@PHDTHESIS{ 2020:680907899,
 	title = {Zika virus and the brain: a functional and structural magnetic resonance imaging study of infants with congenital microcephaly associated to Zika virus exposure},
 	year = {2020},
 	url = "http://tede2.pucrs.br/tede2/handle/tede/9507",
 	abstract = "The outbreak of Zika Virus infections, occurred in all Brazilian territory in 2015, brought a
 significant increase in the number of cases with congenital microcephaly in newborns, increasing
 researchers? interest in how this virus influences the brain development in patients with this
 neurological condition. Since that, several studies showed the anatomical changes in the
 microcephalic brain, without a focus on functional neurodevelopment. The present work provides
 a structural and functional MRI study in infants with congenital microcephaly associated to Zika
 Virus infection. The work is divided in two studies. The first study is a cross-sectional investigation
 of 42 infants born with Zika virus congenital microcephaly. Bayley-III developmental evaluations
 and MRI scans were carried out at ages 13-39 months (mean age = 24.83 months, SD = 5.82
 months). Here we propose a microcephaly severity classification, called ZikV-Microcephaly
 Severity Score. The severity score was generated based on neuroradiologist evaluations of brain
 malformations. Next, we established a distribution of ZikV-Microcephaly into mild, moderate and
 severe and investigated the association of severity with developmental scores. Finally, we propose
 a simplified procedure for estimating the severity score and a prediction of the score, using only
 volumetric measures. Results from the first study showed ZikV-Microcephaly Severity Score
 negatively correlated with neurodevelopmental scores and correlated with trimester of infection.
 The semi-automated method, in turn, correlated with the neuroradiological severity score, and thus
 may be an alternative for prediction of severity of microcephaly using one MRI sequence. Both
 methods may be used to evaluate severity of microcephaly and possible associated developmental
 consequences. The second study is a cross-sectional investigation of the functional connectivity in
 28 infants with congenital microcephaly (mean age = 26.75 months, SD = 5.82 months). Here we
 developed a brain MRI template for infants with moderate microcephaly, called ZikaBraIns
 template. The functional connectivity was assessed through an independent component analysis
 followed by a correlation analysis with the Bayley-III scales. Results from the second study showed
 that the ZikaBraIns template can be used for processing data from infants with moderate
 microcephaly and presented expected results in the correlation analysis. Results showed a
 correlation in the supplementary motor area between the supplementary motor network and the
 Bayley-III score for gross motor. The group analysis results showed a correlation between the temporal network and the Bayley-III scores for expressive communication in the superior
 temporal area. In conclusion, the severity classification allowed for the development of a brain
 MRI template for infants with moderate microcephaly for fMRI analyses, which was subsequently
 used to investigate well-established resting-state fMRI networks, such as the auditory, visual, and
 temporal networks.",
 	publisher = {Pontif?cia Universidade Cat?lica do Rio Grande do Sul},
 	scholl = {Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de},
 	note = {Escola de Medicina}
}