title: Parenteral nutrition compromises neurodevelopment of preterm pigs.
abstract: BACKGROUND
  Despite advances in nutritional support and intensive care, preterm infants are at higher risk of compromised neurodevelopment.
  
  
  OBJECTIVE
  This study evaluated the contribution of total parenteral nutrition (PN) to compromised neurodevelopment after preterm birth.
  
  
  METHODS
  Preterm pigs were provided PN or enteral nutrition (EN) for 10 d. Neurodevelopment was assessed by observations of motor activity and evaluation of sensory/motor reflexes, brain weight, MRI, and cerebellar histology.
  
  
  RESULTS
  Despite similar gains in body weight, PN pigs had smaller brains (32 ± 0.4 vs. 35 ± 0.6 g; P = 0.0002) including the cerebellum, as well as reduced motor activity (P = 0.005), which corresponded to underdeveloped myelination (P = 0.004) measured by diffusion tensor imaging. PN resulted in lower serum triglycerides (17 ± 5.9 vs. 27 ± 3.1 mg/dL; P = 0.05), total cholesterol (31 ± 9.6 vs. 85 ± 8.1 mg/dL; P = 0.04), VLDL cholesterol (3.7 ± 1.2 vs. 5.7 ± 0.7 mg/dL; P = 0.04), and HDL cholesterol (16 ± 4.6 vs. 57 ± 7.3 mg/dL; P = 0.03) and nonsignificantly lower LDL cholesterol (10.7 ± 4.4 vs. 22.7 ± 2.9 mg/dL; P = 0.09).
  
  
  CONCLUSIONS
  The compromised neurodevelopment caused by total PN is a novel finding, was independent of confounding variables (disease, inconsistent gestational ages, diverse genetics, extrauterine growth retardation, and inconsistent neonatal intensive care unit protocols), and highlights a need to improve current PN solutions. The preterm pig is a translational animal model for improving nutrition support to enhance neurodevelopment of preterm infants requiring PN.
authors.affiliation: Departments of Radiology and Le Bonheur Children's Hospital, Memphis, TN; and.
authors.forename: Asim F
authors.initials: AF
authors.lastname: Choudhri
authors.affiliation: Departments of Psychology.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Sable
authors.affiliation: Anatomy and Neurobiology, University of Tennessee Health Science Center.
authors.forename: Viktor V
authors.initials: VV
authors.lastname: Chizhikov
authors.affiliation: Lab Animal Care, and.
authors.forename: Karyl K
authors.initials: KK
authors.lastname: Buddington
authors.affiliation: Health and Sport Sciences, University of Memphis, Memphis, TN rbddngtn@memphis.edu.
authors.forename: Randal K
authors.initials: RK
authors.lastname: Buddington
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D000831:Animals, Newborn; D001219:Aspartate Aminotransferases / Q000097:blood; D001522:Behavior, Animal / Q000187:drug effects; D001663:Bilirubin / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000187:drug effects / Q000254:growth & development*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D004750:Enteral Nutrition; D005865:Gestational Age; D008279:Magnetic Resonance Imaging; D023421:Models, Animal; D009474:Neurons / Q000187:drug effects* / Q000378:metabolism; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012709:Serum Albumin / Q000378:metabolism; D013552:Swine; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D012709:Serum Albumin; D014280:Triglycerides; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin
keywords: animal model; brain; gestation; infant; premature