Longitudinal measurement of the developing grey matter in preterm subjects using multi-modal MRI.

Preterm birth is a major public health concern, with the severity and occurrence of adverse outcome increasing with earlier delivery. Being born preterm disrupts a time of rapid brain development: in addition to volumetric growth, the cortex folds, myelination is occurring and there are changes on the cellular level. These neurological events have been imaged non-invasively using diffusion-weighted (DW) MRI. In this population, there has been a focus on examining diffusion in the white matter, but the grey matter is also critically important for neurological health. We acquired multi-shell high-resolution diffusion data on 12 infants born at ≤28weeks of gestational age at two time-points: once when stable after birth, and again at term-equivalent age. We used the Neurite Orientation Dispersion and Density Imaging model (NODDI) (Zhang et al., 2012) to analyse the changes in the cerebral cortex and the thalamus, both grey matter regions. We showed region-dependent changes in NODDI parameters over the preterm period, highlighting underlying changes specific to the microstructure. This work is the first time that NODDI parameters have been evaluated in both the cortical and the thalamic grey matter as a function of age in preterm infants, offering a unique insight into neuro-development in this at-risk population

Deep convolutional filtering for spatio-temporal denoising and artifact removal in arterial spin labelling MRI

Arterial spin labelling (ASL) is a noninvasive imaging modality, used in the clinic and in research, which can give quantitative measurements of perfusion in the brain and other organs. However, because the signal-to-noise ratio is inherently low and the ASL acquisition is particularly prone to corruption by artifact, image processing methods such as denoising and artifact filtering are vital for generating accurate measurements of perfusion. In this work, we present a new simultaneous approach to denoising and artifact removal, using a novel deep convolutional joint filter architecture to learn and exploit spatio-temporal properties of the ASL signal. We proceed to show, using data from 15 healthy subjects, that our approach achieves state of the art performance in both denoising and artifact removal, improving peak signal-to-noise ratio by up to 50%. By allowing more accurate estimation of perfusion, even in challenging datasets, this technique offers an exciting new approach for ASL pipelines, and might be used both for improving individual images and to increase the power of research studies using ASL

Investigating the maturation of microstructure and radial orientation in the preterm human cortex with diffusion MRI

Preterm birth disrupts and alters the complex developmental processes in the cerebral cortex. This disruption may be a contributing factor to widespread delay and cognitive difficulties in the preterm population. Diffusion-weighted magnetic resonance imaging (DW MRI) is a noninvasive imaging technique that makes inferences about cellular structures, at scales smaller than the imaging resolution. One established finding is that DW MRI shows a transient radial alignment in the preterm cortex. In this study, we quantify this maturational process with the “radiality index”, a parameter that measures directional coherence, which we expect to change rapidly in the perinatal period. To measure this index, we used structural T2-weighted MRI to segment the cortex and generate cortical meshes. We obtained normal vectors for each face of the mesh and compared them to the principal diffusion direction, calculated by both the DTI and DIAMOND models, to generate the radiality index. The subjects included in this study were 89 infants born at fewer than 34 weeks completed gestation, each imaged at up to four timepoints between 27 and 42 weeks gestational age. In this manuscript, we quantify the longitudinal trajectory of radiality, fractional anisotropy and mean diffusivity from the DTI and DIAMOND models. For the radiality index and fractional anisotropy, the DIAMOND model offers improved sensitivity over the DTI model. The radiality index has a consistent progression across time, with the rate of change depending on the cortical lobe. The occipital lobe changes most rapidly, and the frontal and temporal least: this is commensurate with known developmental anatomy. Analysing the radiality index offers information complementary to other diffusion parameters

Somatosensory function and pain in extremely preterm young adults from the UK EPICure cohort: sex-dependent differences and impact of neonatal surgery

Background: Surgery or multiple procedural interventions in extremely preterm neonates influence neurodevelopmental outcome and may be associated with long-term changes in somatosensory function or pain response. Methods: This observational study recruited extremely preterm (EP, <26 weeks' gestation; n=102, 60% female) and term-born controls (TC; n=48) aged 18–20 yr from the UK EPICure cohort. Thirty EP but no TC participants had neonatal surgery. Evaluation included: quantitative sensory testing (thenar eminence, chest wall); clinical pain history; questionnaires (intelligence quotient; pain catastrophising; anxiety); and structural brain imaging. Results: Reduced thermal threshold sensitivity in EP vs TC participants persisted at age 18–20 yr. Sex-dependent effects varied with stimulus intensity and were enhanced by neonatal surgery, with reduced threshold sensitivity in EP surgery males but increased sensitivity to prolonged noxious cold in EP surgery females (P<0.01). Sex-dependent differences in thermal sensitivity correlated with smaller amygdala volume (P<0.05) but not current intelligence quotient. While generalised decreased sensitivity encompassed mechanical and thermal modalities in EP surgery males, a mixed pattern of sensory loss and sensory gain persisted adjacent to neonatal scars in males and females. More EP participants reported moderate–severe recurrent pain (22/101 vs 4/48; χ2=0.04) and increased pain intensity correlated with higher anxiety and pain catastrophising. Conclusions: After preterm birth and neonatal surgery, different patterns of generalised and local scar-related alterations in somatosensory function persist into early adulthood. Sex-dependent changes in generalised sensitivity may reflect central modulation by affective circuits. Early life experience and sex/gender should be considered when evaluating somatosensory function, pain experience, or future chronic pain risk

Multi-modal measurement of the myelin-to-axon diameter g-ratio in preterm-born neonates and adult controls

Infants born prematurely are at increased risk of adverse functional outcome. The measurement of white matter tissue composition and structure can help predict functional performance and this motivates the search for new multi-modal imaging biomarkers. In this work we develop a novel combined biomarker from diffusion MRI and multi-component T2 relaxation measurements in a group of infants born very preterm and scanned between 30 and 40 weeks equivalent gestational age. We also investigate this biomarker on a group of seven adult controls, using a multi-modal joint model-fitting strategy. The proposed emergent biomarker is tentatively related to axonal energetic efficiency (in terms of axonal membrane charge storage) and conduction velocity and is thus linked to the tissue electrical properties, giving it a good theoretical justification as a predictive measurement of functional outcome

CCAAT/enhancer binding proteins in normal mammary development and breast cancer

CCAAT/enhancer binding proteins (C/EBPs) are a family of leucine zipper, transcription factors that bind to DNA as homodimers and heterodimers. They regulate cellular proliferation, differentiation and apoptosis in the mammary gland. Multiple protein isoforms, including truncated, dominant negatives, are generated by translation of the C/EBPβ transcript or via proteolytic cleavage of the full-length C/EBPβ protein. Gene deletion of individual C/EBP family members has demonstrated an essential role for C/EBPβ in normal mammary development, while transgenic and overexpression studies provide evidence that the dominant-negative C/EBPβ-liver-enriched inhibitory protein isoform induces proliferation in mammary epithelial cells. Mounting evidence suggests that alterations in the ratio of the C/EBPβ-liver-enriched inhibitory protein isoform and the C/EBPβ-liver-enriched activating protein isoform may play a role in the development of breast cancer. This review will consequently focus on C/EBP actions in normal mammary development and on the emerging data that supports a role in breast cancer