Pia Wintermark - Academia.edu (original) (raw)

Papers by Pia Wintermark

Research paper thumbnail of Visual Impairments Following Term Neonatal Encephalopathy: Do Retinal Impairments Also Play a Role?

Investigative Opthalmology & Visual Science, 2015

Citation: Jung S, Polosa A, Lachapelle P, Wintermark P. Visual impairments following term neonata... more Citation: Jung S, Polosa A, Lachapelle P, Wintermark P. Visual impairments following term neonatal encephalopathy: do retinal impairments also play a role? Invest Ophthalmol Vis Sci.

Research paper thumbnail of Adrenal Mass in Carney Triad

International Journal on Disability and Human Development, 2001

Research paper thumbnail of Prenatal methamphetamine exposure is associated with smaller caudate volumes in neonates

Background / Purpose: Prenatal methamphetamine exposure has been associated with neuropsychologic... more Background / Purpose: Prenatal methamphetamine exposure has been associated with neuropsychological, behavioural and cognitive alterations, but few neuroimaging studies have been performed to investigate neurostructural effects. No MRI studies have been done previously in neonates with prenatal methamphetamine exposure. This study aimed to investigate, by means of MRI, the potential volumetric changes in the caudates of neonates who had been exposed to methamphetamine in utero . Main conclusion: Increasing methamphetamine exposure was strongly associated with reduced caudate volumes in neonates. This supports the hypothesis that prenatal methamphetamine exposure induces long-lasting changes in dopamine-rich areas of the brain.

Research paper thumbnail of Evolution of Apparent Diffusion Coefficient and Fractional Anisotropy in the Cerebrum of Asphyxiated Newborns Treated with Hypothermia over the First Month of Life

Neural Plasticity, 2015

The objective of this study was to assess the evolution of diffusion-weighted imaging (DWI) and d... more The objective of this study was to assess the evolution of diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI) over the first month of life in asphyxiated newborns treated with hypothermia and to compare it with that of healthy newborns. Asphyxiated newborns treated with hypothermia were enrolled prospectively; and the presence and extent of brain injury were scored on each MRI. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured in the basal ganglia, in the white matter and in the cortical grey matter. Sixty-one asphyxiated newborns treated with hypothermia had a total of 126 ADC and FA maps. Asphyxiated newborns developing brain injury eventually had significantly decreased ADC values on days 2-3 of life and decreased FA values around day 10 and 1 month of life compared with those not developing brain injury. Despite hypothermia treatment, asphyxiated newborns may develop brain injury that still can be detected with advanced neuroimaging techniques such as DWI and DTI as early as days 2-3 of life. A study of ADC and FA values over time may aid in the understanding of how brain injury develops in these newborns despite hypothermia treatment.

Research paper thumbnail of Angiogenesis Dysregulation in Term Asphyxiated Newborns Treated with Hypothermia

PLOS ONE, 2015

Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological i... more Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesisrelated markers following birth asphyxia in human newborns.

Research paper thumbnail of Interobserver variability in assessment of cranial ultrasound in very preterm infants

Journal of neuroradiology. Journal de neuroradiologie, 2011

Cranial ultrasound (cUS) findings help doctors in the clinical management of preterm infants and ... more Cranial ultrasound (cUS) findings help doctors in the clinical management of preterm infants and in their discussion with parents regarding prediction of outcome. cUS is often used as outcome measure in clinical research studies. Accurate cUS performance and interpretation is therefore required. The aims of this study were (i) to assess the interobserver variability in cUS interpretation, and (ii) to evaluate whether level of cUS expertise influences the interobserver variability. Fifty-eight cUS image series of preterm infants born below 32 weeks of gestation collected within the Swiss Neonatal Network were sent to 27 observers for reviewing. Observers were grouped into radiologists, experienced neonatologists and less experienced neonatologists. Agreement between observers was calculated using Kappa statistics. When cystic periventricular leukomalacia, intraventricular haemorrhage and periventricular haemorrhagic infarction were combined to one outcome, agreement among all observe...

Research paper thumbnail of Somatosensory evoked potentials in neonates with hypoxic-ischemic encephalopathy treated with hypothermia

European Journal of Paediatric Neurology, 2015

Neonatal MRI Prognosis a b s t r a c t Objective: Somatosensory evoked potentials (SEPs) are repo... more Neonatal MRI Prognosis a b s t r a c t Objective: Somatosensory evoked potentials (SEPs) are reported to have high positive predictive value (PPV) for neurodevelopmental impairment (NDI) in neonates with moderate or severe hypoxic-ischemic encephalopathy (HIE). Our objective was to assess if this predictive value remains high with the use of therapeutic hypothermia.

Research paper thumbnail of Filamin A Mutation May Be Associated With Diffuse Lung Disease Mimicking Bronchopulmonary Dysplasia in Premature Newborns

Respiratory Care, 2014

Bronchopulmonary dysplasia (BPD) is a common long-term complication in premature newborns requiri... more Bronchopulmonary dysplasia (BPD) is a common long-term complication in premature newborns requiring ventilatory support and is the most common cause of chronic diffuse lung disease in this population. We present the clinical course of a premature newborn with a complicated neonatal respiratory course that was initially thought to be related to BPD, but it did not respond to the typical therapies for this condition. Due to the findings of periventricular nodular heterotopia, the diagnosis of a filamin A gene mutation was eventually made, which explained the respiratory pathology of this patient. When time of onset and clinical course do not correlate with typical BPD, one should consider alternative diagnoses in premature infants, including neonatal diffuse lung disease. Key words: bronchopulmonary dysplasia; filamin A (FLNA) mutation; heterotopia; diffuse lung disease; newborn. [Respir Care 2014;59(11):1-•.

Research paper thumbnail of A DTI-based tractography study of effects on brain structure associated with prenatal alcohol exposure in newborns

Human brain mapping, 2015

Prenatal alcohol exposure (PAE) is known to have severe, long-term consequences for brain and beh... more Prenatal alcohol exposure (PAE) is known to have severe, long-term consequences for brain and behavioral development already detectable in infancy and childhood. Resulting features of fetal alcohol spectrum disorders include cognitive and behavioral effects, as well as facial anomalies and growth deficits. Diffusion tensor imaging (DTI) and tractography were used to analyze white matter (WM) development in 11 newborns (age since conception <45 weeks) whose mothers were recruited during pregnancy. Comparisons were made with nine age-matched controls born to abstainers or light drinkers from the same Cape Coloured (mixed ancestry) community near Cape Town, South Africa. DTI parameters, T1 relaxation time, proton density and volumes were used to quantify and investigate group differences in WM in the newborn brains. Probabilistic tractography was used to estimate and to delineate similar tract locations among the subjects for transcallosal pathways, cortico-spinal projection fibers,...

Research paper thumbnail of Method for performing cerebral perfusion-weighted MRI in neonates

Pediatric Radiology, 2009

Cerebral perfusion-weighted imaging (PWI) in neonates is known to be technically difficult and th... more Cerebral perfusion-weighted imaging (PWI) in neonates is known to be technically difficult and there are very few published studies on its use in preterm infants. In this paper, we describe one convenient method to perform PWI in neonates, a method only recently used in newborns. A device was used to manually inject gadolinium contrast material intravenously in an easy, quick and reproducible way. We studied 28 newborn infants, with various gestational ages and weights, including both normal infants and those suffering from different brain pathologies. A signal intensity-time curve was obtained for each infant, allowing us to build perfusion maps. This technique offered a fast and easy method to manually inject a bolus gadolinium contrast material, which is essential in performing PWI in neonates. Cerebral PWI is technically feasible and reproducible in neonates of various gestational age and with various pathologies.

Research paper thumbnail of Progressive Unilateral Hemispheric Atrophy in an Infant with Neurofibromatosis

Research paper thumbnail of Perfusion Abnormalities in Hemimegalencephaly

Research paper thumbnail of Temporal evolution of MR perfusion in neonatal hypoxic-ischemic encephalopathy

Journal of Magnetic Resonance Imaging, 2008

To illustrate the evolution of brain perfusionweighted magnetic resonance imaging (PWI-MRI) in se... more To illustrate the evolution of brain perfusionweighted magnetic resonance imaging (PWI-MRI) in severe neonatal hypoxic-ischemic (HI) encephalopathy, and its possible relation to further neurodevelopmental outcome.

Research paper thumbnail of Perfusion Imaging of Focal Cortical Dysplasia Using Arterial Spin Labeling: Correlation With Histopathological Vascular Density

Journal of Child Neurology, 2013

Focal cortical dysplasia is the most common malformation of cortical development, causing intract... more Focal cortical dysplasia is the most common malformation of cortical development, causing intractable epilepsy. This study investigated the relationship between brain perfusion and microvessel density in 7 children with focal cortical dysplasia. The authors analyzed brain perfusion measurements obtained by magnetic resonance imaging of 2 of the children and the microvessel density of brain tissue specimens obtained by epilepsy surgery on all of the children. Brain perfusion was approximately 2 times higher in the area of focal cortical dysplasia compared to the contralateral side. The microvessel density was nearly double in the area of focal cortical dysplasia compared to the surrounding cortex that did not have morphological abnormalities. These findings suggest that hyperperfusion can be related to increased microvessel density in focal cortical dysplasia rather than only to seizures. Further investigations are needed to determine the relationship between brain perfusion, microvessel density, and seizure activity.

Research paper thumbnail of Cooling in the real world: Therapeutic hypothermia in hypoxic-ischemic encephalopathy

European Journal of Paediatric Neurology, 2013

and sharing with colleagues.

Research paper thumbnail of Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Cerebrovascular Diseases, 2013

Research paper thumbnail of Auditory brain development in premature infants: the importance of early experience

Annals of the New York Academy of Sciences, 2012

Preterm infants in the neonatal intensive care unit (NICU) often close their eyes in response to ... more Preterm infants in the neonatal intensive care unit (NICU) often close their eyes in response to bright lights, but they cannot close their ears in response to loud sounds. The sudden transition from the womb to the overly noisy world of the NICU increases the vulnerability of these high-risk newborns. There is a growing concern that the excess noise typically experienced by NICU infants disrupts their growth and development, putting them at risk for hearing, language, and cognitive disabilities. Preterm neonates are especially sensitive to noise because their auditory system is at a critical period of neurodevelopment, and they are no longer shielded by maternal tissue. This paper discusses the developmental milestones of the auditory system and suggests ways to enhance the quality control and type of sounds delivered to NICU infants. We argue that positive auditory experience is essential for early brain maturation and may be a contributing factor for healthy neurodevelopment. Further research is needed to optimize the hospital environment for preterm newborns and to increase their potential to develop into healthy children.

Research paper thumbnail of Near-infrared spectroscopy versus magnetic resonance imaging to study brain perfusion in newborns with hypoxic-ischemic encephalopathy treated with hypothermia

NeuroImage, 2014

and sharing with colleagues.

Research paper thumbnail of Newborns Referred for Therapeutic Hypothermia: Association between Initial Degree of Encephalopathy and Severity of Brain Injury (What About the Newborns with Mild Encephalopathy on Admission?)

American Journal of Perinatology, 2015

Research paper thumbnail of Visual Impairments Following Term Neonatal Encephalopathy: Do Retinal Impairments Also Play a Role?

Investigative Opthalmology & Visual Science, 2015

Citation: Jung S, Polosa A, Lachapelle P, Wintermark P. Visual impairments following term neonata... more Citation: Jung S, Polosa A, Lachapelle P, Wintermark P. Visual impairments following term neonatal encephalopathy: do retinal impairments also play a role? Invest Ophthalmol Vis Sci.

Research paper thumbnail of Adrenal Mass in Carney Triad

International Journal on Disability and Human Development, 2001

Research paper thumbnail of Prenatal methamphetamine exposure is associated with smaller caudate volumes in neonates

Background / Purpose: Prenatal methamphetamine exposure has been associated with neuropsychologic... more Background / Purpose: Prenatal methamphetamine exposure has been associated with neuropsychological, behavioural and cognitive alterations, but few neuroimaging studies have been performed to investigate neurostructural effects. No MRI studies have been done previously in neonates with prenatal methamphetamine exposure. This study aimed to investigate, by means of MRI, the potential volumetric changes in the caudates of neonates who had been exposed to methamphetamine in utero . Main conclusion: Increasing methamphetamine exposure was strongly associated with reduced caudate volumes in neonates. This supports the hypothesis that prenatal methamphetamine exposure induces long-lasting changes in dopamine-rich areas of the brain.

Research paper thumbnail of Evolution of Apparent Diffusion Coefficient and Fractional Anisotropy in the Cerebrum of Asphyxiated Newborns Treated with Hypothermia over the First Month of Life

Neural Plasticity, 2015

The objective of this study was to assess the evolution of diffusion-weighted imaging (DWI) and d... more The objective of this study was to assess the evolution of diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI) over the first month of life in asphyxiated newborns treated with hypothermia and to compare it with that of healthy newborns. Asphyxiated newborns treated with hypothermia were enrolled prospectively; and the presence and extent of brain injury were scored on each MRI. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured in the basal ganglia, in the white matter and in the cortical grey matter. Sixty-one asphyxiated newborns treated with hypothermia had a total of 126 ADC and FA maps. Asphyxiated newborns developing brain injury eventually had significantly decreased ADC values on days 2-3 of life and decreased FA values around day 10 and 1 month of life compared with those not developing brain injury. Despite hypothermia treatment, asphyxiated newborns may develop brain injury that still can be detected with advanced neuroimaging techniques such as DWI and DTI as early as days 2-3 of life. A study of ADC and FA values over time may aid in the understanding of how brain injury develops in these newborns despite hypothermia treatment.

Research paper thumbnail of Angiogenesis Dysregulation in Term Asphyxiated Newborns Treated with Hypothermia

PLOS ONE, 2015

Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological i... more Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesisrelated markers following birth asphyxia in human newborns.

Research paper thumbnail of Interobserver variability in assessment of cranial ultrasound in very preterm infants

Journal of neuroradiology. Journal de neuroradiologie, 2011

Cranial ultrasound (cUS) findings help doctors in the clinical management of preterm infants and ... more Cranial ultrasound (cUS) findings help doctors in the clinical management of preterm infants and in their discussion with parents regarding prediction of outcome. cUS is often used as outcome measure in clinical research studies. Accurate cUS performance and interpretation is therefore required. The aims of this study were (i) to assess the interobserver variability in cUS interpretation, and (ii) to evaluate whether level of cUS expertise influences the interobserver variability. Fifty-eight cUS image series of preterm infants born below 32 weeks of gestation collected within the Swiss Neonatal Network were sent to 27 observers for reviewing. Observers were grouped into radiologists, experienced neonatologists and less experienced neonatologists. Agreement between observers was calculated using Kappa statistics. When cystic periventricular leukomalacia, intraventricular haemorrhage and periventricular haemorrhagic infarction were combined to one outcome, agreement among all observe...

Research paper thumbnail of Somatosensory evoked potentials in neonates with hypoxic-ischemic encephalopathy treated with hypothermia

European Journal of Paediatric Neurology, 2015

Neonatal MRI Prognosis a b s t r a c t Objective: Somatosensory evoked potentials (SEPs) are repo... more Neonatal MRI Prognosis a b s t r a c t Objective: Somatosensory evoked potentials (SEPs) are reported to have high positive predictive value (PPV) for neurodevelopmental impairment (NDI) in neonates with moderate or severe hypoxic-ischemic encephalopathy (HIE). Our objective was to assess if this predictive value remains high with the use of therapeutic hypothermia.

Research paper thumbnail of Filamin A Mutation May Be Associated With Diffuse Lung Disease Mimicking Bronchopulmonary Dysplasia in Premature Newborns

Respiratory Care, 2014

Bronchopulmonary dysplasia (BPD) is a common long-term complication in premature newborns requiri... more Bronchopulmonary dysplasia (BPD) is a common long-term complication in premature newborns requiring ventilatory support and is the most common cause of chronic diffuse lung disease in this population. We present the clinical course of a premature newborn with a complicated neonatal respiratory course that was initially thought to be related to BPD, but it did not respond to the typical therapies for this condition. Due to the findings of periventricular nodular heterotopia, the diagnosis of a filamin A gene mutation was eventually made, which explained the respiratory pathology of this patient. When time of onset and clinical course do not correlate with typical BPD, one should consider alternative diagnoses in premature infants, including neonatal diffuse lung disease. Key words: bronchopulmonary dysplasia; filamin A (FLNA) mutation; heterotopia; diffuse lung disease; newborn. [Respir Care 2014;59(11):1-•.

Research paper thumbnail of A DTI-based tractography study of effects on brain structure associated with prenatal alcohol exposure in newborns

Human brain mapping, 2015

Prenatal alcohol exposure (PAE) is known to have severe, long-term consequences for brain and beh... more Prenatal alcohol exposure (PAE) is known to have severe, long-term consequences for brain and behavioral development already detectable in infancy and childhood. Resulting features of fetal alcohol spectrum disorders include cognitive and behavioral effects, as well as facial anomalies and growth deficits. Diffusion tensor imaging (DTI) and tractography were used to analyze white matter (WM) development in 11 newborns (age since conception <45 weeks) whose mothers were recruited during pregnancy. Comparisons were made with nine age-matched controls born to abstainers or light drinkers from the same Cape Coloured (mixed ancestry) community near Cape Town, South Africa. DTI parameters, T1 relaxation time, proton density and volumes were used to quantify and investigate group differences in WM in the newborn brains. Probabilistic tractography was used to estimate and to delineate similar tract locations among the subjects for transcallosal pathways, cortico-spinal projection fibers,...

Research paper thumbnail of Method for performing cerebral perfusion-weighted MRI in neonates

Pediatric Radiology, 2009

Cerebral perfusion-weighted imaging (PWI) in neonates is known to be technically difficult and th... more Cerebral perfusion-weighted imaging (PWI) in neonates is known to be technically difficult and there are very few published studies on its use in preterm infants. In this paper, we describe one convenient method to perform PWI in neonates, a method only recently used in newborns. A device was used to manually inject gadolinium contrast material intravenously in an easy, quick and reproducible way. We studied 28 newborn infants, with various gestational ages and weights, including both normal infants and those suffering from different brain pathologies. A signal intensity-time curve was obtained for each infant, allowing us to build perfusion maps. This technique offered a fast and easy method to manually inject a bolus gadolinium contrast material, which is essential in performing PWI in neonates. Cerebral PWI is technically feasible and reproducible in neonates of various gestational age and with various pathologies.

Research paper thumbnail of Progressive Unilateral Hemispheric Atrophy in an Infant with Neurofibromatosis

Research paper thumbnail of Perfusion Abnormalities in Hemimegalencephaly

Research paper thumbnail of Temporal evolution of MR perfusion in neonatal hypoxic-ischemic encephalopathy

Journal of Magnetic Resonance Imaging, 2008

To illustrate the evolution of brain perfusionweighted magnetic resonance imaging (PWI-MRI) in se... more To illustrate the evolution of brain perfusionweighted magnetic resonance imaging (PWI-MRI) in severe neonatal hypoxic-ischemic (HI) encephalopathy, and its possible relation to further neurodevelopmental outcome.

Research paper thumbnail of Perfusion Imaging of Focal Cortical Dysplasia Using Arterial Spin Labeling: Correlation With Histopathological Vascular Density

Journal of Child Neurology, 2013

Focal cortical dysplasia is the most common malformation of cortical development, causing intract... more Focal cortical dysplasia is the most common malformation of cortical development, causing intractable epilepsy. This study investigated the relationship between brain perfusion and microvessel density in 7 children with focal cortical dysplasia. The authors analyzed brain perfusion measurements obtained by magnetic resonance imaging of 2 of the children and the microvessel density of brain tissue specimens obtained by epilepsy surgery on all of the children. Brain perfusion was approximately 2 times higher in the area of focal cortical dysplasia compared to the contralateral side. The microvessel density was nearly double in the area of focal cortical dysplasia compared to the surrounding cortex that did not have morphological abnormalities. These findings suggest that hyperperfusion can be related to increased microvessel density in focal cortical dysplasia rather than only to seizures. Further investigations are needed to determine the relationship between brain perfusion, microvessel density, and seizure activity.

Research paper thumbnail of Cooling in the real world: Therapeutic hypothermia in hypoxic-ischemic encephalopathy

European Journal of Paediatric Neurology, 2013

and sharing with colleagues.

Research paper thumbnail of Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Cerebrovascular Diseases, 2013

Research paper thumbnail of Auditory brain development in premature infants: the importance of early experience

Annals of the New York Academy of Sciences, 2012

Preterm infants in the neonatal intensive care unit (NICU) often close their eyes in response to ... more Preterm infants in the neonatal intensive care unit (NICU) often close their eyes in response to bright lights, but they cannot close their ears in response to loud sounds. The sudden transition from the womb to the overly noisy world of the NICU increases the vulnerability of these high-risk newborns. There is a growing concern that the excess noise typically experienced by NICU infants disrupts their growth and development, putting them at risk for hearing, language, and cognitive disabilities. Preterm neonates are especially sensitive to noise because their auditory system is at a critical period of neurodevelopment, and they are no longer shielded by maternal tissue. This paper discusses the developmental milestones of the auditory system and suggests ways to enhance the quality control and type of sounds delivered to NICU infants. We argue that positive auditory experience is essential for early brain maturation and may be a contributing factor for healthy neurodevelopment. Further research is needed to optimize the hospital environment for preterm newborns and to increase their potential to develop into healthy children.

Research paper thumbnail of Near-infrared spectroscopy versus magnetic resonance imaging to study brain perfusion in newborns with hypoxic-ischemic encephalopathy treated with hypothermia

NeuroImage, 2014

and sharing with colleagues.

Research paper thumbnail of Newborns Referred for Therapeutic Hypothermia: Association between Initial Degree of Encephalopathy and Severity of Brain Injury (What About the Newborns with Mild Encephalopathy on Admission?)

American Journal of Perinatology, 2015