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Early Extra-Uterine Exposure Alters Regional Cerebellar Growth in Infants Born Preterm

26 Pages Posted: 4 Sep 2018 First Look: Under Review

See all articles by Marie Brossard-Racine

Marie Brossard-Racine

Children’s National Health System - The Developing Brain Research Program

Robert McCarter

Children’s National Health System - Center for Translational Science

Jonathan Murnick

Children’s National Health System - Division of Diagnostic Imaging and Radiology

Laura Tinkelman

Children’s National Health System - The Developing Brain Research Program

Gilbert Vezina

Children’s National Health System - Division of Diagnostic Imaging and Radiology

Catherine Limperopoulos

Children’s National Health System - The Developing Brain Research Program

Abstract

Objectives: To compare third trimester global and regional cerebellar volumetric growth at two time-points between very preterm (PT) infants and healthy gestational age-matched fetuses in the PT period and at term equivalent age (TEA). Study Design: Using a prospective study design, high resolution anatomic magnetic resonance images (MRI) were acquired in PT infants (gestational age at birth<32 weeks; birthweight<1500g) and healthy full-term controls. PT infants completed two MRIs, one as soon as medically stable and the other around TEA. Controls also completed two MRIs, one in utero (i.e. fetal MRI) and a postnatal MRI shortly after birth. The injury-free cerebellum of each participant was parcellated into 5 regions: left and right hemispheres, the anterior, neo and posterior vermis. Evidence of differences in regional volumes between term and pre-term infants matched for gestational age (GA) at the time of the first MRI were assessed using multiple linear regression. Results: We studied 76 subjects: 38 PT infants were matched to 38 healthy fetuses. At MRI-1, PT infants demonstrated decreased cerebellar hemispheric volumes and increased anterior, neo- and posterior vermian regional volumes when compared to healthy fetuses. At TEA, PT infants demonstrated a persistent increase in anterior, neo- and posterior vermian regional volumes but no longer showed reductions in cerebellar hemispheric volume. Only the neo-vermis volume demonstrated a significant negative association with birthweight, male gender and supratentorial injury. Conclusions: In the absence of demonstrable cerebellar parenchymal injury evident on conventional MRI, PT birth is associated with cerebellar growth alterations that are regionally- and temporally-specific.

Suggested Citation

Brossard-Racine, Marie and McCarter, Robert and Murnick, Jonathan and Tinkelman, Laura and Vezina, Gilbert and Limperopoulos, Catherine, Early Extra-Uterine Exposure Alters Regional Cerebellar Growth in Infants Born Preterm (September 1, 2018). NICL-18-829, Available at SSRN: https://ssrn.com/abstract=3242822 or http://dx.doi.org/10.2139/ssrn.3242822

Marie Brossard-Racine

Children’s National Health System - The Developing Brain Research Program

111 Michigan Avenue NW
D.C., WA 20010
United States

Robert McCarter

Children’s National Health System - Center for Translational Science ( email )

111 Michigan Avenue NW
D.C., WA 20010
United States

Jonathan Murnick

Children’s National Health System - Division of Diagnostic Imaging and Radiology ( email )

111 Michigan Avenue NW
D.C., WA 20010
United States

Laura Tinkelman

Children’s National Health System - The Developing Brain Research Program

111 Michigan Avenue NW
D.C., WA 20010
United States

Gilbert Vezina

Children’s National Health System - Division of Diagnostic Imaging and Radiology ( email )

111 Michigan Avenue NW
D.C., WA 20010
United States

Catherine Limperopoulos (Contact Author)

Children’s National Health System - The Developing Brain Research Program ( email )

111 Michigan Avenue NW
D.C., WA 20010
United States

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