Functional neuroimaging of responses to multiple sensory stimulations in newborns with perinatal asphyxia

Carla R Pinto; João V Duarte; Alexandra Dinis; Isabel C Duarte; João Castelhano; Joana Pinto; Guiomar Oliveira; Miguel Castelo-Branco

doi:10.21037/tp-23-135

Functional neuroimaging of responses to multiple sensory stimulations in newborns with perinatal asphyxia

Transl Pediatr. 2023 Sep 18;12(9):1646-1658. doi: 10.21037/tp-23-135. Epub 2023 Sep 11.

Authors

Carla R Pinto^{1

2

3}, João V Duarte^{3

4}, Alexandra Dinis¹, Isabel C Duarte^{3

4}, João Castelhano^{3

4}, Joana Pinto⁵, Guiomar Oliveira^{2

3

6}, Miguel Castelo-Branco^{3

4}

Affiliations

¹ Pediatric Intensive Care Unit, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, Portugal.
² University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³ Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT) and Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.
⁴ Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁵ Neuroradiology Unit, Medical Imaging Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
⁶ Child Developmental Center, Research and Clinical Training Center, Pediatric Hospital, Coimbra Hospital and University Centre, Coimbra, Portugal.

Abstract

Background: Functional neuroimaging can provide pathophysiological information in perinatal asphyxia (PA). However, fundamental unresolved questions remain related to the influence of neurovascular coupling (NVC) maturation on functional responses in early development. We aimed to probe the feasibility and compare the responses to multiple sensory stimulations in newborns with PA using functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy (fNIRS).

Methods: Responses to visual, auditory, and sensorimotor passive stimulation were measured with fMRI and fNIRS and compared in 18 term newborns with PA and six controls.

Results: Most newborns exhibited a positive fMRI response during visual and sensorimotor stimulation, higher in the sensorimotor. An asymmetric pattern (negative in the left hemisphere) was observed in auditory stimulation. The fNIRS response most resembling the adult pattern (positive) in PA occurred during auditory stimulation, in which oxyhemoglobin (HbO) increased, and deoxyhemoglobin (HbR) decreased. Significative differences were found in the HbO and HbR profiles in newborns with PA compared to the controls, more evident in auditory stimulation. Positive correlations between the fMRI BOLD signal and at least one fNIRS channel (HbO) in all stimuli in newborns with PA were identified: the strongest was in the auditory (r=0.704) and the weakest in the sensorimotor (r=0.544); in more fNIRS channels, in the visual.

Conclusions: Both techniques are feasible physiological assessment tools, suggesting a distinctive level of maturation in sensory and motor areas. Differences in fNIRS profiles in newborns with PA and controls and the fMRI-fNIRS relationship observed can encourage the fNIRS as a clinically emergent valuable tool.

Keywords: Newborn; functional magnetic resonance imaging (fMRI); functional near-infrared spectroscopy (fNIRS); multiple sensory stimulations; perinatal asphyxia (PA).