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. 2021 Apr 2;11(4):455.
doi: 10.3390/brainsci11040455.

Morphometric Analysis of Brain in Newborn with Congenital Diaphragmatic Hernia

Martina Lucignani  1 , Daniela Longo  2 , Elena Fontana  2 , Maria Camilla Rossi-Espagnet  2   3 , Giulia Lucignani  2 , Sara Savelli  4 , Stefano Bascetta  4 , Stefania Sgrò  5 , Francesco Morini  6 , Paola Giliberti  6 , Antonio Napolitano  1
Affiliations

Morphometric Analysis of Brain in Newborn with Congenital Diaphragmatic Hernia

Martina Lucignani et al. Brain Sci. .

Abstract

Congenital diaphragmatic hernia (CDH) is a severe pediatric disorder with herniation of abdominal viscera into the thoracic cavity. Since neurodevelopmental impairment constitutes a common outcome, we performed morphometric magnetic resonance imaging (MRI) analysis on CDH infants to investigate cortical parameters such as cortical thickness (CT) and local gyrification index (LGI). By assessing CT and LGI distributions and their correlations with variables which might have an impact on oxygen delivery (total lung volume, TLV), we aimed to detect how altered perfusion affects cortical development in CDH. A group of CDH patients received both prenatal (i.e., fetal stage) and postnatal MRI. From postnatal high-resolution T2-weighted images, mean CT and LGI distributions of 16 CDH were computed and statistically compared to those of 13 controls. Moreover, TLV measures obtained from fetal MRI were further correlated to LGI. Compared to controls, CDH infants exhibited areas of hypogiria within bilateral fronto-temporo-parietal labels, while no differences were found for CT. LGI significantly correlated with TLV within bilateral temporal lobes and left frontal lobe, involving language- and auditory-related brain areas. Although the causes of neurodevelopmental impairment in CDH are still unclear, our results may suggest their link with altered cortical maturation and possible impaired oxygen perfusion.

Keywords: congenital diaphragmatic hernia (CDH); cortical thickness (CT); local gyrification index (LGI); magnetic resonance imaging (MRI); total lung volume (TLV).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
T2-weighted MRI of a CDH patient. Sagittal, axial and coronal view of the brain shows an enlargement of the SAS in the fronto-insular region bilaterally.
Figure 2
Figure 2
Statistical results mapped on the inflated surface of a 2-months template. (A) Family-wise error (FWE) corrected p-value maps for LGI comparison, obtained for HC > CDH contrast. Significance was set at 0.01. (B) Brain areas with significant total lung volume-local gyrification index (TLV-LGI) correlation and significant reduced gyrification.
Figure 3
Figure 3
Scatter plot of TLV-LGI correlation for LH (left) and RH (right). Scatter plot with line of best fit (red line) within 95% confident interval (dashed grey lines).
See this image and copyright information in PMC

References

    1. Clark R.H., Hardin W.D., Hirschl R.B., Jaksic T., Lally K.P., Langham M.R., Wilson J.M. Current surgical management of congenital diaphragmatic hernia: A report from the congenital diaphragmatic hernia study group. J. Pediatr. Surg. 1998;33:1004–1009. doi: 10.1016/S0022-3468(98)90522-X. - DOI - PubMed
    1. Morini F., Valfrè L., Bagolan P. Long-term morbidity of congenital diaphragmatic hernia: A plea for standardization. Semin. Pediatr. Surg. 2017;26:301–310. doi: 10.1053/j.sempedsurg.2017.09.002. - DOI - PubMed
    1. Long A.M., Bunch K.J., Knight M., Kurinczuk J.J., Losty P.D. Early population-based outcomes of infants born with congenital diaphragmatic hernia. Arch. Dis. Child. Fetal Neonatal Ed. 2018;103:F517–F522. doi: 10.1136/archdischild-2017-313933. - DOI - PubMed
    1. Danzer E., Gerdes M., D’Agostino J.A., Bernbaum J., Hoffman C., Herkert L., Rintoul N.E., Peranteau W.H., Flake A.W., Adzick N.S., et al. Neurodevelopmental outcome at one year of age in congenital diaphragmatic hernia infants not treated with extracorporeal membrane oxygenation. J. Pediatr. Surg. 2015;50:898–903. doi: 10.1016/j.jpedsurg.2015.03.040. - DOI - PubMed
    1. Crankson S.J., Al Jadaan S.A., Namshan M.A., Al-Rabeeah A.A., Oda O. The immediate and long-term outcomes of newborns with congenital diaphragmatic hernia. Pediatr. Surg. Int. 2006;22:335–340. doi: 10.1007/s00383-006-1643-6. - DOI - PubMed

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