Infant study of hemispheric asymmetry after long‐gap esophageal atresia repair
Abstract Objectives Previous studies have demonstrated that infants are typically born with a left‐greater‐than‐right forebrain asymmetry that reverses throughout the first year of life. We hypothesized that critically ill term‐born and premature patients following surgical and critical care for lon...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51465 |
| _version_ | 1818842250824646656 |
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| author | Mackenzie S. Kagan Chandler R. L. Mongerson David Zurakowski Russell W. Jennings Dusica Bajic |
| author_facet | Mackenzie S. Kagan Chandler R. L. Mongerson David Zurakowski Russell W. Jennings Dusica Bajic |
| author_sort | Mackenzie S. Kagan |
| collection | DOAJ |
| description | Abstract Objectives Previous studies have demonstrated that infants are typically born with a left‐greater‐than‐right forebrain asymmetry that reverses throughout the first year of life. We hypothesized that critically ill term‐born and premature patients following surgical and critical care for long‐gap esophageal atresia (LGEA) would exhibit alteration in expected forebrain asymmetry. Methods Term‐born (n = 13) and premature (n = 13) patients, and term‐born controls (n = 23) <1 year corrected age underwent non‐sedated research MRI following completion of LGEA treatment via Foker process. Structural T1‐ and T2‐weighted images were collected, and ITK‐SNAP was used for forebrain tissue segmentation and volume acquisition. Data were presented as absolute (cm3) and normalized (% total forebrain) volumes of the hemispheres. All measures were checked for normality, and group status was assessed using a general linear model with age at scan as a covariate. Results Absolute volumes of both forebrain hemispheres were smaller in term‐born and premature patients in comparison to controls (p < 0.001). Normalized hemispheric volume group differences were detected by T1‐weighted analysis, with premature patients demonstrating right‐greater‐than‐left hemisphere volumes in comparison to term‐born patients and controls (p < 0.01). While normalized group differences were very subtle (a right hemispheric predominance of roughly 2% of forebrain volume), they represent a deviation from the expected pattern of hemispheric brain asymmetry. Interpretation Our pilot quantitative MRI study of hemispheric volumes suggests that premature patients might be at risk of altered expected left‐greater‐than‐right forebrain asymmetry following repair of LGEA. Future neurobehavioral studies in infants born with LGEA are needed to elucidate the functional significance of presented anatomical findings. |
| first_indexed | 2024-12-19T04:39:00Z |
| format | Article |
| id | doaj.art-2aa3a66caff5401ba3d13489c1424f77 |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-12-19T04:39:00Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-2aa3a66caff5401ba3d13489c1424f772022-12-21T20:35:41ZengWileyAnnals of Clinical and Translational Neurology2328-95032021-11-018112132214510.1002/acn3.51465Infant study of hemispheric asymmetry after long‐gap esophageal atresia repairMackenzie S. Kagan0Chandler R. L. Mongerson1David Zurakowski2Russell W. Jennings3Dusica Bajic4Department of Anesthesiology Critical Care and Pain Medicine Boston Children’s Hospital 300 Longwood Ave. Boston Massachusetts 02115USADepartment of Anesthesiology Critical Care and Pain Medicine Boston Children’s Hospital 300 Longwood Ave. Boston Massachusetts 02115USADepartment of Anesthesiology Critical Care and Pain Medicine Boston Children’s Hospital 300 Longwood Ave. Boston Massachusetts 02115USAHarvard Medical School Harvard University 25 Shattuck St. Boston Massachusetts 02115USADepartment of Anesthesiology Critical Care and Pain Medicine Boston Children’s Hospital 300 Longwood Ave. Boston Massachusetts 02115USAAbstract Objectives Previous studies have demonstrated that infants are typically born with a left‐greater‐than‐right forebrain asymmetry that reverses throughout the first year of life. We hypothesized that critically ill term‐born and premature patients following surgical and critical care for long‐gap esophageal atresia (LGEA) would exhibit alteration in expected forebrain asymmetry. Methods Term‐born (n = 13) and premature (n = 13) patients, and term‐born controls (n = 23) <1 year corrected age underwent non‐sedated research MRI following completion of LGEA treatment via Foker process. Structural T1‐ and T2‐weighted images were collected, and ITK‐SNAP was used for forebrain tissue segmentation and volume acquisition. Data were presented as absolute (cm3) and normalized (% total forebrain) volumes of the hemispheres. All measures were checked for normality, and group status was assessed using a general linear model with age at scan as a covariate. Results Absolute volumes of both forebrain hemispheres were smaller in term‐born and premature patients in comparison to controls (p < 0.001). Normalized hemispheric volume group differences were detected by T1‐weighted analysis, with premature patients demonstrating right‐greater‐than‐left hemisphere volumes in comparison to term‐born patients and controls (p < 0.01). While normalized group differences were very subtle (a right hemispheric predominance of roughly 2% of forebrain volume), they represent a deviation from the expected pattern of hemispheric brain asymmetry. Interpretation Our pilot quantitative MRI study of hemispheric volumes suggests that premature patients might be at risk of altered expected left‐greater‐than‐right forebrain asymmetry following repair of LGEA. Future neurobehavioral studies in infants born with LGEA are needed to elucidate the functional significance of presented anatomical findings.https://doi.org/10.1002/acn3.51465 |
| spellingShingle | Mackenzie S. Kagan Chandler R. L. Mongerson David Zurakowski Russell W. Jennings Dusica Bajic Infant study of hemispheric asymmetry after long‐gap esophageal atresia repair Annals of Clinical and Translational Neurology |
| title | Infant study of hemispheric asymmetry after long‐gap esophageal atresia repair |
| title_full | Infant study of hemispheric asymmetry after long‐gap esophageal atresia repair |
| title_fullStr | Infant study of hemispheric asymmetry after long‐gap esophageal atresia repair |
| title_full_unstemmed | Infant study of hemispheric asymmetry after long‐gap esophageal atresia repair |
| title_short | Infant study of hemispheric asymmetry after long‐gap esophageal atresia repair |
| title_sort | infant study of hemispheric asymmetry after long gap esophageal atresia repair |
| url | https://doi.org/10.1002/acn3.51465 |
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