Keywords: Fetal, Fetus, Cortical development, gestational age prediction, shape signatures

Motivation: Capture more nuanced aspects of fetal brain cortex development.

Goal(s): Investigate the cortical surface of 65 fetal brain reconstructions from MRI examinations with global descriptors derived from scalar point-wise curvature-based metrics (H, K, SI, C, FI) and multidimensional point-wise shape signatures (HKS, WKS, SHOT).

Approach: The morphometric properties extracted by these descriptors were provided as input to SVR models to predict the gestational age. Two public atlases and one dataset were adopted to train and test the models, respectively.

Results: SHOT better encode the cerebral cortex development during pregnancy, achieving a prediction R² of 0.89 and MAE of 6.3 days.

Impact: SHOT provides researchers with sophisticated tool to capture more nuanced aspects of the fetal brain cortex development across gestational ages.

Keywords: Neuro, Neuro

Motivation: Direct contrast synthesis (AI-DCS) enables the derivation of synthetic images from a trained neural network.  Its utility in clinical practice has yet to be adequately explored.  

Goal(s): To evaluate the image quality and diagnostic confidence of these synthetic images in the brain in the pediatric population. 

Approach: The study radiologist compares the image quality and diagnostic confidence of AI-DCS images to standard of care (SOC) and SyMRI.  

Results: AI-DCS demonstrates better overall image quality and diagnostic confidence than SyMRI on T1, T2 and FLAIR in majority of patients.  AI-DCS demonstrates better overall image quality on FLAIR when compared to SOC.   

Impact: AI-DCS demonstrates improved image quality and diagnostic confidence compared to SyMRI and comparable image quality to the current standard of care.  

Keywords: Neuro, Diffusion/other diffusion imaging techniques

Motivation: Congenital heart disease (CHD) negatively impacts brain development and cognition.

Goal(s): We aim to elucidate the role of clinical and environmental factors on brain development and cognition.

Approach: A cumulative clinical risk (CCR) score derived from neonatal, cardiac, and neurological variables, brain connectivity metrics using diffusion-MRI, and cognitive outcomes were obtained in 53 CHD adolescents and 75 controls. 

Results: Higher CCR scores correlated with weaker brain network strength in a fronto-parietal-thalamic network, lower network segregation and poorer cognitive function, independent of family-environmental factors. These findings underscore the need for early risk assessment to predict brain development and aid vulnerable adolescents with CHD. 

Impact: Adolescents with congenital heart disease demonstrate altered brain networks, particularly those who face a cumulative exposure to multiple risk factors over time. Early assessment of risk load could help predict brain development and support the most vulnerable patients early on. 

Keywords: Neuro, Brain, metabolism, development

Motivation: N-acetyl-aspartyl-glutamate (NAAG) is a dipeptide and glutamate neuromodulator with possible significance as therapeutical target for injuries and diseases associated with glutamate neurotoxicity.

Goal(s): Determine age-dependent differences in its accumulation in white and grey matter in the human brain.

Approach: Existing MR spectra from 410 “closest-to-normal” pediatric patients and controls were evaluated.

Results: NAAG concentrations in the human brain were low and borderline detectable from birth to early childhood but then increased in late childhood in the parietal white matter whereas NAAG remained low in parietal grey matter.

Impact: This study demonstrates that NAAG accumulates at late childhood predominantly in WM. Furthermore, it suggests that in vivo MRS can be used to assess NAAG levels in disorders associated with excessive glutamatergic neurotransmission, such as childhood seizures.  

Keywords: Neuro, Brain, Cerebral palsy, Periventricular white matter injury, MRI, Diagnose, MultiReader MultiCase

Motivation: Early diagnosis of cerebral palsy  in infants with periventricular white matter injury is crucial for rehabilitation.

Goal(s): To develop and externally validate a MRI-based model to predict CP in infants with PWMI aged 6 to 24 months, and evaluate the diagnostic performance of the model using the MRMC analysis.

Approach: In this study, A MRI-based multivariable logistic regression model was develop at one center , and was validated at the three centers, and to evaluate the diagnostic performance of the model using the MRMC analysis. 

Results: The model showed both excellent predictive performance in the multicenter cohorts and high diagnostic performance  in MRMC analysis.

Impact: Our model is a reliable and reproducible tool for diagnosis of CP in infants with PWMI aged 6 to 24 months.

Keywords: Fetal, Fetus, gastrointestinal disorders

Motivation: In the prenatal diagnosis of gastrointestinal abnormality,fetal magnetic resonance imaging (MRI) is becoming increasingly relevant. 

Goal(s): T1-weighted sequences enable assessment of the presence of  meconium, allowing  diagnosis of  gastrointestinal abnormality, a method with a higher success rate and better image quality is necessary.

Approach: In this work, we compared the performance of three rapid 3D T₁-weighted imaging sequences for fetal gastrointestinal MRI at 1.5 T MRI scanner, including free-breathing radial and breath-hold, as well as the free-breathing multi-average 3D VIBE sequences. 

Results:  Our results demonstrated that free-breathing multi-average VIBE sequence not only demonstrates a higher success rate but also delivers superior image quality.

Impact: The T1WI images of  fetal gastrointestinal were barely satisfactory , which accompanied by motion and other artifacts.  It is necessary to find a scanning method that is tolerable to the mother and has good image quality.

Keywords: Neuro, Pediatric, Other Interventional

Motivation: Infantile Tremor syndrome (ITS) is a neurocutaneous syndrome observed in infants breastfed by vegetarian mothers who are deficient in vitamin B12. Its is accompanied by cerebral and white matter atrophy, delayed myelination, and delayed neurodevelopment.

Goal(s): To evaluate the efficacy of B12 treatment in infants with ITS on microstructural development and myelination using DTI.

Approach: In this longitudinal study, changes in DTI metrics are evaluated before and after vitamin B12 treatment using an atlas-based approach.

Results: Results show substantial increases in WM FA and decrease in WM RD, as evidence of the role of B12 in the myelination process.

Impact: Our findings will contribute to understanding the pathophysiological basis of ITS and highlight the efficacy of B12 treatment in rapidly reversing delayed brain development

Keywords: Neuro, MR-Guided Interventions

Motivation: Transcranial magnetic stimulation (TMS)-assisted rehabilitation therapy has demonstrated the potential to enhance prognoses in spastic cerebral palsy (SCP). However, there are still great differences in the efficacy among individuals. 

Goal(s): We employed personalized MRI-guided TMS to precisely target symptomatic neural circuits in children with SCP. 

Approach: We used DSI Studio software to track symptom-related fibre bundles within the cortex for targeting and analysed MRI structural and functional differences before and after treatment.

Results: Our findings revealed post-treatment improvements in the quantity, maximum length, and mean length of fiber bundles. Additionally, enhanced neural activity and improved consistency of neural signals were observed after treatment. 

Impact: Individualized MRI-guided TMS interventions have shown promise in ameliorating neurological symptoms in individuals with SCP.

Keywords: Neuro, Nervous system

Motivation: Non-invasive quantitative methods to assess the brain development of children with congenital heart disease (CHD) has been a hot topic . 

Goal(s): The main focus of this study is to investigate how MAP-MRI can be used to assess preoperative brain development in children with CHD.

Approach:  In this study, quantitative and correlational analyses of preoperative brain development in CHD children were performed using the multi-parameter indicators of the MAP-MRI diffusion model. 

Results: The results show that children with CHD exhibit cerebral microstructural abnormalities preoperatively, and MAP-MRI parameter indicators can be used for early prediction of preoperative neurodevelopment in CHD children.

Impact: MAP-MRI parameter indicators can serve as imaging reference values for preoperative brain development in children with CHD, aiding clinical professionals in focusing on the neurodevelopment of these patients while treating their CHD.

Keywords: Neuro, fMRI (resting state)

Motivation: Obesity and its associated comorbidities represent a health risk to population. This is even more relevant to children, as it can affect their cognitive development. 

Goal(s): Understanding the neurological pathophysiology of infant obsity is of paramount interest.

Approach: Find differences in functional connectivity between infant obese and normoweight groups. This using Resting State and ROI to ROI analyses

Results: Both groups presented the 15 RS-networks except for the Executive Control Network for the obese. The obese groups recruited three times more brain regions for the different RS-networks. ROI-to-ROI analysis presented larger number of connections for the Normoweight involving the Cerebellum and the Left-Inferior-Gyrus.

Impact: This is a first step in a larger project in which cognitive deficits of children associated with obesity are correlated to brain function through MRI and cytokine measurements. Here we establish ground differences between obese and normoweight cohorts. 

Keywords: Neonatal, Neonatal, Neonatal, Point-of-care MRI, Machine Learning/Artificial Intelligence, Segmentation

Motivation: To propose a new approach for managing hydrocephalus in neonates based on neonatal MRI and AI-based brain ventricle volume quantitation, brain parenchyma volume and ventricle-to-brain volumes ratio.

Goal(s): To evaluate the robustness of quantitative measurements of ventricle and brain volumes using AI-based algorithms, on scans acquired on a 1 Tesla permanent magnet neonatal MRI.

Approach: The performance of three AI-based segmentation algorithms was evaluated using linear correlations and Intersection over Union (IoU) score between ground truth and predictions.

Results: Results show high linear correlations between ground truth and algorithm predictions, validating  the use of these volumetric measurements to monitor hydrocephalus longitudinally.

Impact: An AI based method for segmenting neonatal MRI images may provide volumetric quantitation and enable fast and accurate decision making on surgical intervention in preterm infants with hydrocephalus.

Keywords: Neuro, Diffusion/other diffusion imaging techniques

Motivation: Given known associations between maternal distress during pregnancy and increased risk of offspring to develop psychopathology, it is critical to assess the influences of prenatal maternal depression & anxiety (pMDA) on infant brain organization.

Goal(s): To investigate the relationship between pMDA and GM organization and assess differences in this relationship between male and female infants.

Approach: In this study, we apply the NODDI GM- Based Spatial Statistics framework adapted for the infant brain to assess the relationship with pMDA and infant GM organization and investigate sex-related differences within this relationship.

Results: Our findings suggest a sex-dependent association between pMDA and infant GM microstructure.

Impact: Results may inform the development of interventions for maternal support during pregnancy.

Keywords: Neonatal, Pediatric

Motivation: The effect of preterm birth on cerebral oxygenation and its underlying mechanism have not been fully elucidated.

Goal(s): The goal of current study is to evalute cerebral oxygenation with non-contrast MRI techniques in a group of preterm-born neonates.

Approach: Cerebral oxygen extraction fraction (OEF) and metabolic rate of oxygen (CMRO₂) were measured with TRUST MRI together with cerebral blood flow (CBF) in 50 neonates.

Results: We showed that neonates with lower gestational age had higher OEF, lower CBF and lower CMRO₂, controlling for postmenstrual age. Higher OEF was associated with higher Apgar score. Hematocrit significantly mediated the increase of OEF in preterm neonates.

Impact: The results suggested a potential role of MRI-based oxygenation measurement in the assessment of transfusion and intervention for preterm neonates.

Keywords: Neuro, Pediatric, Cortex

Motivation: Congenital heart disease (CHD) is common and associated with impaired early brain development. 

Goal(s): To assess whether preoperative cortical Gyrification Index (GI) in infants with CHD deviates from the normal trajectory.

Approach: GI trajectories were normatively-modelled using reference control MRI data from 320 healthy infants, enabling calculation of GI Z-scores for the whole brain and frontal, occipital, parietal, temporal, cingulate and insular cortices for 130 infants with CHD, after accounting for sex, postmenstrual age at scan and days since birth at scan.

Results: Mean GI Z-scores were significantly lower for the whole brain and all cortical regions in infants with CHD (All P_FDR<0.018)

Impact: Global and regional brain gyrification is reduced in infants with critical or severe CHD in the neonatal period, prior to cardiac surgery, and these individualised measures of cortical folding are significantly associated with cerebral oxygen delivery in the neonatal period.