T2 MRI visible perivascular spaces preterm and term born neonates
Poster No:
1253
Submission Type:
Abstract Submission
Authors:
Lena Meinhold1, Antonio Gennari1, Giancarlo Natalucci2, Beatrice Latal3, Brigitte Koller4, Jean-Claude Fauchere4, Cornelia Hagmann5, Ruth Tuura1
Institutions:
1Centre for MR Research, University Children`s Hospital Zurich, Zurich, Switzerland, 2FLRF Center for Neurodevelopment, Growth and Nutrition of the Newborn Zurich, Zurich, Switzerland, 3Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland, 4Department of Neonatology, University Hospital Zurich, Zurich, Switzerland, 5University Children`s Hospital Zurich, Zurich, Switzerland
First Author:
Co-Author(s):
Antonio Gennari, AG
Centre for MR Research, University Children`s Hospital Zurich
Zurich, Switzerland
Centre for MR Research, University Children`s Hospital Zurich
Zurich, Switzerland
Giancarlo Natalucci
FLRF Center for Neurodevelopment, Growth and Nutrition of the Newborn Zurich
Zurich, Switzerland
FLRF Center for Neurodevelopment, Growth and Nutrition of the Newborn Zurich
Zurich, Switzerland
Introduction:
Target audience: Researchers and clinicians interested in the clinical implications and developmental correlates of enlarged perivascular spaces in preterm and term born neonates.
Background: Human perivascular spaces (PVS) are recognized as important immunological sites and form part of the brain`s neurofluid clearance system (Iliff et al., 2012). PVS are known to become enlarged with aging and may be associated with several CNS disorders (Wardlaw et al., 2020), however very little is known about PVS in the neonatal brain and PVS alterations in preterm birth (Kim et al., 2023). The purpose of this study was to investigate PVS in preterm and term born neonates and explore potential associations of PVS with preterm birth, maturation and developmental outcome.
Background: Human perivascular spaces (PVS) are recognized as important immunological sites and form part of the brain`s neurofluid clearance system (Iliff et al., 2012). PVS are known to become enlarged with aging and may be associated with several CNS disorders (Wardlaw et al., 2020), however very little is known about PVS in the neonatal brain and PVS alterations in preterm birth (Kim et al., 2023). The purpose of this study was to investigate PVS in preterm and term born neonates and explore potential associations of PVS with preterm birth, maturation and developmental outcome.
Methods:
In this retrospective study, we evaluated a cohort of 86 preterm born neonates and 21 term born neonates. T2-weighted fast spin echo (FSE) MRI data were acquired at term equivalent age with a 3T GE HD.xt scanner, using an 8-channel head coil, with TE/TR= 109/5700 ms, FOV=25.6 cm, acquisition matrix=256x256, reconstruction matrix=512x512, slice thickness = 2 mm. T2-weighted images were visually inspected and PVS counts were estimated manually in the basal ganglia (BG) and centrum semiovale (CSO), using a validated scoring system (Wardlaw et al,. 2013). Developmental outcome in the preterm group was evaluated with the mental development index (MDI) and psychomotor developmental index (PDI) of the Bayley scales of infant development II. Developmental outcome in the control group was evaluated with the cognitive, language and motor composite scores of the Bayley scales of infant development III. Groupwise differences in PVS counts and associations with postmenstrual age, preterm birth and developmental outcomes were evaluated with Mann-Whitney tests, Kendall`s correlation coefficients and regression analyses, respectively. All statistical analyses were performed with RStudio, R version 4.1.2.
Results:
PVS counts in the basal ganglia did not differ between groups, whereas PVS counts in the CSO were significantly higher in preterm born neonates (mean = 1.42, sd = 2.24), compared to control subjects (mean = 0.43, sd = 1.12, p < 0.01). CSO PVS were positively associated with postmenstrual age both before and after controlling for gestational age b = 0.27, p < 0.01, CI [0.08, 0.47] and b = 0.39, p < 0.01, CI [0.19, 0.6], respectively. The effect of gestational age on CSO PVS was significant with b = -0.13, p < 0.01, CI [-0.23, -0.04]. We found no evidence for an association of PVS with developmental outcome.
Discussion: To our knowledge, only one other study investigated perivascular spaces in preterm born neonates, demonstrating a lower basal ganglia PVS fraction with increasing maturation (postmenstrual age) (Kim et al., 2023). Interestingly, in our cohort, we identified significantly more white matter PVS in preterm born neonates which increased with maturation, and more PVS were seen in those with lower gestational age, suggesting two separate underlying processes: A) PVS evolve naturally with maturation and B) PVS may be associated with preterm birth. Premature births are often accompanied by neonatal cerebral white matter injury, inflammation and glial activation (Back, 2017) and PVS swelling may be part of the brain`s protective response to white matter injury but may also influence the development of the neuroimmune and neurofluid clearance system in neonates.
Discussion: To our knowledge, only one other study investigated perivascular spaces in preterm born neonates, demonstrating a lower basal ganglia PVS fraction with increasing maturation (postmenstrual age) (Kim et al., 2023). Interestingly, in our cohort, we identified significantly more white matter PVS in preterm born neonates which increased with maturation, and more PVS were seen in those with lower gestational age, suggesting two separate underlying processes: A) PVS evolve naturally with maturation and B) PVS may be associated with preterm birth. Premature births are often accompanied by neonatal cerebral white matter injury, inflammation and glial activation (Back, 2017) and PVS swelling may be part of the brain`s protective response to white matter injury but may also influence the development of the neuroimmune and neurofluid clearance system in neonates.
·Association of centrum semiovale PVS with postmenstrual age at MRI in preterm and term born neonates
Conclusions:
These results demonstrate an increase of CSO PVS with maturation in both preterms and healthy controls, as well as an association of CSO PVS with preterm birth. Longitudinal studies may shed further light on the role of preterm birth in the brain`s neurofluid clearance system during development.
Lifespan Development:
Early life, Adolescence, Aging 1
Normal Brain Development: Fetus to Adolescence
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Anatomy and Functional Systems 2
Keywords:
Basal Ganglia
Cerebro Spinal Fluid (CSF)
Development
Glia
MRI
PEDIATRIC
White Matter
1|2Indicates the priority used for review
Provide references using author date format
Iliff, J.J. et al.,(2012). A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid β. Science Translational Medicine, 4(147), 147ra111-147ra111. ;
Kim, J. Y., et al (2023). MRI-visible perivascular spaces in the neonatal brain. Radiology, 307(2), e221314. ;
Wardlaw, J.M. et al.,(2013). Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. The Lancet Neurology, 12(8), 822-838. ;
Wardlaw, J.M., et al., (2020). Perivascular spaces in the brain: anatomy, physiology and pathology. Nature Reviews Neurology, 16(3), 137-153.