Q Yuan1, M Rubic1, J Seah1, C Rae2, I M R Wright3, K Kaltenbach4, J M Feller5, M E Abdel-Latif6, C Chu7, J L Oei8. 1. School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia. 2. Neuroscience Research Australia, University of New South Wales, Randwick, NSW, Australia. 3. Graduate School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia. 4. Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA. 5. 1] School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia [2] Department of Paediatrics, Sydney Children's Hospital, Randwick, NSW, Australia. 6. 1] Department of Neonatology, Centenary Hospital for Women and Children, Canberra, ACT, Australia [2] School of Clinical Medicine, Australian National University, Woden, ACT, Australia. 7. Department of Radiology, The Wollongong Hospital, Wollongong, NSW, Australia. 8. 1] School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia [2] Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia.
Abstract
OBJECTIVE: A substantial number of children exposed to gestational opioids have neurodevelopmental, behavioral and cognitive problems. Opioids are not neuroteratogens but whether they affect the developing brain in more subtle ways (for example, volume loss) is unclear. We aimed to determine the feasibility of using magnetic resonance imaging (MRI) to assess volumetric changes in healthy opioid-exposed infants. STUDY DESIGN: Observational pilot cohort study conducted in two maternity hospitals in New South Wales, Australia. Maternal history and neonatal urine and meconium screens were obtained to confirm drug exposure. Volumetric analysis of MRI scans was performed with the ITK-snap program. RESULT: Scans for 16 infants (mean (s.d.) gestational age: 40.9 (1.5) weeks, birth weight: 3022.5 (476.6) g, head circumference (HC): 33.7 (1.5 cm)) were analyzed. Six (37.5%) infants had HC <25th percentile. Fourteen mothers used methadone, four used buprenorphine and 11 used more than one opioid (including heroin, seven). All scans were structurally normal whole brain volumes (357.4 (63.8)) and basal ganglia (14.5 (3.5)) ml were significantly smaller than population means (425.4 (4.8), 17.1 (4.4) ml, respectively) but lateral ventricular volumes (3.5 (1.8) ml) were larger than population values (2.1(1.5)) ml. CONCLUSION: Our pilot study suggests that brain volumes of opioid-exposed babies may be smaller than population means and that specific regions, for example, basal ganglia, that are involved in neurotransmission, may be particularly affected. Larger studies including correlation with neurodevelopmental outcomes are warranted to substantiate this finding.
OBJECTIVE: A substantial number of children exposed to gestational opioids have neurodevelopmental, behavioral and cognitive problems. Opioids are not neuroteratogens but whether they affect the developing brain in more subtle ways (for example, volume loss) is unclear. We aimed to determine the feasibility of using magnetic resonance imaging (MRI) to assess volumetric changes in healthy opioid-exposed infants. STUDY DESIGN: Observational pilot cohort study conducted in two maternity hospitals in New South Wales, Australia. Maternal history and neonatal urine and meconium screens were obtained to confirm drug exposure. Volumetric analysis of MRI scans was performed with the ITK-snap program. RESULT: Scans for 16 infants (mean (s.d.) gestational age: 40.9 (1.5) weeks, birth weight: 3022.5 (476.6) g, head circumference (HC): 33.7 (1.5 cm)) were analyzed. Six (37.5%) infants had HC <25th percentile. Fourteen mothers used methadone, four used buprenorphine and 11 used more than one opioid (including heroin, seven). All scans were structurally normal whole brain volumes (357.4 (63.8)) and basal ganglia (14.5 (3.5)) ml were significantly smaller than population means (425.4 (4.8), 17.1 (4.4) ml, respectively) but lateral ventricular volumes (3.5 (1.8) ml) were larger than population values (2.1(1.5)) ml. CONCLUSION: Our pilot study suggests that brain volumes of opioid-exposed babies may be smaller than population means and that specific regions, for example, basal ganglia, that are involved in neurotransmission, may be particularly affected. Larger studies including correlation with neurodevelopmental outcomes are warranted to substantiate this finding.
Authors: Jarred W Younger; Larry F Chu; Nicole T D'Arcy; Kiley E Trott; Laura E Jastrzab; Sean C Mackey Journal: Pain Date: 2011-04-30 Impact factor: 6.961
Authors: Stephen W Patrick; Robert E Schumacher; Brian D Benneyworth; Elizabeth E Krans; Jennifer M McAllister; Matthew M Davis Journal: JAMA Date: 2012-04-30 Impact factor: 56.272
Authors: Irma Convertino; Alice Capogrosso Sansone; Alessandra Marino; Maria T Galiulo; Stefania Mantarro; Luca Antonioli; Matteo Fornai; Corrado Blandizzi; Marco Tuccori Journal: Drug Saf Date: 2016-10 Impact factor: 5.606
Authors: Konrad Stawiski; Joanna Trelińska; Dobromiła Baranska; Iwona Dachowska; Katarzyna Kotulska; Sergiusz Jóźwiak; Wojciech Fendler; Wojciech Młynarski Journal: MAGMA Date: 2017-03-20 Impact factor: 2.310
Authors: Carla M Bann; Jamie E Newman; Brenda Poindexter; Katherine Okoniewski; Sara DeMauro; Scott A Lorch; Deanne Wilson-Costello; Namasivayam Ambalavanan; Myriam Peralta-Carcelen; Catherine Limperopoulos; Kushal Kapse; Jonathan M Davis; Michele Walsh; Stephanie Merhar Journal: Pediatr Res Date: 2022-08-30 Impact factor: 3.953
Authors: Laura Garrison; Lawrence Leeman; Renate D Savich; Hilda Gutierrez; William F Rayburn; Ludmila N Bakhireva Journal: J Reprod Med Date: 2016 Jul-Aug Impact factor: 0.142
Authors: Mary-Margaret A Fill; Angela M Miller; Rachel H Wilkinson; Michael D Warren; John R Dunn; William Schaffner; Timothy F Jones Journal: Pediatrics Date: 2018-09 Impact factor: 7.124
Authors: Rupa Radhakrishnan; Brandon P Brown; David M Haas; Yong Zang; Christina Sparks; Senthilkumar Sadhasivam Journal: J Neuroradiol Date: 2021-01-05 Impact factor: 3.447
Authors: Andrew E Weller; Richard C Crist; Benjamin C Reiner; Glenn A Doyle; Wade H Berrettini Journal: Cold Spring Harb Perspect Med Date: 2021-03-01 Impact factor: 6.915