{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T16:51:22Z","timestamp":1774025482923,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2020A1515011332"],"award-info":[{"award-number":["2020A1515011332"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515012503"],"award-info":[{"award-number":["2022A1515012503"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Birth asphyxia (BA) and germinal matrix hemorrhage\u2013intraventricular hemorrhage (GMH\u2010IVH) are common clinical events in preterm neonates. However, their effects on the glymphatic system (GS) development in preterm neonates remain arcane.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the developmental trajectory of the GS, and to investigate the effects of BA and GMH\u2010IVH on GS function in preterm neonates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Two independent datasets, prospectively acquired internal dataset (including 99 preterm neonates, 40 female, mean [standard deviation] gestational age (GA) at birth, 29.95 [2.63] weeks) and the developing Human Connectome Project (dHCP) dataset (including 81 preterm neonates, 29 female, median [interquartile range] GA at birth, 32.71 [4.28] weeks).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3.0\u2009T MRI and diffusion\u2010weighted spin\u2010echo planar imaging sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>The diffusion\u2010weighted images were preprocessed in volumetric space using the FMRIB Software Library and diffusion along the perivascular space (DTI\u2010ALPS) index was accessed to evaluate GS function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Two sample <jats:italic>t<\/jats:italic> tests, one\u2010way analysis of variance followed by least\u2010significant difference (LSD) post hoc analysis, chi\u2010squared tests, and Pearson's correlation analysis. Significance level: <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In prospectively acquired internal dataset, preterm neonates with BA exhibited a significant lower DTI\u2010ALPS index than those without BA (0.98\u2009\u00b1\u20090.08 vs. 1.08\u2009\u00b1\u20090.07, <jats:italic>T<\/jats:italic>\u2009=\u2009\u22125.89); however, GMH\u2010IVH did not exert significant influences on the DTI\u2010ALPS index (<jats:italic>P<\/jats:italic>\u2009=\u20090.83 and 0.27). The DTI\u2010ALPS index increased significantly at postmenstrual age ranging from 25 to 34\u2009weeks (<jats:italic>r<\/jats:italic>\u2009=\u20090.38) and then plateaued after 34\u2009weeks (<jats:italic>P<\/jats:italic>\u2009=\u20090.35), which we also observed in the dHCP dataset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>BA rather than GMH\u2010IVH serves as the major influencing factor in the development of GS in preterm neonates. Moreover, as GS development follows a nonlinear trajectory, we recommend close monitoring of GS development in preterm neonates with a GA less than 34\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29615","type":"journal-article","created":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T02:16:07Z","timestamp":1726884967000},"page":"1761-1769","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Glymphatic System in Preterm Neonates: Developmental Insights Following Birth Asphyxia"],"prefix":"10.1002","volume":"61","author":[{"given":"Shiwei","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Radiology Huazhong University of Science and Technology Union Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoshan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiology Huazhong University of Science and Technology Union Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qunjun","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Radiology Huazhong University of Science and Technology Union Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengli","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology Huazhong University of Science and Technology Union Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University Guangzhou Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology Huazhong University of Science and Technology Union Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianfa","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University Guangzhou Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-8506","authenticated-orcid":false,"given":"Yingwei","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Radiology Huazhong University of Science and Technology Union Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"WHO.Preterm birth 2023. 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