Structural growth trajectories and rates of change in the first 3 months of infant brain development.
Structural growth trajectories and rates of change in the first 3 months of infant brain development.
复制标题
DOI：
10.1001/jamaneurol.2014.1638
复制
发表时间：
2014-10
期刊：
影响因子：
29
通讯作者：
Dale AM
中科院分区：
文献类型：
--
作者：
Holland D;Chang L;Ernst TM;Curran M;Buchthal SD;Alicata D;Skranes J;Johansen H;Hernandez A;Yamakawa R;Kuperman JM;Dale AM
出生后极早期的生长速度极快，但这一时期大脑结构的发育在很大程度上尚未进行纵向探究。这种评估对于检测和治疗神经发育障碍的早期迹象可能至关重要。
目的：评估出生后前3个月内婴儿全脑及感兴趣区域的结构生长轨迹和变化率。
方法：在2007年10月5日至2013年6月12日期间，获取了87名健康足月儿或相当于足月儿的早产儿（年龄为2至90天）的211个时间点的系列结构T1加权和/或T2加权磁共振图像。
我们使用一种基于贝叶斯方法的新应用对全脑及多个感兴趣的皮质下区域进行了分割。我们对生长和生长轨迹的速率进行了非参数建模，并评估了左右不对称性和性别二态性。
结果：出生时的全脑体积约为健康老年人脑体积的三分之一，男婴和女婴之间无显著差异（分别为347388立方毫米和335509立方毫米，P = 0.12）。生长速率约为每天1%，到前3个月末放缓至每天0.4%，此时脑体积达到老年人大脑体积的一半多一点。前90天的总体生长率为64%。存在显著的年龄 - 性别效应，导致男婴和女婴之间脑体积随年龄的差距增大（男婴比女婴生长快200.4立方毫米/天，标准误 = 67.2，P = 0.003）。妊娠期越长，脑体积越大（2215立方毫米/天，标准误 = 284，P = 4×10⁻¹³）。比平均出生日期早一周出生的婴儿，其预期脑体积比平均体积小5%；到90天时仍未赶上，比平均体积小2%。小脑的生长速率最高，90天内增长一倍多，海马体的生长速率最慢，90天内增长47%。多个感兴趣区域存在左右不对称性，特别是侧脑室，平均左侧比右侧大462立方毫米（约为2个月时侧脑室体积的5%）。我们计算了体积 - 年龄百分位图用于评估个体发育。
结论：出生后早期大脑结构发育的标准轨迹可通过磁共振成像确定，并可用于改进对提示神经发育障碍的异常成熟模式的检测。
The very early postnatal period witnesses extraordinary rates of growth, but structural brain development in this period has largely not been explored longitudinally. Such assessment may be key in detecting and treating the earliest signs of neurodevelopmental disorders. To assess structural growth trajectories and rates of change in the whole brain and regions of interest in infants during the first 3 months after birth. Serial structural T1-weighted and/or T2-weighted magnetic resonance images were obtained for 211 time points from 87 healthy term-born or term-equivalent preterm-born infants, aged 2 to 90 days, between October 5, 2007, and June 12, 2013. We segmented whole-brain and multiple subcortical regions of interest using a novel application of Bayesian-based methods. We modeled growth and rate of growth trajectories nonparametrically and assessed left-right asymmetries and sexual dimorphisms. Whole-brain volume at birth was approximately one-third of healthy elderly brain volume, and did not differ significantly between male and female infants (347 388 mm3 and 335 509 mm3, respectively, P = .12). The growth rate was approximately 1%/d, slowing to 0.4%/d by the end of the first 3 months, when the brain reached just more than half of elderly adult brain volume. Overall growth in the first 90 days was 64%. There was a significant age-by-sex effect leading to widening separation in brain sizes with age between male and female infants (with male infants growing faster than females by 200.4 mm3/d, SE = 67.2, P = .003). Longer gestation was associated with larger brain size (2215 mm3/d, SE = 284, P = 4×10−13). The expected brain size of an infant born one week earlier than average was 5% smaller than average; at 90 days it will not have caught up, being 2% smaller than average. The cerebellum grew at the highest rate, more than doubling in 90 days, and the hippocampus grew at the slowest rate, increasing by 47% in 90 days. There was left-right asymmetry in multiple regions of interest, particularly the lateral ventricles where the left was larger than the right by 462 mm3 on average (approximately 5% of lateral ventricular volume at 2 months). We calculated volume-by-age percentile plots for assessing individual development. Normative trajectories for early postnatal brain structural development can be determined from magnetic resonance imaging and could be used to improve the detection of deviant maturational patterns indicative of neurodevelopmental disorders.