Publications by authors named "Inder T"

Introduction: Maternal undernutrition and inflammation in utero may significantly impact the neurodevelopmental potential of offspring. However, few studies have investigated the effects of pregnancy interventions on long-term child growth and development. This study will examine the effects of prenatal nutrition and infection management interventions on long-term growth and neurodevelopmental outcomes of offspring.

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Article Synopsis
  • - The objective of the study was to review how neonatal status epilepticus (SE) is defined and measured, focusing on literature available on seizure burden in newborns.
  • - The review analyzed 44 studies that primarily included infants with conditions like hypoxic-ischemic encephalopathy, using continuous EEG (cEEG) for SE identification, and mostly defined SE via specific seizure durations.
  • - Key findings revealed significant variability in definitions of neonatal SE, with a consistent trend showing that higher seizure burden was linked to worse outcomes in the 16 studies that explored this relationship.
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Aim: To compare trajectories of social functioning in peer problems and prosocial behavior from 5 to 13 years between individuals born very preterm (VPT) and full-term (FT).

Methods: Participants were from the Victorian Infant Brain Study (VIBeS) longitudinal cohort, consisting of 224 individuals born VPT and 77 born FT recruited at birth. Social functioning was measured using the parent-rated Strengths and Difficulties Questionnaire (SDQ) peer problems and prosocial behavior subscales at 5, 7, and 13 years' corrected age.

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Background: The preterm infants are at risk of cerebellar injury and the risk factors for necrotizing enterocolitis (NEC) associated cerebellar injury are not fully understood.

Aim: Determine the risk factors of cerebellar injury in infants with surgical necrotizing enterocolitis (NEC).

Methods: Retrospective study compared clinical/pathological information between surgical NEC infants with and those without cerebellar injury detected on brain MRI obtained at term equivalent age.

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Background: This retrospective study aims to assess the added diagnostic utility and clinical value of a 3-Tesla neonatal brain magnetic resonance imaging after obtaining a 1-Tesla magnetic resonance imaging within the neonatal intensive care unit.

Methods: A cohort of 34 infants had an initial 1-Tesla magnetic resonance imaging and repeat imaging within 14 days in a 3-Tesla scanner. All infants were admitted to the level III neonatal intensive care unit at Brigham and Women's Hospital, and all images were interpreted by pediatric neuroradiologists.

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MRI of the brain is a critical tool in the diagnosis, evaluation, and management of neonatal encephalopathy (NE). More than simply a diagnostic and prognostic tool, MRI informs the biology, nature, and timing of the disease process resulting in NE, of which the largest single etiology is hypoxic-ischemic encephalopathy (HIE). Historically, 2 major patterns of injury were seen in HIE: a basal ganglia/thalamus predominant pattern and a watershed pattern of injury.

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Background: Associations of neonatal infection with brain growth and later neurodevelopmental outcomes in very preterm (VP) infants are unclear. This study aimed to assess associations of neonatal sepsis in VP infants with (1) brain growth from term-equivalent age to 13 years; and (2) 13-year brain volume and neurodevelopmental outcomes.

Methods: 224 infants born VP ( < 30 weeks' gestation/<1250 g birthweight) were recruited.

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As care of the most vulnerable infants in the neonatal intensive care unit (NICU) evolves, improved and real-time understanding of brain health becomes key. The availability of an in-NICU magnetic resonance imaging (MRI) scanner provides unique options to bedside care providers and researchers. We present our perspective on the 1-Tesla MRI unit in our NICU and its utilities and applications both in the clinical and research fields.

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Background: Limited serial neuroimaging studies use magnetic resonance imaging (MRI) to define the evolution of hypoxic-ischemic insults to the brain of term infants and encompass both the primary injury and its secondary impact on cerebral development. The optimal timing of MRI to fully evaluate the impact of hypoxic-ischemic encephalopathy on brain development and associated neurodevelopmental sequelae remains unknown.

Methods: Goals: (a) review literature related to serial neuroimaging in term infants with HIE; (b) describe pilot data in two infants with HIE treated with therapeutic hypothermia who had a brain injury at day 3-5 and underwent four additional MRIs over the next 12 weeks of life and developmental evaluation at 24 months of age.

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Background: The role of music in the NICU continues to evolve, with recent studies documenting the positive impact of music therapy for hospitalized infants and families. With many potential benefits and no substantial adverse effects reported to date in medically stable infants, we aimed to create a clinical guideline to integrate this therapy into the NICU operations.

Methods: we launched and implemented a pilot music therapy clinical program within a subunit of a level-III NICU, building upon available evidence.

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Background: There are limited data on the impact of perinatal inflammation on child neurodevelopment in low-middle income countries and among growth-restricted infants.

Methods: Population-based, prospective birth cohort study of 288 infants from July 2016-March 2017 in Sylhet, Bangladesh. Umbilical cord blood was analyzed for interleukin(IL)-1α, IL-1β, IL-6, IL-8, and C-reactive protein(CRP).

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Article Synopsis
  • Brain injury is closely linked to preterm birth, with complications like intestinal perforations contributing to long-term neurological issues that are not well understood.
  • The study found that subventricular zone echogenicity (SVE) on cranial ultrasound in preterm infants after intestinal perforations was associated with motor impairment at age 2.
  • Research in a neonatal mouse model showed that SVE involves specific cellular changes, suggesting that ultrasound detection of SVE could be an early indicator of neurodevelopmental impairment in preterm infants experiencing inflammatory conditions.
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Infants born at an extremely low gestational age (ELGA, < 29 weeks) are at an increased risk of intraventricular hemorrhage (IVH), and there is a need for standalone, safe, easy-to-use tools for monitoring cerebral hemodynamics. We have built a multi-wavelength multi-distance diffuse correlation spectroscopy device (MW-MD-DCS), which utilizes time-multiplexed, long-coherence lasers at 785, 808, and 853 nm, to simultaneously quantify the index of cerebral blood flow (CBF) and the hemoglobin oxygen saturation (SO). We show characterization data on liquid phantoms and demonstrate the system performance on the forearm of healthy adults, as well as clinical data obtained on two preterm infants.

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Background And Objective: Hospitalized preterm infants experience reduced meaningful auditory exposures during a critical period of brain development. Music-based interventions (MBI) may be beneficial, though it remains unclear which stimuli optimally enhance infant stabilization. We investigated the relationship between three conceptually-different MBIs and short-term responses in hospitalized preterm infants.

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  • - The study aimed to assess the effectiveness and safety of therapeutic hypothermia (TH) for treating neonatal encephalopathy in preterm infants born at 34-35 weeks of gestation.
  • - Researchers conducted a matched retrospective study comparing outcomes of 20 preterm infants (34-35 weeks) receiving TH with 40 infants (36 weeks or more) over a period from 2015 to 2021.
  • - Results showed that short-term outcomes were similar between the two groups, indicating that TH is a feasible and safe option for preterm infants at 34-35 weeks of gestation.
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Background And Purpose: White matter injury in infants born preterm is associated with adverse neurodevelopmental outcomes, depending on the extent and location. White matter injury can be visualized with MR imaging in the initial weeks following preterm birth but is more commonly defined at term-equivalent-age MR imaging. Our aim was to see how white matter injury detection in MR imaging compares between the 2 time points.

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Background: Lactoferrin is an immuno-modulatory nutrient in human milk that may be neuroprotective.

Methods: In 36 infants born <32 weeks' gestation, we sampled human milk at 14 and 28 days of chronologic age and measured lactoferrin by electrochemiluminescence multiplex immunoassay. Using 3T quantitative brain magnetic resonance imaging scans obtained at term equivalent, we estimated total and regional brain volumes.

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Objective: Determine the risk factors of cerebellar injury in infants with surgical necrotizing enterocolitis (NEC).

Methods: Retrospective study compared clinical/pathological information between surgical NEC infants with and those without cerebellar injury.

Results: Infants with cerebellar injury (21/65, 32.

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As the first extra-uterine setting for hospitalized infants, the neonatal intensive care unit (NICU) environment can make a lasting impact on their long-term neurodevelopment. This impact is likely mediated through both specific characteristics of the physical design of the care environment, as well as the experiences that occur within this environment. Recent studies document many established benefits of single-family rooms (SFRs).

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Introduction: Children born very preterm (VP) remain at risk for long-term neurodevelopmental impairment. Patterns of brain growth and injury, and how early neuropromotive therapies might mitigate developmental risk in VP infants remain insufficiently understood.

Methods: This is a prospective cohort study of VP infants born at/before 32 weeks gestation.

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