Apnea of prematurity (AOP) affects more than 50% of preterm infants and leads to perinatal intermittent hypoxia (IH) which is a major cause of morbimortality worldwide. At birth, the human cerebellar cortex is still immature, making it vulnerable to perinatal events. Additionally, studies have shown a correlation between cerebellar functions and the deficits observed in children who have experienced AOP. Yet, the cerebellar alterations underpinning this link remain poorly understood. To gain insight into the involvement of the cerebellum in perinatal hypoxia-related consequences, we developed a mouse model of AOP. Our previous research has revealed that IH induces oxidative stress in the developing cerebellum, as evidenced by the over-expression of genes involved in reactive oxygen species production and the under-expression of genes encoding antioxidant enzymes. These changes suggest a failure of the defense system against oxidative stress and could be responsible for neuronal death in the cerebellum. Building upon these findings, we conducted a transcriptomic study of the genes involved in the processes that occur during cerebellar development. Using real-time PCR, we analyzed the expression of these genes at different developmental stages and in various cell types. This enabled us to pinpoint a timeframe of vulnerability at P8, which represents the age with the highest number of downregulated genes in the cerebellum. Furthermore, we discovered that our IH protocol affects several molecular pathways, including proliferation, migration, and differentiation. This indicates that IH can impact the development of different cell types, potentially contributing to the histological and behavioral deficits observed in this model. Overall, our data strongly suggest that the cerebellum is highly sensitive to IH, and provide valuable insights into the cellular and molecular mechanisms underlying AOP. In the long term, these findings may contribute to the identification of novel therapeutic targets for improving the clinical management of this prevalent pathology.
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http://dx.doi.org/10.1016/j.crneur.2023.100113 | DOI Listing |
Children (Basel)
January 2025
Connecticut Children's Medical Center-Hartford, 282 Washington Street, Hartford, CT 06106, USA.
Background/objectives: Determine the appropriate duration for multichannel sleep studies in former preterm infants with cardio-respiratory events beyond term equivalent age.
Hypothesis: A sleep study of 10 h will provide equivalent information compared to a 20-h study to detect significant cardio-respiratory abnormalities in this population.
Methods: Single-center retrospective study of 50 infants with 20-h sleep study.
Curr Opin Pediatr
December 2024
Division of Neonatology, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
Purpose Of Review: This review outlines the prevalence and complications of apneas and intermittent hypoxemic events in preterm infants, examines current monitoring limitations in neonatal ICUs (NICUs), and explores emerging technologies addressing these challenges.
Recent Findings: New evidence from the Prematurity-Related Ventilatory Control (Pre-Vent) study, which analyzed cardiorespiratory data from 717 extremely preterm infants, exposes the varying frequency, duration, and severity of apneas, intermittent hypoxemia, bradycardias, and periodic breathing during hospitalization, and highlights the negative impact of intermittent hypoxemia on pulmonary outcomes at discharge. Although traditional monitoring methods cannot differentiate between apnea types and quantify their burden, recent advancements in sensor technologies and data integration hold promise for improving real-time detection and evaluation of apneas in the NICU.
Brain Commun
January 2025
Department of Biological Sciences, Southern Methodist University, Dallas, TX 75275, USA.
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related death, likely stemming from seizure activity disrupting vital brain centres controlling heart and breathing function. However, understanding of SUDEP's anatomical basis and mechanisms remains limited, hampering risk evaluation and prevention strategies. Prior studies using a neuron-specific conditional knockout mouse model of SUDEP identified the primary importance of brain-driven mechanisms contributing to sudden death and cardiorespiratory dysregulation; yet, the underlying neurocircuits have not been identified.
View Article and Find Full Text PDFActa Paediatr
January 2025
Department of Neonatology, University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.
Aim: We evaluated whether sample entropy of heart rate time series could serve as a biomarker for guiding caffeine cessation in preterm infants treated for apnoea of prematurity (AOP). We also assessed associations of sample entropy with weeks of gestation, clinical morbidity, AOP frequency and caffeine reinitiation.
Methods: We conducted a prospective single-centre study at the University Children's Hospital Basel, Switzerland, from July 2019 to June 2020.
PLoS One
January 2025
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Background: Minimizing the duration of mechanical ventilation is one of the most important therapeutic goals during the care of preterm infants at neonatal intensive care units (NICUs). The rate of extubation failure among preterm infants is between 16% and 40% worldwide. Numerous studies have been conducted on the assessment of extubation suitability, the optimal choice of respiratory support around extubation, and the effectiveness of medical interventions.
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