The Developing Human Brain

ForewordSection One Overview of Epidemiologic Methods and Material 1 Introduction Background Conceptual Problems Hypothesis Generation Pathologic Changes in Neonatal Brains The Pathologic Material in the NINCDS Collaborative Perinatal Project Observer Variability The Criteria Used in this Study The Assumptions of this Study Goals Confounding Factors Range of Abnormalities Preview Project Directors Pathologists Acknowledgments 2 Epidemiologic Methods Definitions Analysis 3 Autopsy Data in Epidemiologic Studies Introduction Advantages of Autopsy Data Disadvantages of Autopsy Data Strategies to Minimize the Effects of Selection Bias Summary 4 Selection Bias in the Creation of the NINCDS Collaborative Perinatal Project Neuropathology Sample Introduction Sample Description Analysis #1: Correlates of Postmortem Examination Analysis #2: Correlates of All Three Selection Processes (Death, Postmortem Examination, and Availability of Adequate Tissue) 5 Characteristics of the Neuropathology Sample Sample Description Processing and Observers Check-off Sheets Characteristics of Neonates Samples for Risk Factor AnalysisSection Two Overview. Growth and Development of the Human Fetal Brain 6 A Model of Growth of the Human Fetal Brain Historical Introduction to Growth Studies: Justification of Gompertz Function Other Growth Models Early Human Embryo Dating Derivation of Prenatal and Postnatal Brain Growth Model NINCDS Collaborative Perinatal Project Prenatal Brain Growth Model Uses of the NINCDS Collaborative Perinatal Project Brain Growth Model for Subpopulation Comparisons Autopsy Characteristics of Human Fetal Neural Tissue 7 Telecephalon Medium and the Olfacto-Cerebral Outpuching Introduction Materials Reference Points and Landmarks Olfaction Basicranium Fundamental Olfactory and Telencephalic Relationships Phylogenetic Constancy of Blood Supply Interventricular Foramen Transverse Germinal Bar Amygdala Corpus Striatrum and Internal Capsule Claustrum Hippocampal Formation and the Medial Edge of the Cerebrum Olfactory Placodes—Olfactory Bulbs Tuberculum Olfactorium Isocortex and Commissures Summary 8 Telecephalic Development: Matrix Volume and Isocortex and Allocortex Surface Areas Introduction Topographic Landmarks Material and Methods Results Discussion Summary Acknowledgment 9 Telecephalic Development: Changing Gyral Patterns Introduction Materials and Methods The Primary Fissures and Sulci Lobar Development Special Features Discussion Conclusion 10 Dorsal Mesodiencephalic Junction: Pineal, Subcommissural Organ, and Mesocoelic Recess Introduction The Pineal The Subcommissural Organ 11 Developmental Changes in Ventricular Epithelia Introduction Materials and Methods Histologie Features Discussion 12 Myelinated Tracts: Growth Patterns Introduction Materials and Ascertainment Assumptions Sites Evaluated An Overview of Myelination in the Fetal Human Nervous System Sequence of Myelination Progression of Myelination Myelination at the Median Statistical Maxima Deposition of Myelin at Each Site Evaluation of Myelination in a New Fetal Brain SummarySection Three Overview. Damage to the Fetal Brain in Last Half of Gestation 13 The Epidemiology of Delayed Myelination Introduction Sample Definition of Outcome Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis Correlates of Discriminating Variables Synthesis 14 Intracranial Hemorrhage: Topography Introduction Materials and Methods Results Discussion 15 The Epidemology of Ganglionic Eminence Hemorrhage Introduction Definitions Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis Independent Variables as Dependent Variables Discussion 16 The Epidemiology of Subarachnoid Hemorrhages Definition Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis Risk Factors of Subarachnoid Hemorrhage as Dependent Variables Synthesis 17 Neural Damage: Inconstancy During Gestation Background Kinds of Reactions in Fetal Brain Complicating Variables Misleading Notions Changes During Specific Developmental Periods Specific Events Markers of Damage in the NCPP Population Materials and Methods Pathologic Processes Sites of Occurrence of Each of the Pathologic Processes Summary 18 Classifications of the Perinatal Telecephalic Leucoencephalopathies Terminology What's in a Name? Homogeneity How to Achieve Homogeneity Age Classification Decisions 19 The Epidemiology of the Perinatal Telecephalic Leucoencephalopathy Characterized by Hypertrophic Astrocytes Introduction Sample Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis of Risk Risk Factors as Outcomes Discussion 20 The Epidemiology of the Perinatal Telecephalic Leucoencephalopathy Characterized by Amphophilic Globules Introduction Sample Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis Correlates of Risk Factors Synthesis 21 The Epidemiology of the Perinatal Telecephalic Leucoencephalopathy Characterized by Focal Necrosis Introduction Sample Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis Correlation Coefficients of Risk Factors Proposed Mechanisms by Which the Identified RUk Factors Contribute to the Occurrence of Necrotic Foci 22 The Epidemiology of the Perinaral Telecephalic Leucoencephalopathy Characterized by Acutely Damaged Glia Introduction Sample Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis Correlation of Risk Factors Identified by Multivariate Analysis Synthesis 23 The Epidemiology of the Perinatal Telecephalic Leucoencephalopathy Characterized by Hypertrophic Astrocytes and Amphophilic Globules Introduction Sample Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis Correlates of Discriminating Variables Synthesis 24 The Epidemiology of the Perinatal Telencephalic Leucoencephalopathy Characterized by Hypertrophic Astrocytes and Acutely Damaged Glia Introduction Similar Risk Factor Hypotheses Different Risk Factor Hypotheses Sample Univariate Analysis—Increased Risk Univariate Analysis—Decreased Risk Multivariate Analysis of Risk Correlates of Identified Risk Factors Synthesis 25 Etiologic Relationships Among the Perinatal Telecephalic Leucoencephalopathies Introduction Age Effects Measures of Endotoxin Exposure Unfavorable Uterine Environment Congenital Anomaly Effect Socioeconomic Effect Synthesis The Natural History of the Perinatal Telencephalic Leucoencephalopathies 26 Changes in Growth and Vulnerability at the End of the Second Trimester Anatomic Changes Changers in the Markers of Damage 27 SummaryBibliographyIndex