Vincent Jerome Schmithorst¹, Jodie Votava-Smith², Vince Lee¹, Vidya Rajagopalan², Shaheda Suleiman¹, Lisa Paquette², and Ashok Panigrahy^1
1Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States, ²Children's Hospital of Los Angeles, Los Angeles, CA, United States

We used functional connectivity MRI and graph analysis to investigate the impact of congenital heart disease (CHD) on functional network topology in neonates.  Cost-dependent and cost-independent analyses both showed decreases in global segregation (transitivity).  The cost-dependent analysis showed a decrease in clustering coefficient (reflective of nodal changes) while the cost-independent analysis showed a decrease in modularity and an increase in participation coefficient (reflective of changed community structure).  Minimal differences were seen for CHD patients scanned post-operatively compared to those scanned pre-operatively.  Results indicate complex CHD results in lasting changes to functional network topology not ameliorated by the effects of surgery. 

Santosh Kumar Yadav¹, Rakesh Kumar Gupta², Ravindra Kumar Garg³, Vimala Venkatesh⁴, Ena Wang¹, Francesco M Marincola¹, and Mohammad Haris^1
1Division of Translational Medicine, Sidra Medical and Research Center, Doha, Qatar, ²Department of Radiology, Fortis Memorial Research Institute, Gurgaon, India, ³Department of Neurology, King George Medical University, Lucknow, India, ⁴Department of Microbiology, King George Medical University, Lucknow, India

Cortical thickness, subcortical volumes and structural brain connectivity changes in HIV-seropositive children were evaluated in comparison to HIV-seronegative children. HIV-seropositive children showed altered cortical thicknesses, subcortical volumes and structural connectivity compared to those of HIV-seronegative children. In addition, changes in cortical and subcortical structures were significantly correlated with CD4+ counts and neuropsychological scores in HIV-seropositive children. We suggest that neuronal injury due to HIV-infection and inflammation might be possible reasons for the altered cortical thickness, subcortical volumes and connectivity in these patients.

Eliza Orasanu¹, Andrew Melbourne¹, Marc Modat¹, Marco Lorenzi¹, Herve Lombaert², Zach Eaton-Rosen¹, Nicola Robertson³, Giles Kendall⁴, Neil Marlow⁵, and Sebastien Ourselin^1
1Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom, ²INRIA, Palaiseau, France, ³Academic Neonatology, Institute for Women's Health, University College London, London, United Kingdom, ⁴Academic Neonatology, Institute for Women's Health, University College Hospital, London, United Kingdom, ⁵Institute for Women's Health, University College London, London, United Kingdom

During the preterm period, the brain undergoes changes in volume, structure and cortical folding, which can be connected with cognitive abilities in preterm born infants. Diffusion MRI allows us to investigate microstructural changes during this period. In this study we registered the longitudinal diffusion tensor images of six extremely preterm born infants and looked at white matter changes. The corpus callosum and internal capsule exhibits the most microstructural changes during this crucial period and we hypothesis that this can affect the neurodevelopment in these infants.

Alex Pagnozzi¹, Nicholas Dowson¹, James Doecke¹, Simona Fiori², Andrea Guzzetta³, Roslyn N Boyd⁴, and Stephen Rose^1
1The Australian e-Health Research Centre, CSIRO Health & Biosecurity, Brisbane, Australia, ²Stella Maris Institute, Pisa, Italy, ³Stella Maris institute, Pisa, Italy, ⁴The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia

Magnetic Resonance Imaging (MRI) is the clinical standard for assessing developmental brain injury in children with Cerebral Palsy (CP). We propose an automated process that segments the spectrum of white and grey matter injury, including tissue lesions and malformations of the cortex, and correlates biomarkers of injury with the Assisting Hand Assessment (AHA), a clinical score quantifying hand function. The proposed method is shown to perform accurate tissue and injury segmentation using T1 and T2 MRI compared to the manual classification of injury, and was significantly correlated with AHA (p<0.001).

Diane van Rappard¹, Antoine Klauser², Marjan Steenweg¹, Marjo van der Knaap¹, Nicole Wolf¹, and Petra Pouwels^3
1Child Neurology, VU University Medical Center, Amsterdam, Netherlands, ²Centre d'Imagerie BioMédicale, Geneva University, Geneva, Switzerland, ³Physics & Medical Technology, VU University Medical Center, Amsterdam, Netherlands

Currently, hematopoietic stem cell transplantation (HSCT) is the only treatment option for patients with metachromatic leukodystrophy (MLD). This study in MLD patients and controls investigated the possible additional prognostic value of quantitative MRSI. In WM (consisting of lesions and NAWM), ratios of Cho/NAA and Ins/NAA were significantly higher in patients who were considered non-eligible for HSCT than in eligible patients. Follow-up of successfully treated patients showed partial normalization of concentrations and ratios. This study suggests that quantitative MRS can support the decision whom to treat, especially when neurological and cognitive examinations are ambiguous.

Jeffrey N Stout¹, Silvina Ferradal², Borjan Gagoski², Lilla Zollei³, Divya S Bolar^3,4, Alex Lin⁵, Henry H Cheng⁶, Elfar Adalsteinsson^1,7,8, and Patricia Ellen Grant^2
1Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, United States, ²Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA, United States, ³Martinos Center for Biomedical Imaging, MGH/Harvard Medical School, Boston, MA, United States, ⁴Department of Radiology, Massachusetts General Hospital, Boston, MA, United States, ⁵Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States, ⁶Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States, ⁷Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁸Institute for Medical Engineering and Science, Cambridge, MA, United States

Concern for cerebral perfusion in neonates with congenital heart disease (CHD) has driven investigations into cerebral hemodynamics. MRI in combination with bedside NIRS has the potential to provide complementary measures of hemodynamics to guide surgical timing and assess response to surgery. We compare MRI and NIRS measures of cerebral hemodynamics. Modality results compare well to literature studies, but intermodality correlation is limited. Before combining modalities additional studies are needed to better understand why cerebral blood flow and CMRO₂ measures in MRI and NIRS differ.

Jessica Lee Wisnowski^1,2, Aaron J Reitman^3,4, Tai-Wei Lee Wu³, Eugenia Ho⁵, Claire McLean⁶, Douglas Lee Vanderbilt⁶, Marvin D Nelson¹, Ashok Panigrahy⁷, Philippe Lee Friedlich^3,8, and Stefan Lee Bluml^1
1Radiology, Children's Hospital Los Angeles, Los Angeles, CA, United States, ²Rudi Schulte Research Institute, Santa Barbara, CA, United States, ³Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States, ⁴Division of Neonatal Medicine, LAC + USC Medical Center, Los Angeles, CA, United States, ⁵Division of Child Neurology, Children's Hospital Los Angeles, Los Angeles, CA, United States, ⁶Children's Hospital Los Angeles, Los Angeles, CA, United States, ⁷Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States, ⁸Division of Neonatal Medicine, University of Southern California, Los Angeles, CA, United States

Polyunsaturated fatty acids (PUFA) are endogenous components of cellular membranes and a potential biomarker for apoptosis following hypoxic-ischemic (HI) brain injury. Prior studies have applied ¹H-MRS techniques for quantifying PUFA in human carcinomas. Here, using a retrospective dataset of 1,046 neonatal ¹H-MRS spectra, we demonstrate that PUFA can be routinely characterized in newborns using a modified LCModel (Provencher, Inc) pipeline.

 

Diliana Pecheva¹, Hui Zhang², Gareth Ball¹, Mary Rutherford¹, Nigel Kennea ³, Joseph V. Hajnal¹, Daniel Alexander², A. David Edwards¹, and Serena J. Counsell^1
1Centre for the Developing Brain, King's College London, London, United Kingdom, ²Department of Computer Science & Centre for Medical Image Computing, University College London, London, United Kingdom,³Neonatal Unit, St Georges Hospital NHS Trust, London, United Kingdom

Preterm birth adversely affects brain development and diffuse white matter (WM) injury is often observed in preterm infants. Diffusion tensor imaging (DTI) allows us to study these effects in vivo. In this study tract-specific analysis, a novel method for large infant cohort analyses, was used to study the effects of age at scan and prematurity at birth on major WM tracts in 384 preterm infants. Our results show that age at scan is associated with widespread changes in DTI metrics across WM tracts, while the impact of prematurity at birth is more localized. 

Jeong-Won Jeong^1,2, Eishi Asano¹, Csaba Juhasz^1,2, and Harry T. Chugani^1,2
1Pediatrics and Neurology, Wayne State University, Detroit, MI, United States, ²Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, MI, United States

Both ictal and interictal epileptic activities  can lead to progressive deterioration of affected brain structure and function with an additional indirect impairment of functional reorganization (or compensation) in no-epileptic areas. This study applies whole brain connectome analysis for children with intractable focal epilepsy in order to investigate the potential effect of epilepsy surgery and surgical outcome on the pattern of axonal plasticity in the contralateral hemisphere.  We found that post-operative seizures are associated with increased connectivity, most pronounced in the temporal pole region of the contralateral hemisphere. Such increased connectivity may be an imaging marker of recurrent epilepsy after focal cortical resection.

John O Glass¹, Robert J Ogg¹, Jung W Hyun², Julie H Harreld¹, Yimei Li², Amar Gajjar³, and Wilburn E Reddick^1
1Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, United States, ²Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, United States, ³Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States

This study assessed the longitudinal white matter (WM) microstructure of 129 patients and 72 normal healthy age-similar controls. WM volume, fractional anisotropy (FA), and radial (RAD) and axial (AX) diffusivity trajectories were examined. After surgery but before any additional therapy, frontal WM volume in patients was similar to controls, while FA and AX were reduced in patients, suggestive of acute, indirect microstructural/axonal injury caused by disease and/or surgical excision. Over the next three years, AX, RAD, and WM volume decreased in patients, which would be consistent with possible resolution of axonal swelling combined with chronic demyelination.