Brainstem shape is affected by clinical course in the neonatal intensive care unit

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dc.contributor.authorLo, Marcus
dc.contributor.authorZubiaurre Elorza, Leire
dc.contributor.authorWild, Conor J.
dc.contributor.authorLinke, Annika
dc.contributor.authorLee, David S.C.
dc.contributor.authorHan, Victor .K.
dc.contributor.authorCusack, Rhodri
dc.date.accessioned2026-01-20T18:55:44Z
dc.date.available2026-01-20T18:55:44Z
dc.date.issued2017
dc.date.updated2026-01-20T18:55:44Z
dc.description.abstractThe brainstem, critical for motor function, autonomic regulation, and many neurocognitive functions, undergoes rapid development from the third trimester. Accordingly, we hypothesized it would be vulnerable to insult during this period, and that a difficult clinical course in the neonatal intensive care unit (NICU) would affect development, and be reflected through atypical shape. Our study population consisted of 66 neonates – all inpatients from the NICU at Victoria Hospital, London Health Sciences Centre, ON, Canada, of which 45 entered the final analysis. The cohort varied in gestational age (GA) and ranged from neurologically healthy to severely brain-injured. Structural MRI was used to quantify brainstem shape at term-equivalent age. From these images, brainstems were semi-automatically segmented and co-registered across subjects. The anterior-posterior dimensions on a sagittal maximum intensity projection were used as the basis for shape comparison. Factor analysis was used to summarize variation in shape and in clinical course to determine three shape factors and three clinical factors, and their relationship assessed using correlation. A factor driven by low GA and associated complications correlated with alterations in the posterior medulla, while a factor driven by complications independent of GA correlated with alterations in the midbrain. Additionally, single clinical measures most representative of their respective clinical factor (days in NICU; days on ventilation) predicted the changes. Thus, different clinical courses in the NICU may have different effects on the shape of the brainstem, and may mediate some of the distinct neurodevelopmental profiles observed in premature and brain-injured neonates.en
dc.description.sponsorshipThis work was supported by the Canada Excellence Research Chair (CERC) in Cognitive Neuroimaging, a Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant (NSERC 418293DG-2012), CIHR/NSERC Collaborative Health Research Project (CHRP 201110CPG)en
dc.identifier.citationLo, M., Zubiaurre-Elorza, L., Wild, C., Linke, A. C., Lee, D. S. C., Han, V. K., & Cusack, R. (2017). Brainstem shape is affected by clinical course in the neonatal intensive care unit. NeuroImage: Clinical, 15, 62-70. https://doi.org/10.1016/J.NICL.2017.04.007
dc.identifier.doi10.1016/J.NICL.2017.04.007
dc.identifier.eissn2213-1582
dc.identifier.urihttps://hdl.handle.net/20.500.14454/4773
dc.language.isoeng
dc.publisherElsevier Inc.
dc.rights© 2017 The Authors
dc.subject.otherBrainstem
dc.subject.otherMagnetic resonance imaging (MRI)
dc.subject.otherNeonatal intensive care unit (NICU)
dc.subject.otherPerinatal
dc.subject.otherPreterm birth
dc.titleBrainstem shape is affected by clinical course in the neonatal intensive care uniten
dc.typejournal article
dcterms.accessRightsopen access
oaire.citation.endPage70
oaire.citation.startPage62
oaire.citation.titleNeuroImage: Clinical
oaire.citation.volume15
oaire.licenseConditionhttps://creativecommons.org/licenses/by-nc-nd/4.0/
oaire.versionVoR
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