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Article ; Online: Antenatal diagnosis, neonatal brain volumes, and neurodevelopment in transposition of the great arteries.

Selvanathan, Thiviya / Mabbott, Connor / Au-Young, Stephanie H / Seed, Mike / Miller, Steven P / Chau, Vann

Developmental medicine and child neurology

2024

Abstract: Aim: To examine whether antenatal diagnosis modifies relationships between neonatal brain volumes and 18-month neurodevelopmental outcomes in children with transposition of the great arteries (TGA).: Method: In a retrospective cohort of 139 children ... ...

Abstract	Aim: To examine whether antenatal diagnosis modifies relationships between neonatal brain volumes and 18-month neurodevelopmental outcomes in children with transposition of the great arteries (TGA). Method: In a retrospective cohort of 139 children with TGA (77 antenatally diagnosed), we obtained total brain volumes (TBVs) on pre- (n = 102) and postoperative (n = 112) magnetic resonance imaging. Eighteen-month neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition. Generalized estimating equations with interaction terms were used to determine whether antenatal diagnosis modified associations between TBVs and neurodevelopmental outcomes accounting for postmenstrual age at scan, brain injury, and ventricular septal defect. Results: Infants with postnatal diagnosis had more preoperative hypotension (35% vs 14%, p = 0.004). The interactions between antenatal diagnosis and TBVs were significantly related to cognitive (p = 0.003) outcomes. Specifically, smaller TBVs were associated with lower cognitive scores in infants diagnosed postnatally; this association was attenuated in those diagnosed antenatally. Interpretation: Antenatal diagnosis modifies associations between neonatal brain volume and 18-month cognitive outcome in infants with TGA. These findings suggest that antenatal diagnosis may be neuroprotective, possibly through improved preoperative clinical status. These data highlight the need to improve antenatal diagnosis rates.
Language	English
Publishing date	2024-01-11
Publishing country	England
Document type	Journal Article
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/dmcn.15840
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Article ; Online: Neurodevelopment in Children With Congenital Heart Disease: An Opportunity for the Cardiovascular Trainee.

Chetan, Devin / Selvanathan, Thiviya / Alzamil, Jawad / Chau, Vann / Seed, Mike

The Canadian journal of cardiology

2023 Volume 39, Issue 7, Page(s) 880–882

MeSH term(s)	Humans ; Child ; Heart Defects, Congenital/complications ; Heart ; Cardiovascular System
Language	English
Publishing date	2023-03-13
Publishing country	England
Document type	Editorial ; Research Support, Non-U.S. Gov't
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2023.03.009
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Article: Early Discontinuation of Phenobarbital After Acute Symptomatic Neonatal Seizures in the Term Newborn.

Carrasco, Melisa / Bonifacio, Sonia Lomeli / deVeber, Gabrielle / Chau, Vann

Neurology. Clinical practice

2023 Volume 13, Issue 2, Page(s) e200125

Abstract: Acute symptomatic seizures in the term newborn are often seen after perinatal brain injury. Common etiologies include hypoxic-ischemic encephalopathy, ischemic stroke, intracranial hemorrhage, metabolic derangements, and intracranial infections. Neonatal ...

Abstract	Acute symptomatic seizures in the term newborn are often seen after perinatal brain injury. Common etiologies include hypoxic-ischemic encephalopathy, ischemic stroke, intracranial hemorrhage, metabolic derangements, and intracranial infections. Neonatal seizures are often treated with phenobarbital, which may cause sedation and may have significant long-term effects on brain development. Recent literature has suggested that phenobarbital may be safely discontinued in some patients before discharge from the neonatal intensive care unit. Optimizing a strategy for selective early phenobarbital discontinuation would be of great value. In this study, we present a unified framework for phenobarbital discontinuation after resolution of acute symptomatic seizures in the setting of brain injury of the newborn.
Language	English
Publishing date	2023-02-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2645818-4
ISSN	2163-0933 ; 2163-0402
ISSN (online)	2163-0933
ISSN	2163-0402
DOI	10.1212/CPJ.0000000000200125
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Article ; Online: Neonatal Seizures: Challenges and the Road Ahead.

Chau, Vann / Bonifacio, Sonia L / Wintermark, Pia

Pediatric neurology

2021 Volume 128, Page(s) 76

MeSH term(s)	Epilepsy ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; Seizures/diagnosis ; Seizures/therapy
Language	English
Publishing date	2021-12-16
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/j.pediatrneurol.2021.11.014
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Article ; Online: Preterm Neurodevelopmental Trajectories from 18 Months to 4.5 Years.

Christensen, Rhandi / Chau, Vann / Synnes, Anne / Guo, Ting / Grunau, Ruth E / Miller, Steven P

The Journal of pediatrics

2023 Volume 258, Page(s) 113401

Abstract: Objective: To assess the longitudinal trajectory of cognitive, language, and motor outcomes from 18 months to 4.5 years of age in children born very preterm.: Study design: This was a prospective cohort study of 163 infants born very preterm (born 24- ...

Abstract	Objective: To assess the longitudinal trajectory of cognitive, language, and motor outcomes from 18 months to 4.5 years of age in children born very preterm. Study design: This was a prospective cohort study of 163 infants born very preterm (born 24-32 weeks of gestation) followed longitudinally and assessed with neurodevelopmental scales and magnetic resonance imaging of the brain. Outcomes at 18 months and 3 years were assessed with the Bayley Scales of Infant and Toddler Development, 3rd Edition, and at 4.5 years with the Wechsler Preschool and Primary Scale of Intelligence-III and the Movement Assessment Battery for Children. Cognitive, language, and motor outcomes were categorized as below-average, average, and above-average, and compared across time. Clinical data were analyzed using ANOVA, χ Results: Cognitive and language trajectories were stable from 18 months to 4.5 years for all outcome groups. Motor impairment increased over time, with a greater proportion of children having motor deficits at 4.5 years. Children with below-average cognitive and language outcomes at 4.5 years had more clinical risk factors, greater white matter injury, and lower maternal education. Children with severe motor impairment at 4.5 years were born earlier, had more clinical risk factors, and demonstrated greater white matter injury. Conclusions: Children born preterm have stable cognitive and language trajectories, while motor impairment increased at 4.5 years. These results highlight the importance of continued developmental surveillance for children born preterm into preschool age.
MeSH term(s)	Infant, Newborn ; Infant ; Humans ; Child, Preschool ; Infant, Premature ; Prospective Studies ; Gestational Age ; Brain/diagnostic imaging ; Cognition ; Brain Injuries ; Child Development
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2023.113401
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Article ; Online: Child Neurology: Cortical Malformations in Preterm Infants: Case From a Prospective Cohort.

Selvanathan, Thiviya / Guillot, Mireille / Branson, Helen M / Chau, Vann / Kelly, Edmond N / Miller, Steven P

Neurology

2023 Volume 101, Issue 5, Page(s) 235–238

Abstract: Malformations of cortical development (MCD) are a rare group of disorders with heterogeneous clinical, neuroimaging, and genetic features. MCD consist of disruptions in the development of the cerebral cortex secondary to genetic, metabolic, infectious, ... ...

Abstract	Malformations of cortical development (MCD) are a rare group of disorders with heterogeneous clinical, neuroimaging, and genetic features. MCD consist of disruptions in the development of the cerebral cortex secondary to genetic, metabolic, infectious, or vascular etiologies. MCD are typically classified by stage of disrupted cortical development as secondary to abnormal: (1) neuronal proliferation or apoptosis, (2) neuronal migration, or (3) postmigrational cortical development. MCD are typically detected with brain MRI when an infant or child becomes symptomatic, presenting with seizures, developmental delay, or cerebral palsy. With recent advances in neuroimaging, cortical malformations can be detected using ultrasound or MRI during the fetal period or in the neonatal period. Of interest, preterm infants are born at a time when many cortical developmental processes are still occurring. However, there is a paucity of literature describing the neonatal imaging findings, clinical presentation, and evolution over time of cortical malformations in preterm infants. In this study, we present the neuroimaging findings from early life to term-equivalent age and childhood neurodevelopmental outcomes of an infant born very preterm (<32 weeks' postmenstrual age) with MCD detected incidentally on neonatal research brain MRI. These brain MRIs were performed as part of a prospective longitudinal cohort study of 160 very preterm infants; MCD were detected incidentally in 2 infants.
MeSH term(s)	Infant ; Infant, Newborn ; Humans ; Child ; Infant, Premature ; Prospective Studies ; Longitudinal Studies ; Cerebral Palsy/diagnostic imaging ; Cerebral Palsy/etiology ; Magnetic Resonance Imaging/methods ; Neurology ; Brain
Language	English
Publishing date	2023-04-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000207265
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Article: Hypothermia for newborns with hypoxic-ischemic encephalopathy.

Lemyre, Brigitte / Chau, Vann

Paediatrics & child health

2018 Volume 23, Issue 4, Page(s) 285–291

Abstract: Therapeutic hypothermia is a standard of care for infants ≥36 weeks gestational age (GA) with moderate-to-severe hypoxic-ischemic encephalopathy. Because some studies included infants born at 35 weeks GA, hypothermia should be considered if they meet ... ...

Abstract	Therapeutic hypothermia is a standard of care for infants ≥36 weeks gestational age (GA) with moderate-to-severe hypoxic-ischemic encephalopathy. Because some studies included infants born at 35 weeks GA, hypothermia should be considered if they meet other criteria. Cooling for infants <35 weeks GA is not recommended. Passive cooling should be started promptly in community centres, in consultation with a tertiary care centre neonatologist, while closely monitoring the infant's temperature. Best evidence suggests that maintaining core body temperature between 33°C and 34°C for 72 hours, followed by a period of rewarming of 6 to 12 hours, is optimal. Antiepileptic medications should be used when clinical or electrographic seizures are present. Maintaining serum electrolytes and glucose within normal ranges, and avoiding hypo- or hypercarbia and hyperoxia, are important adjunct treatments. A brain magnetic resonance image (MRI) is advised shortly after rewarming and, in cases where earlier findings do not match the clinical picture, a repeat MRI after 10 days of life is suggested. Multidisciplinary neurodevelopmental follow-up is recommended.
Language	French
Publishing date	2018-06-12
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2106767-3
ISSN	1918-1485 ; 1205-7088
ISSN (online)	1918-1485
ISSN	1205-7088
DOI	10.1093/pch/pxy028
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Article: Routine imaging of the preterm neonatal brain.

Guillot, Mireille / Chau, Vann / Lemyre, Brigitte

Paediatrics & child health

2020 Volume 25, Issue 4, Page(s) 249–262

Abstract: Routine brain imaging to detect injuries affecting preterm infants is used to predict long-term outcomes and identify complications that might necessitate an intervention. Although magnetic resonance imaging may be indicated in some specific cases, head ... ...

Abstract	Routine brain imaging to detect injuries affecting preterm infants is used to predict long-term outcomes and identify complications that might necessitate an intervention. Although magnetic resonance imaging may be indicated in some specific cases, head ultrasound is the most widely used technique and, because of portability and ease of access, is the best modality for routine imaging. Routine head ultrasound examination is recommended for all infants born at or before 31+6 weeks gestation. For preterm neonates born between 32+0 to 36+6 weeks gestation, routine head ultrasound is recommended only in presence of risk factors for intracranial hemorrhage or ischemia. Brain imaging in the first 7 to 14 days postbirth is advised to detect most germinal matrix and intraventricular hemorrhages. Repeat imaging at 4 to 6 weeks of age is recommended to detect white matter injury.
Language	French
Publishing date	2020-06-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2106767-3
ISSN	1918-1485 ; 1205-7088
ISSN (online)	1918-1485
ISSN	1205-7088
DOI	10.1093/pch/pxaa033
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Article ; Online: Brain Development and Maternal Behavior in Relation to Cognitive and Language Outcomes in Preterm-Born Children.

Miller, Jillian Vinall / Chau, Vann / Synnes, Anne / Miller, Steven P / Grunau, Ruth E

Biological psychiatry

2022 Volume 92, Issue 8, Page(s) 663–673

Abstract: Background: Children born very preterm (≤32 weeks gestational age) show poorer cognitive and language development compared with their term-born peers. The importance of supportive maternal responses to the child's cues for promoting neurodevelopment is ... ...

Abstract	Background: Children born very preterm (≤32 weeks gestational age) show poorer cognitive and language development compared with their term-born peers. The importance of supportive maternal responses to the child's cues for promoting neurodevelopment is well established. However, little is known about whether supportive maternal behavior can buffer the association of early brain dysmaturation with cognitive and language performance. Methods: Infants born very preterm (N = 226) were recruited from the neonatal intensive care unit for a prospective, observational cohort study. Chart review (e.g., size at birth, postnatal infection) was conducted from birth to discharge. Magnetic resonance imaging, including diffusion tensor imaging, was acquired at approximately 32 weeks postmenstrual age and again at term-equivalent age. Fractional anisotropy, a quantitative measure of brain maturation, was obtained from 11 bilateral regions of interest in the cortical gray matter. At 3 years (n = 187), neurodevelopmental testing (Bayley Scales of Infant and Toddler Development-III) was administered, and parent-child interaction was filmed. Maternal behavior was scored using the Emotional Availability Scale-IV. A total of 146 infants with neonatal brain imaging and follow-up data were included for analysis. Generalized estimating equations were used to examine whether maternal support interacted with mean fractional anisotropy values to predict Cognitive and Language scores at 3 years, accounting for confounding neonatal and maternal factors. Results: Higher maternal support significantly moderated cortical fractional anisotropy values at term-equivalent age to predict higher Cognitive (interaction term β = 2.01, p = .05) and Language (interaction term β = 1.85, p = .04) scores. Conclusions: Findings suggest that supportive maternal behavior following early brain dysmaturation may provide an opportunity to promote optimal neurodevelopment in children born very preterm.
MeSH term(s)	Brain/pathology ; Child Development ; Cognition/physiology ; Diffusion Tensor Imaging/methods ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Maternal Behavior ; Prospective Studies
Language	English
Publishing date	2022-03-26
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	209434-4
ISSN	1873-2402 ; 0006-3223
ISSN (online)	1873-2402
ISSN	0006-3223
DOI	10.1016/j.biopsych.2022.03.010
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Article ; Online: Pearls & Oy-sters: Genetic Epilepsy: An Important Cause of Neonatal Seizures in Infants With Complex Congenital Heart Disease.

Kazazian, Vanna / Selvanathan, Thiviya / Chau, Vann / Tam, Emily W Y / Miller, Steven P

Neurology

2022 Volume 99, Issue 18, Page(s) 811–814

Abstract: Genetic epilepsies, such ... ...

Abstract	Genetic epilepsies, such as
MeSH term(s)	Infant ; Infant, Newborn ; Humans ; Electroencephalography/methods ; Epilepsy/drug therapy ; Seizures/genetics ; Seizures/diagnosis ; Anticonvulsants/therapeutic use ; Infant, Newborn, Diseases/diagnosis ; Heart Defects, Congenital/complications ; Heart Defects, Congenital/genetics
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2022-10-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000201229
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