Brain growth in the NICU: critical periods of tissue-specific expansion

Lillian G Matthews, Brian H Walsh, Clare Knutsen, Jeffrey J Neil, Christopher D Smyser, Cynthia E Rogers, Terrie E Inder, Lillian G Matthews, Brian H Walsh, Clare Knutsen, Jeffrey J Neil, Christopher D Smyser, Cynthia E Rogers, Terrie E Inder

Abstract

ObjectiveTo examine, using serial magnetic resonance imaging (MRI), total and tissue-specific brain growth in very-preterm (VPT) infants during the period that coincides with the early and late stages of the third trimester.MethodsStructural MRI scans were collected from two prospective cohorts of VPT infants (≤30 weeks of gestation). A total of 51 MRI scans from 18 VPT subjects were available for volumetric analysis. Brain tissue was classified into cerebrospinal fluid, cortical gray matter, myelinated and unmyelinated white matter, deep nuclear gray matter, and cerebellum. Nine infants had sufficient serial scans to allow comparison of tissue growth during the periods corresponding to the early and late stages of the third trimester.ResultsTissue-specific differences in ex utero brain growth trajectories were observed in the period corresponding to the third trimester. Most notably, there was a marked increase in cortical gray matter expansion from 34 to 40 weeks of postmenstrual age, emphasizing this critical period of brain development.ConclusionUtilizing serial MRI to document early brain development in VPT infants, this study documents regional differences in brain growth trajectories ex utero during the period corresponding to the first and second half of the third trimester, providing novel insight into the maturational vulnerability of the rapidly expanding cortical gray matter in the NICU.

Conflict of interest statement

Disclosure: The authors declare no conflicts of interest. No honorarium, grant or other form of payment was given to anyone to produce the manuscript.

Figures

Figure 1.. Longitudinal brain tissue growth in…
Figure 1.. Longitudinal brain tissue growth in the NICU.
Longitudinal growth trajectories for total tissue (a), unmyelinated white matter (b), myelinated white matter (c), cortical grey matter (d), cerebellum (e) and deep nuclear grey matter (f) in preterm infants from 26 weeks’ gestation to term-equivalent age. cc=cubic centimeters; PMA=postmenstrual age; wks=weeks

Source: PubMed

3
Subscribe