Abstract
Background
Zika virus infection during pregnancy is linked to birth defects, most notably microcephaly, which is associated with neurodevelopmental delays.
Objective
The goals of the study were to propose a method for severity classification of congenital microcephaly based on neuroradiologic findings of MRI scans, and to investigate the association of severity with neuropsychomotor developmental scores. We also propose a semi-automated method for MRI-based severity classification of microcephaly.
Materials and methods
We conducted a cross-sectional investigation of 42 infants born with congenital Zika infection. Bayley Scales of Infant and Toddler Development III (Bayley-III) developmental evaluations and MRI scans were carried out at ages 13–39 months (mean: 24.8 months; standard deviation [SD]: 5.8 months). The severity score was generated based on neuroradiologist evaluations of brain malformations. Next, we established a distribution of Zika virus–microcephaly severity score including mild, moderate and severe and investigated the association of severity with neuropsychomotor developmental scores. Finally, we propose a simplified semi-automated procedure for estimating the severity score based only on volumetric measures.
Results
The results showed a correlation of r=0.89 (P<0.001) between the Zika virus–microcephaly severity score and the semi-automated method. The trimester of infection did not correlate with the semi-automated method. Neuropsychomotor development correlated with the severity classification based on the radiologic readings and semi-automated method; the more severe the imaging scores, the lower the neuropsychomotor developmental scores.
Conclusion
These severity classification methods can be used to evaluate severity of microcephaly and possible association with developmental consequences. The semi-automated methods thus provide an alternative for predicting severity of microcephaly based on only one MRI sequence.
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Acknowledgments
The authors would like to thank all the participants and their families for their cooperation and participation in the study, especially for their willingness to travel long distances with their children. This study was funded by Financiadora de Estudos e Projetos (FINEP). Magda Lahorgue Nunes, Jaderson Costa da Costa and Augusto Buchweitz are supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico grants. Nathalia Bianchini Esper was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES).
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Esper, N.B., Franco, A.R., Soder, R.B. et al. Zika virus congenital microcephaly severity classification and the association of severity with neuropsychomotor development. Pediatr Radiol 52, 941–950 (2022). https://doi.org/10.1007/s00247-022-05284-z
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DOI: https://doi.org/10.1007/s00247-022-05284-z