title: Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage.
abstract: Low-grade germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common complication in extremely premature neonates. The occurrence of GM-IVH is highly associated with hemodynamic instability in the premature brain, yet the long-term impact of low-grade GM-IVH on cerebral blood flow and neuronal health have not been fully investigated. We used an innovative combination of frequency-domain near infrared spectroscopy and diffuse correlation spectroscopy (FDNIRS-DCS) to measure cerebral oxygen saturation (SO2) and an index of cerebral blood flow (CBFi) at the infant's bedside and compute an index of cerebral oxygen metabolism (CMRO2i). We enrolled twenty extremely low gestational age (ELGA) neonates (seven with low-grade GM-IVH) and monitored them weekly until they reached full-term equivalent age. During their hospital stay, we observed consistently lower CBFi and CMRO2i in ELGA neonates with low-grade GM-IVH compared to neonates without hemorrhages. Furthermore, lower CBFi and CMRO2i in the former group persists even after the resolution of the hemorrhage. In contrast, SO2 does not differ between groups. Thus, CBFi and CMRO2i may have better sensitivity than SO2 in detecting GM-IVH-related effects on infant brain development. FDNIRS-DCS methods may have clinical benefit for monitoring the evolution of GM-IVH, evaluating treatment response, and potentially predicting neurodevelopmental outcome.
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA 02129, USA.
authors.forename: Pei-Yi
authors.initials: PY
authors.lastname: Lin
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA 02129, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Hagan
authors.affiliation: Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA.|Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital/Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Fenoglio
authors.affiliation: Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital/Harvard Medical School, Boston, MA 02115, USA.
authors.forename: P Ellen
authors.initials: PE
authors.lastname: Grant
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA 02129, USA.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Franceschini
mesh_terms: D001921:Brain / Q000098:blood supply*; D000074042:Cerebral Intraventricular Hemorrhage / Q000000981:diagnostic imaging* / Q000378:metabolism; D002560:Cerebrovascular Circulation; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature / Q000378:metabolism*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000378:metabolism*; D019265:Spectroscopy, Near-Infrared
chemical_list: D010100:Oxygen