Regional brain volumes and their later neurodevelopmental correlates in term and preterm infants
Regional brain volumes and their later neurodevelopmental correlates in term and preterm infants
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DOI：
10.1542/peds.111.5.939
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发表时间：
2003-05-01
期刊：
影响因子：
8
通讯作者：
Ment, LR
中科院分区：
文献类型：
--
作者：
Peterson, BS;Anderson, AW;Ment, LR
客观的。比较足月儿和早产儿测量的区域脑容量，并将区域脑容量与神经发育结果的测量相关联。方法。对 10 名早产儿和 14 名足月儿进行了近足月扫描，获得了高对比度、高分辨率磁共振成像扫描。大脑分为皮质灰质、白质、脑室、皮质下灰质、小脑和脑干。皮质灰质、白质和脑室进一步分为特定的解剖分区，并比较各组的体积。认知和运动发育的测量是在校正年龄 18 至 20 个月之间进行的。在早产儿组中评估了区域脑容量与发育结果的相关性。结果。早产儿顶枕灰质的体积减少，中体、枕角和侧脑室颞角的体积增加。感觉运动皮质和下枕叶皮质的灰质体积也没有那么明显减少。早产儿顶枕区白质体积的正常侧化发生了改变，其左侧结构明显较大，右侧结构较小。感觉运动区和颞中区的白质体积与神经发育结果的测量密切相关。结论。这些关于早产儿感觉运动和顶枕区体积减少的发现，以及区域体积与认知结果的前瞻性相关性，证实并扩展了先前在一项针对 8 岁早产儿的横断面研究中报告的发现。数据表明，近期区域脑容量是预测早产儿认知结果紊乱的一个有希望的标志。需要对新生儿脑容量和儿童后期发育指数进行进一步的前瞻性纵向研究，以确认区域脑容量作为长期结果预测因子的效用。
Objective. To compare regional brain volumes measured in term and preterm infants, and to correlate regional volumes with measures of neurodevelopmental outcome.Methods. High-contrast, high-resolution magnetic resonance imaging scans were acquired in 10 preterm and 14 term infants who were scanned near term. The cerebrum was segmented into cortical gray matter, white matter, cerebral ventricles, subcortical gray matter, cerebellum, and brainstem. The cortical gray matter, white matter, and ventricles were further divided into specific anatomic subregions, and the volumes were compared across groups. Measures of cognitive and motor development were acquired between 18 and 20 months of corrected age. Correlations of regional brain volumes with developmental outcome were assessed in the preterm group.Results. Volumes in preterm infants were reduced in parieto-occipital gray matter and increased in the midbody, occipital horn, and temporal horns of the lateral ventricles. Gray matter volumes were also less prominently reduced in the sensorimotor and inferior occipital cortices. Normal lateralization of white matter volumes were altered in the parieto-occipital region in the preterm infants, who had significantly larger left-sided and smaller right-sided structures. White matter volumes in the sensorimotor and midtemporal regions correlated strongly with measures of neurodevelopmental outcome.Conclusions. These findings of reduced volumes in sensorimotor and parieto-occipital regions in preterm infants, and the prospective correlations of regional volumes with cognitive outcome, confirm and extend findings previously reported in a cross-sectional study of 8-year-old prematurely born children. The data suggest that regional brain volumes near term are a promising marker for predicting disturbances of cognitive outcome in preterm infants. Further prospective, longitudinal studies of neonatal brain volumes and developmental indices into later childhood are required to confirm the utility of regional brain volumes as predictors of longer term outcome.