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Brain Injury and Pain Exposure Are A...

Selvanathan, Thiviya.

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Brain Injury and Pain Exposure Are Associated with Alterations in Structural Connectivity and Neurodevelopment in Very Preterm Infants.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Brain Injury and Pain Exposure Are Associated with Alterations in Structural Connectivity and Neurodevelopment in Very Preterm Infants./
作者:	Selvanathan, Thiviya.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
面頁冊數:	250 p.
附註:	Source: Dissertations Abstracts International, Volume: 85-05, Section: B.
Contained By:	Dissertations Abstracts International85-05B.
標題:	Neurosciences. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30640386
ISBN:	9798380834964

Brain Injury and Pain Exposure Are Associated with Alterations in Structural Connectivity and Neurodevelopment in Very Preterm Infants.
Selvanathan, Thiviya.

Brain Injury and Pain Exposure Are Associated with Alterations in Structural Connectivity and Neurodevelopment in Very Preterm Infants. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 250 p.

Source: Dissertations Abstracts International, Volume: 85-05, Section: B.

Thesis (Ph.D.)--University of Toronto (Canada), 2023.

Preterm infants undergo neonatal intensive care during a period of maturation of structural brain networks, which may be affected by clinical illness and exposures such as brain injury and pain. This thesis explores (1) the impacts of brain injury and pain on development of structural connectivity and neurodevelopmental outcomes, and (2) whether aberrations in structural connectivity are an important mediator of outcomes. A prospective cohort of very preterm infants underwent early-life and term-equivalent age brain MRI to assess brain injury and structural connectivity. Exposure to pain was quantified as number of invasive procedures. Neurodevelopmental outcomes were assessed at 18 months corrected age with the Bayley Scales of Infant and Toddler Development, Third edition. Brain injuries were segmented to quantify volumes and develop voxel-wise lesion-symptom maps to assess relationships between brain injury size and location with neurodevelopmental outcomes. These data were combined with data of structural connectivity to develop voxel-wise disconnection-symptom maps that assessed relationships between brain injury size and location with aberrations in structural connectivity and neurodevelopmental outcomes. These maps revealed that brain injury involving tracts passing through the basal ganglia, thalamus and pons were associated with poorer neurodevelopmental outcomes. This highlights the importance of considering brain injury relative to white matter tracts when predicting neurodevelopmental outcomes. Greater early-life pain was associated with poorer neurodevelopmental outcomes, and potentially mediated by alterations in neonatal structural connectivity. Specifically, greater invasive procedures were associated with widespread reductions in structural brain connectivity, and reduced connectivity was associated with poorer neurodevelopmental outcomes with specificity for the striatum. The relationship between greater early-life pain and adverse neurodevelopmental outcomes was modified by duration of morphine exposure. However, morphine exposure was not associated with neonatal structural connectivity suggesting that morphine may modify neurodevelopmental outcomes through alternative mechanisms. Finally, associations observed between pain and brain injury, aberrant connectivity within the striatum, and neurodevelopmental outcomes highlight a potential vulnerability of this region to clinical illness and exposures during early brain development in very preterm infants. These data also suggest that the striatum may play an important role in neurodevelopment in this population; this warrants further study.

ISBN: 9798380834964Subjects--Topical Terms:

588700
Neurosciences.
Subjects--Index Terms:

Brain injury

Brain Injury and Pain Exposure Are Associated with Alterations in Structural Connectivity and Neurodevelopment in Very Preterm Infants.
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