cortex morphogenesis.
- Histological brain abnormalities were significantly more prevalent in fetuses with chorioamnionitis compared to controls (p=0.019).
- These alterations suggest indirect injury mechanisms like hypoxia and free radical generation.
Implications:
- Chorioamnionitis is identified as a significant risk factor for fetal brain developmental abnormalities.
- The findings suggest a pathway from infection-induced damage to conditions like polymicrogyria in surviving infants.
- This research highlights the vulnerability of the developing brain to intrauterine infections.
