09 Dec Cerebral Perfusion Is Perturbed by Preterm Birth and Brain Injury
MedicalResearch.com Interview with:
Eman S. Mahdi, MD, MBChB
Pediatric Radiology Fellow
Catherine Limperopoulos, PhD
Director, Developing Brain Research Laboratory
Co-Director of Research, Division of Neonatology
Diagnostic Imaging and Radiology
Children’s National Health System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Premature birth is a major public health concern in the United States affecting 1 in 10 infants each year. Prematurity-related brain injury is very common and associated with a high prevalence of brain injury and accompanying lifelong neurodevelopmental morbidities.
Early disturbances in systemic and cerebral hemodynamics are thought to mediate prematurity-related brain injury. The extent to which cerebral blood flow (CBF) is disturbed in preterm birth is poorly understood, in large part because of the lack of monitoring techniques that can directly and non-invasively measure cerebral blood flow.
We report for the first time early disturbances in global and regional cerebral blood flow in preterm infants following brain injury on conventional magnetic resonance imaging (MRI) over the third trimester of ex-uterine life using arterial spin labelling images. In terms of regional differences, we saw a marked decrease in blood flow to the thalamus and the pons, regions known to be metabolically active during this time.
MedicalResearch.com: What should readers take away from your report?
Response: Regional cerebral perfusion alterations in preterm infants with brain injury suggest regional vulnerability of the developing cerebro-ponto-cerebellar circuitry. Arterial spin labelling sequence provides a useful non-invasive tool for identifying early cerebral perfusion abnormalities in preterm infants. The ability to directly and non-invasively monitor CBF with arterial spin labelling MRI in the early postnatal period, when preterm infants are at greatest risk for brain injury is promising and may assist in identifying candidates for future therapeutic targets and measuring treatment effectiveness.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The degree to which early alterations in global and regional cerebral blood flow in preterm infants correlate with illness severity awaits further study. Moreover, the extent to which these early regional cerebral blood flow disturbances impair subsequent cerebro-ponto-cerebellar development and connectivity, and functional outcomes in survivors of preterm birth is an intriguing question that is currently being explored.
MedicalResearch.com: Is there anything else you would like to add?
Response: Working on arterial spin labelling sequence for premature infants is a challenging process as many factors might contribute to changes of the perfusion that need to be kept in consideration, such as hematocrit level, oxygenation status and medical condition of the preterm infant.
Mahdi,E, Bouyssi-Kobar,M, Murnick,J, Loucas,C, Chang,T, Limperopoulos,C, Cerebral Perfusion is Perturbed by Preterm Birth and Brain Injury. Radiological Society of North America 2016 Scientific Assembly and Annual Meeting, November 27 – December 2, 2016, Chicago IL. archive.rsna.org/2016/16011069.html Accessed December 9, 2016
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