ABSTRACT
In the last years, the characterization of brain-heart interactions (BHIs) in epilepsy has gained great interest. For some specific seizures there is still a lack of information about the mechanisms occurring during or close to ictal events between the central nervous system (CNS) and the autonomic nervous system (ANS). This is the case for neonatal seizures, one of the most common neurological emergencies in the first days of life. This paper evaluates possible differences in BHIs between newborns with seizures and seizure-free ones. We applied convergent cross mapping approaches to a cohort of 52 newborns from a public dataset. Preliminary results show that newborns with seizures have a lower degree of interaction between the CNS and the ANS than seizure-free ones (Mann-Whitney test: p-value <0.05). These results are of clinical relevance for future BHI-based approaches to better understand the neural mechanisms behind neonatal seizures. Clinical Relevance- The study of BHIs in newborns with seizures might be helpful to better characterize the disorder or the aetiologies behind ictal events. Moreover, BHI approaches may confirm the involvement of the ANS during or close to a neonatal seizure event.
Subject(s)
Electroencephalography , Epilepsy , Brain , Epilepsy/complications , Heart , Humans , Infant, Newborn , Seizures/etiologyABSTRACT
BACKGROUND: Citomegalovirus (CMV) infects approximately 1% of live newborns. About 10% of the infants affected by congenital CMV infection are symptomatic at birth and up to 60% of these infants will develop permanent neurological disabilities. Depending on gestational age (GA) at the time of infection, the involvement of central nervous system (CNS) can lead to malformations of cortical development, calcifications, periventricular white matter lesions and cysts, ventriculomegaly and cerebellar hypoplasia. CASE PRESENTATION: We report the MRI findings in a Caucasian female born at 32 weeks of post-menstrual age with post-birth diagnosis of congenital CMV infection showing an unusual and peculiar marked T2 hyperintensity of the inner part of olfactory bulbs in addition to the CMV related diffuse brain involvement. Despite the known extensively described fetal and neonatal Magnetic Resonance Imaging (MRI) findings in CMV infected fetuses and newborns, any in vivo MRI depiction of olfactory system damage have never been reported so far. Nevertheless, in murine studies CMV is known to infect the placenta during pregnancy showing particular tropism for neural stem cells of the olfactory system and previous neuropathologic study on CMV infected human fetal brains from 23 to 28 weeks of GA reported damage in the olfactory bulbs (OB) consisting in disseminated cytomegalic cells, inflammation, necrosis and neuronal and radial glial cell loss. Therefore, we assume an OB involvement and damage in congenital CMV infection. CONCLUSION: To our knowledge this is the first in vivo MRI evidence of OB damage in a newborn with congenital CMV infection that may give new insights on CMV infection.