Understanding the impact of congenital infections and perinatal viral exposures on the developing brain using white matter magnetic resonance imaging: A scoping review

Abstract Background Magnetic Resonance Imaging (MRI)-based imaging techniques are useful to assess white matter (WM) structural and microstructural integrity in the context of infection and inflammation. The purpose of this scoping review was to examine current existing published literature exploring WM neuroimaging approaches to understand the impact of congenital and perinatal viral infections or exposures on the developing brain. Methods This scoping review was conducted according to the Arksey and O’ Malley framework. A literature search was performed in Web of Science, Scopus and PubMed for primary research articles published from database conception up to January 2022. Studies evaluating the use of MRI-based WM imaging techniques in congenital and perinatal viral infections or exposures were included. Results were grouped by age and infection status. Results A total of 826 articles were identified for screening and 28 final articles were included. Congenital and perinatal infections represented in the included studies were cytomegalovirus (CMV) infection, human immunodeficiency virus (HIV) infection and exposure, and herpes simplex virus (HSV) infection. The MRI-based WM imaging methods represented in the included studies were structural MRI and diffusion-weighted and diffusion tensor MRI (DWI/ DTI). The most frequently reported regions with diffusion parameter group differences included the cerebellar region, corticospinal tract and association fibre WM tracts in both children with HIV infection and children who are HIV-exposed uninfected, although there were fewer studies in the latter group. In qualitative imaging studies, WM hyperintensities were the most frequently reported brain abnormality in children with CMV infection and children with HSV infection. Scoping review findings suggested that diffusion parameters have the potential to be specific markers of impairment or damage of WM in viral infections. Conclusion There was evidence to suggest that WM imaging techniques can play a role as diagnostic and evaluation tools, while metrics of quantitative WM imaging modalities have the potential to be specific markers of impairment or damage.