Scientists identify cause of serious brain bleeding in premature babies

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A recent study by researchers at Massachusetts General Hospital reveals insights that could lead to new treatments for serious brain bleeding, which is common in very low birth weight babies. The results were published in Brain.

“Intraventricular hemorrhage, which is characterized by bleeding in or around the spaces in the brain where cerebrospinal fluid is contained, occurs in about one-third of very low birth weight infants, and more than half of those who survive are neurologically disabled for life,” said senior author Kevin J. Staley, MD, chief of the Division of Pediatric Neurology at Massachusetts General Hospital.

“The pathophysiology of brain injury leading to intraventricular hemorrhage in preterm infants is unclear—making effective intervention challenging.”

Studies in animal models indicate that shrinkage of brain tissue and the resulting stretching of blood vessels is an important step in the pathophysiology of intraventricular hemorrhage, but the cause of this shrinkage is unknown.

Staley and his colleagues conducted experiments in mice to show that certain salt and water transporters located in the cell membranes of neurons play a role in this tissue shrinkage in response to oxygen deprivation in the brain. Changing the activity of these transporters prevented the shrinkage of neurons and the stretching of blood vessels after brain damage in immature neurons.

“We found that because of unique salt and water transport systems expressed in immature neurons, neurons shrink in response to injury. This is the opposite of the injury response in the mature brain, which swells after injury. The volume loss in immature neurons leads to local tissue shrinkage, which then stretches blood vessels, which can lead to rupture and intraventricular hemorrhage,” Staley explained.

“We have shown in animal models that manipulation of transporters will ameliorate these consequences of brain damage.”

The researchers will then analyze clinical data to assess whether the results of their experiments in mice can be extrapolated to human newborns.

More information:
Fatemeh Bahari et al., Intraventricular hemorrhage in premature infants: the role of immature salt and water transport in neurons, Brain (2024). DOI: 10.1093/brain/awae161

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