Destruction and reconstruction: Hypoxia and the developing brain

Robert D. Barrett, Laura Bennet, Joanne Davidson, Justin M. Dean, Sherly George, Bright S. Emerald, Alistair Jan Gunn

Research output: Contribution to journalReview articlepeer-review

72 Citations (Scopus)

Abstract

Preterm infants have a high rate of neurodevelopmental handicap. Recent imaging studies have revealed that adverse outcomes are strongly associated with reduced brain growth and neural complexity in later life. Increasing data suggest that these chronic deficits primarily reflect acute neuronal and glial injury sustained during adverse in utero events, such as exposure to severe hypoxia-ischemia and inflammation. In the present review we examine recent evidence that this chronic impairment is partly due to upregulation of physiological apoptosis, related to input deprivation, and output isolation secondary to acute white and gray matter damage and axonal injury. However, progenitor cells in the subventricular zone (SVZ) are also vulnerable to injury, and loss of part of this critical population likely further compromises brain development. Based on these concepts the impact of proposed interventions such as induced hypothermia and endogenous growth factors are likely to be complex, but potentially offer focused ways of improving the outcomes of premature birth.

Original languageEnglish
Pages (from-to)163-176
Number of pages14
JournalBirth Defects Research Part C - Embryo Today: Reviews
Volume81
Issue number3
DOIs
Publication statusPublished - Sept 2007
Externally publishedYes

ASJC Scopus subject areas

  • Embryology
  • Developmental Biology

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