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中度-晚期早产儿的区域性脑容量、微观结构和神经发育。

Regional brain volumes, microstructure and neurodevelopment in moderate-late preterm children.

机构信息

Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2020 Nov;105(6):593-599. doi: 10.1136/archdischild-2019-317941. Epub 2020 Mar 4.

Abstract

OBJECTIVE

To explore whether regional brain volume and white matter microstructure at term-equivalent age (TEA) are associated with development at 2 years of age in children born moderate-late preterm (MLPT).

STUDY DESIGN

A cohort of MLPT infants had brain MRI at approximately TEA (38-44 weeks' postmenstrual age) and had a developmental assessment (Bayley Scales of Infant and Toddler Development and Infant Toddler Social Emotional Assessment) at 2 years' corrected age. Relationships between cortical grey matter and white matter volumes and 2-year developmental outcomes were explored using voxel-based morphometry. Relationships between diffusion tensor measures of white matter microstructure (fractional anisotropy (FA) and axial (AD), radial (RD) and mean (MD) diffusivities) and 2-year developmental outcomes were explored using tract-based spatial statistics.

RESULTS

189 MLPT children had data from at least one MRI modality (volumetric or diffusion) and data for at least one developmental domain. Larger cortical grey and white matter volumes in many brain regions, and higher FA and lower AD, RD and MD in several major white matter regions, were associated with better cognitive and language scores. There was little evidence that cortical grey matter and white matter volumes and white matter microstructure were associated with motor and behavioural outcomes.

CONCLUSIONS

Regional cortical grey matter and white matter volumes and white matter microstructure are associated with cognitive and language development at 2 years of age in MLPT children. Thus, early alterations to brain volumes and microstructure may contribute to some of the developmental deficits described in MLPT children.

摘要

目的

探讨足月后相当年龄(TEA)时的区域性脑容量和白质微观结构是否与中度晚期早产儿(MLPT)儿童 2 岁时的发育相关。

研究设计

对一组 MLPT 婴儿在 TEA(胎龄 38-44 周)左右进行脑部 MRI 检查,并在 2 岁矫正年龄时进行发育评估(贝利婴幼儿发育量表和婴幼儿社会情感评估)。使用基于体素的形态测量学方法探讨皮质灰质和白质体积与 2 岁发育结果之间的关系。使用基于束的空间统计学方法探讨白质微观结构的扩散张量测量值(各向异性分数(FA)和轴向(AD)、径向(RD)和平均(MD)扩散率)与 2 岁发育结果之间的关系。

结果

189 名 MLPT 儿童至少有一项 MRI 模态(容积或弥散)的数据,以及至少一个发育领域的数据。许多脑区的皮质灰质和白质体积较大,以及几个主要白质区域的 FA 较高,AD、RD 和 MD 较低,与认知和语言评分较高相关。几乎没有证据表明皮质灰质和白质体积以及白质微观结构与运动和行为结果相关。

结论

MLPT 儿童的区域性皮质灰质和白质体积以及白质微观结构与 2 岁时的认知和语言发育相关。因此,大脑体积和微观结构的早期改变可能导致 MLPT 儿童描述的一些发育缺陷。

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