Grey and white matter distribution in very preterm adolescents mediates neurodevelopmental outcome
Grey and white matter distribution in very preterm adolescents mediates neurodevelopmental outcome
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DOI：
10.1093/brain/awm282
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发表时间：
2008-01-01
期刊：
影响因子：
14.5
通讯作者：
Murray, Robin M.
中科院分区：
文献类型：
--
作者：
Nosarti, Chiara;Giouroukou, Elena;Murray, Robin M.
极早产（VPT）与皮质发育改变和长期神经发育后遗症有关。我们使用基于体素的形态测量法研究VPT青少年和对照组的白色（WM）和灰质（GM）分布，以及VPT个体与胎龄和新生儿超声检查结果的相关性。此外，还研究了GM和WM体积与青少年神经发育结局的关系。在218名VPT青少年（33周，妊娠）和128名年龄为14 - 15岁的对照组中，使用1.5特斯拉机器采集结构MRI数据，并使用SPM 2软件进行分析。与对照组相比，VPT患者的颞叶、额叶、枕叶皮质和小脑（包括壳核、齿状回、楔叶、梭状回、丘脑和尾状核）的GM减少，而颞叶和额叶（包括扣带回和梭状回和小脑）的GM增加。WM丢失主要集中在脑干、内囊、颞额区和大束。在颞叶、顶叶和额叶观察到WM过度。对大脑区域和变化之间的相互关系的研究显示，观察到组间WM和GM体积差异增加和减少的所有选定区域在结构上相关，突出了一个大脑区域异常可能对其他区域产生的影响。新生儿超声显示有心室周围出血和心室扩张证据的VPT个体表现出最大的WM和GM改变。VPT青少年在语言和执行功能方面的得分低于对照组，并且与对照组相比更容易出现认知障碍（分别为27%和14%）。VPT个体表现出GM和WM体积减少的几个区域与胎龄和介导的认知障碍呈线性相关。总之，我们的数据表明，VPT出生与青春期大脑结构的改变有关。GM和WM的改变与妊娠期长短有关，并介导青少年神经发育障碍。因此，解剖大脑的变化可能有助于特定的认知缺陷与VPT出生，并可用于识别那些可能是在认知障碍的风险增加的人。
Very preterm (VPT) birth is associated with altered cortical development and long-term neurodevelopmental sequelae. We used voxel-based morphometry to investigate white (WM) and grey matter (GM) distribution in VPT adolescents and controls, and the association with gestational age and neonatal ultrasound findings in the VPT individuals. GM and WM volumes were additionally investigated in relation to adolescent neurodevelopmental outcome. Structural MRI data were acquired with a 1.5 Tesla machine in 218 VPT adolescents (33 weeks, gestation) and 128 controls aged 1415 years, and analysed using SPM2 software. VPT individuals compared to controls showed reduced GM in temporal, frontal, occipital cortices and cerebellum, including putamen, insula, cuneus, fusiform gyrus, thalamus and caudate nucleus, and increased GM predominantly in temporal and frontal lobes, including cingulate and fusiform gyri and cerebellum. WM loss was concentrated in the brainstem, internal capsule, temporal and frontal regions and the major fasciculi. WM excesses were observed in temporal, parietal and frontal regions. Investigation of the inter-relationships between brain regions and changes revealed that all selected areas where between-group increased and decreased WM and GM volumes differences were observed, were structurally associated, highlighting the influence that abnormalities in one brain area may exert over others. VPT individuals with evidence of periventricular haemorrhage and ventricular dilatation on neonatal ultrasound exhibited the greatest WM and GM alterations. VPT adolescents obtained lower scores than controls on measures of language and executive function and were more likely to show cognitive impairment compared to controls (27% versus 14%, respectively). Several areas where VPT individuals demonstrated decreased GM and WM volume were linearly associated with gestational age and mediated cognitive impairment. To summarize, our data demonstrates that VPT birth is associated with altered brain structure in adolescence. GM and WM alterations are associated with length of gestation and mediate adolescent neurodevelopmental impairment. Thus, anatomical brain changes may contribute to specific cognitive deficits associated with VPT birth and could be used in the identification of those individuals who may be at increased risk for cognitive impairment.