Neonatal Neuroscience

Brain health in the preterm baby: Pain, Sedation and Nutrition

In collaboration with The Canadian Premature Babies Foundation

Parenting strategies may help preterm babies thrive

Bridging the gap between early corpus callosal growth and neurodevelopmental outcome in infants born very preterm

Photo of Dr. Steven Miller

Developmental Medicine & Child Neurology, April 2017  — The incidence of preterm birth is rising and is recognized to be associated with a marked increase in the risk of adverse neurodevelopmental outcomes later in childhood. A pressing need has therefore emerged to develop new techniques that can accurately identify high-risk infants.

Mapping Brain in Preemies May Predict Later Disability

Photo of child playing with lego Press Release, Jan. 18, 2017 — Scanning a premature infant’s brain shortly after birth to map the location and volume of lesions, small areas of injury in the brain’s white matter, may help doctors better predict whether the baby will have disabilities later, according to a new study published in the online issue of Neurology®.

Congenital Heart Disease: From Surviving to Thriving

SickKids Breakthrough Spring 2016 Newsletter

SickKids Breakthrough. Spring 2016 Newsletter, Issue 2 — Dr. Mike Seed and Dr. Steven Miller have seen the effect that spectacular advances in surgery for babies with congenital heart disease have made. The surgery works. More babies survive. It’s their mission to see that babies do more than survive. They want to see them thrive.

A brighter future for children with brain-based disabilities

Child-BRIGHT Network Logo

MUHC Public Affairs, April 6, 2016 — The Research Institute of the McGill University Health Centre (RI-MUHC) will lead an innovative pan-Canadian network named CHILD-BRIGHT that aims to improve life outcomes for children with brain-based development disabilities and their families.

Midazolam Exposure May Impair Hippocampal Growth in Preemies

Photo of baby in an incubator with a nurse

NeurologyAdvisor, Shannon Aymes, MD.  January 18, 2016 — Higher exposure to midazolam in very preterm babies is linked to impaired hippocampal growth and lower cognitive scores, according to data published in the Annals of Neurology.

Preemies at significant risk of neurodevelopmental problems: study

Photo of baby in incubator with hat on

CTVNews, Helen Branswell, August 26, 2013 — Children born extremely pre-term have a substantial likelihood of developing moderate to severe neurodevelopmental impairments, a new Canadian study suggests.

A Strong Heart for the Brain's Healthy Start

Here are some highlight papers from the NeoNs group.

Dalit Cayam-Rand, MD

Staff Child Neurologist – Shaare Zedek Medical Center (affiliated with Hebrew University Medical School), Jerusalem, Israel

Predicting developmental outcomes in preterm infants – a simple white matter imaging rule – This study demonstrated that among very preterm children with brain injury in the white matter, location of the injury is as valuable as the amount of injury when predicting 4.5 year outcomes.

Emma Duerden, PhD

Assistant Professor – Faculty of Education, Western University, London, Canada

White matter injury predicts disrupted functional connectivity and microstructure in very preterm born neonates – We examined how brain injury impacts preterm born infants and found that babies with brain injury had weaker connectivity pathways in key regions of the brain responsible for movement and reasoning capabilities. We expect this research will aid in identifying the central locations in the brain that are most vulnerable to injury.

Early Procedural Pain is Associated with Regionally-Specific Alterations in Thalamic Development in Preterm Neonates – We examined the development of key brain regions involved in mental reasoning and movement in preterm babies using brain imaging and found that babies born the youngest may be most vulnerable to invasive procedures experienced during the first weeks of life.

Isabel Benavente-Fernandez, MD

Neonatologist – Hospital Puerta del Mar, Cádiz, Spain and Associate Professor – University of Cadiz, Spain

Association of Socioeconomic Status and Brain Injury With Neurodevelopmental Outcomes of Very Preterm Children – We found higher parental socioeconomic status is associated with reduced impact of brain injury on neurodevelopment of preterm children.

Jarred Garfinkle, MD

Assistant Professor – Department of Pediatrics, McGill University and Neonatologist – Montreal Children’s Hospital, McGill University Health Centre, Montreal, Canada

Location and Size of Preterm Cerebellar Hemorrhage and Childhood Development – Preterm newborns can have bleeding in the cerebellum, which is an area at the back and bottom of the brain. We showed that the size and location of the bleeding within the cerebellum can predict later childhood motor and behavioural development.

Mireille Guillot, MD

Neurology Clinical Fellow – The Hospital for Sick Children, Toronto, Canada

Mechanical Ventilation duration, brainstem development, and neurodevelopment in children born preterm: a prospective cohort study – We discovered that adverse brainstem development was involved in the relationship between exposure to mechanical ventilation and motor development. Although mechanical ventilation can be lifesaving, our study provides further evidence that minimizing exposure to mechanical ventilation in preterm neonates should be part of the strategies to optimize their brain development and long-term outcomes.

Alharbi HM, Pinchefsky EF, Tran MA, Salazar Cerda CI, Parokaran Varghese J, Kamino D, Widjaja E, Mamak E, Ly L, Nevalainen P, Hahn CD, Tam EWY. Seizure Burden and Neurologic Outcomes After Neonatal Encephalopathy. Neurology. 2023 May 9;100(19):e1976-e1984. doi: 10.1212/WNL.0000000000207202. Epub 2023 Mar 29.


Kamino D, Widjaja E, Brant R, Ly LG, Mamak E, Chau V, Moore AM, Williams T, Tam EWY. Severity and duration of dysglycemia and brain injury among patients with neonatal encephalopathy. EClinicalMedicine. 2023 Mar 23;58:101914. doi: 10.1016/j.eclinm.2023.101914.


Goswami I, Kamino D, Widjaja E, Paniccia M, Mitsakakis N, Moore A, Tam EWY. Early neonatal heart rate variability patterns in different subtypes of perinatal hypoxic-ischemic brain injury. Pediatr Res. 2022 Mar 15.


Tam EWY, Kamino D, Shatil AS, Chau V, Moore AM, Brant R, Widjaja E. Hyperglycemia associated with acute brain injury in neonatal encephalopathy. Neuroimage Clin. 2021;32:102835. doi: 10.1016/j.nicl.2021.102835. Epub 2021 Sep 28


Kamino D, Almazrooei A, Pang EW, Widjaja E, Moore AM, Chau V, Tam EWY. Evoked potentials are associated with abnormal glucose and brain injury in neonatal hypoxic ischemic encephalopathy. Clinical Neurophysiology. 2021 Jan; 132(1): 307-313.


Akiyama, A, Tsai J-D, Tam EWY, Kamino D, Hahn C, Go CY, Chau V, Whyte H, Wilson D, McNair C, Papioannou V, Hugh SC, Papsin BC, Yoshimoto S, Yamazaki Y, Miller SP, Ochi A. The effect of music and white noise on EEG functional connectivity in neonates in NICU. Journal of Child Neurology. 2020. Accepted


McDonald, KP, Connolly, JC, Roberts, SD, Ford, MK, Westmacott, R, Dlamini, N, Tam, EWY, & Williams, T. A tool to guide early intervention: The adapted Response to Stress Questionnaire for parents following neonatal brain injury. Journal of Pediatric Psychology. 2020;45:1005-1015.


Tam EWY, Chau V, Lavoie R, Chakravarty MM, Guo T, Synnes A, Zwicker J, Grunau R, Miller SP. Neurological examination findings associated with smaller cerebellar volumes after prematurity. Journal of Child Neurology. 2019 Sep; 34(10):586-592


Pinchefsky EF, Hahn CD, Kamino D, Chau V, Brant R, Moore A, Tam EWY. Hyperglycemia and glucose variability are associated with worse brain function and seizures on amplitude-integrated EEG in neonatal encephalopathy: a prospective cohort study. Journal of Pediatrics. 2019 Jun;209:23-32.


Williams TS, McDonald KP, Roberts SD, Westmacott R, Dlamini N, Tam EWY. Understanding early childhood resilience following neonatal brain injury from parents’ perspectives using a mixed-method design. Journal of the International Neuropsychological Society. 2019 Apr; 25(4):390-402


Kamino D, Chau V, Studholme C, Liu M, Xu D, Barkovich AJ, Ferriero DM, Miller SP, Brant R, Tam EWY. Plasma cholesterol levels and brain development in preterm newborns. Pediatric Research. 2019 Feb;85(3):299-304.


Kamino D, Studholme C, Liu MY, Chau V, Miller SP, Barkovich AJ, Ferriero DM, Brant R, Tam EWY. Postnatal polyunsaturated fatty acids associated with larger preterm brain tissue volumes and better outcomes. Pediatric Research. 2018 Jan;83(1-1):93-101


Wagenaar N, Chau V, Groenendaal F, Kersbergen KJ, Poskitt KJ, Grunau RE, Synnes A, Duerden EG, de Vries LS, Miller SP, Benders MJ. Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns. J Pediatr. 2017 Mar;182:34-40.e1.


Guo T, Duerden EG, Adams E, Chau V, Branson HM, Chakravarty MM, Poskitt KJ, Synnes A, Grunau RE, Miller SP. Quantitative assessment of white matter injury in preterm neonates: Association with outcomes. Neurology. 2017 Feb 14;88(7):614-622


Lim JM, Kingdom T, Saini B, Chau V, Post M, Blaser S, Macgowan C, Miller SP, Seed M. Cerebral oxygen delivery is reduced in newborns with congenital heart disease. J Thorac Cardiovasc Surg. 2016 Oct;152(4):1095-103.


Tam EWY, Chau V, Barkovich AJ, Ferriero DM, Miller SP, Rogers EE, Grunau RE, Synnes AR, Xu D, Foong J, Brant R, Innis SM. Early postnatal docosahexaenoic acid levels and improved preterm brain development. Pediatric Research. 2016 May;79(5):723-730.


Zwicker JG, Miller SP, Grunau RE, Chau V, Studholme C, Liu M, Brant R, Synnes A, Poskitt KJ, Stiver ML, Tam EWY. Smaller cerebellar growth and poorer neurodevelopmental outcomes in very preterm infants exposed to morphine. Journal of Pediatrics. 2016 May;172:81-87.e2.


Chakkarapani E, Poskitt KJ, Miller SP, Zwicker J, Xu Q, Wong DWT, Roland EH, Hill A, Chau V. Reliability of Early Magnetic Resonance Imaging (MRI) and Necessity of Repeating MRI in Noncooled and Cooled Infants With Neonatal Encephalopathy.  Journal of Child Neurology 2016 Apr; 31(5): 553-9.


Duerden EG, Guo T, Dodbiba L, Chakravarty MM, Chau V, Poskitt KJ, Synnes A, Grunau RE, Miller SP. Midazolam dose correlates with abnormal hippocampal growth and neurodevelopmental outcome in preterm infants. Ann Neurol. 2016 Apr;79(4):548-59. doi: 10.1002/ana.24601.


Zhu MY, Milligan N, Keating S, Windrim R, Keunen J, Thakur V, Ohman A, Portnoy S, Sled JG, Kelly E, Yoo SJ, Gross-Wortmann L, Jaeggi E, Macgowan CK, Kingdom JC, Seed M. The Hemodynamics of late-onset intrauterine growth restriction by MRI. Am J Obstet Gynecol. 2016 Mar;214(3):367.e1-367.e17


Sun L, Macgowan CK, Sled JG, Yoo SJ, Manlhiot C, Porayette P, Grosse-Wortmann L, Jaeggi E, McCrindle BW, Kingdom J, Hickey E, Miller S, Seed M. Reduced Fetal Cerebral Oxygen Consumption is Associated with Smaller Brain Size in Fetuses with Congenital Heart Disease. Circulation. 2015 Apr 14;131(15):1313-23.


Chau V, Synnes A, Grunau RE, Poskitt KJ, Brant R, Miller SP. Abnormal brain maturation in preterm neonates associated with adverse developmental outcomesNeurology 2013 Dec 10; 81(24):2082-9.


Gano D, Sargent MA, Miller SP, Connolly MB, Wong P, Glass HC, Poskitt KJ, Chau V. MRI findings in infants with infantile spasms after neonatal hypoxic-ischemic encephalopathy. Pediatric Neurology 2013; Dec; 49(6): 401-5.


Wong DST, Poskitt KJ, Chau V, Miller SP, Roland E, Hill A, Tam EWY. Brain Injury Patterns in Hypoglycemia in Neonatal Encephalopathy. American Journal of Neuroradiology. 2013 Jul;34(7):1456-61.