Quantitative MRI Study of Infant Regional Brain Size Following Surgery for Long-gap Esophageal Atresia Requiring Prolonged Critical Care

Overview

Journal Int J Dev Neurosci

Specialty Neurology

Date 2019 Sep 30

PMID 31563705

Citations 8

Authors

Chandler Rebecca Lee Mongerson

Russell William Jennings

David Zurakowski

Dusica Bajic

Affiliations

Soon will be listed here.

Abstract

Introduction: Little is known regarding the impact of concurrent critical illness and thoracic noncardiac perioperative critical care on postnatal brain development. Previously, we reported smaller total brain volumes in both critically ill full-term and premature patients following complex perioperative critical care for long-gap esophageal atresia (LGEA). Our current report assessed trends in regional brain sizes during infancy, and probed for any group differences.

Methods: Full-term (n = 13) and preterm (n = 13) patients without any previously known neurological concerns, and control infants (n = 16), underwent non-sedated 3 T MRI in infancy (<1 year old). T2-weighted images underwent semi-automated brain segmentation using Morphologically Adaptive Neonatal Tissue Segmentation (MANTiS). Regional tissue volumes of the forebrain, deep gray matter (DGM), cerebellum, and brainstem are presented as absolute (cm3) and normalized (% total brain volume (%TBV)) values. Group differences were assessed using a general linear model univariate analysis with corrected age at scan as a covariate.

Results: Absolute volumes of regions analyzed increased with advancing age, paralleling total brain size, but were significantly smaller in both full-term and premature patients compared to controls. Normalized volumes (%TBV) of forebrain, DGM, and cerebellum were not different between subject groups analyzed. Normalized brainstem volumes showed group differences that warrant future studies to confirm the same finding.

Discussion: Both full-term and premature critically ill infants undergoing life-saving surgery for LGEA are at risk of smaller total and regional brain sizes. Normalized volumes support globally delayed or diminished brain growth in patients. Future research should look into neurodevelopmental outcomes of infants born with LGEA.

Citing Articles

Individual Assessment of Perioperative Brain Growth Trajectories in Infants With Congenital Heart Disease: Correlation With Clinical and Surgical Risk Factors.

Cromb D, Bonthrone A, Maggioni A, Cawley P, Dimitrova R, Kelly C J Am Heart Assoc. 2023; 12(14):e028565.

PMID: 37421268 PMC: 10382106. DOI: 10.1161/JAHA.122.028565.

Infant Perioperative Risk Factors and Adverse Brain Findings Following Long-Gap Esophageal Atresia Repair.

Kagan M, Wang J, Pier D, Zurakowski D, Jennings R, Bajic D J Clin Med. 2023; 12(5).

PMID: 36902591 PMC: 10003188. DOI: 10.3390/jcm12051807.

Impact of Infant Thoracic Non-cardiac Perioperative Critical Care on Homotopic-Like Corpus Callosum and Forebrain Sub-regional Volumes.

Kagan M, Mongerson C, Zurakowski D, Bajic D Front Pain Res (Lausanne). 2022; 3:788903.

PMID: 35465294 PMC: 9021551. DOI: 10.3389/fpain.2022.788903.

Impact of surgery and anesthesia during early brain development: A perfect storm.

Keunen K, Sperna Weiland N, de Bakker B, de Vries L, Stevens M Paediatr Anaesth. 2022; 32(6):697-705.

PMID: 35266610 PMC: 9311405. DOI: 10.1111/pan.14433.

Infant study of hemispheric asymmetry after long-gap esophageal atresia repair.

Kagan M, Mongerson C, Zurakowski D, Jennings R, Bajic D Ann Clin Transl Neurol. 2021; 8(11):2132-2145.

PMID: 34662511 PMC: 8607454. DOI: 10.1002/acn3.51465.

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