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Joseph Volpe is generally considered to have founded the field of neonatal neurology. His research is aimed at defining the mechanism of and strategies to prevent periventricular leukomalacia in premature infants. He has approached this goal through both basic and clinical research.
Through basic research he has demonstrated that early differentiating oligodendrocytes are exquisitely vulnerable to free radical attack and discovered that this vulnerability requires iron, leads to apoptotic death, is highly maturation-dependent, and is preventable by mechanism-specific interventions.
His clinical research has demonstrated that periventricular white matter injury in the premature newborn is followed by subsequent impairment of brain development and has also contributed to possible strategies for preventing that damage. He has demonstrated that :
- Infants with a pressure-passive cerebral circulation can be identified in the first hours of life and
are at very high risk for the subsequent occurrence of periventricular white matter injury.
- Infants with cerebral hemodynamic disturbance can be identified prior to the occurrence of injury, raising the possibility that correcting the disturbance could prevent of white-matter injury.
- The critical diffuse component of periventricular white matter injury invisible to conventional MRI, can be identified by diffusion-based MRI (decreased diffusion) and by proton MR spectroscopy (increased lactate).
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