Midline corpus callosum is a neuroanatomical focus of fetal alcohol damage
Midline corpus callosum is a neuroanatomical focus of fetal alcohol damage
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DOI：
10.1002/ar.10110
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发表时间：
2002-06-15
影响因子：
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通讯作者：
Streissguth, Ann P.
中科院分区：
文献类型：
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作者：
Bookstein, Fred L.;Sampson, Paul D.;Streissguth, Ann P.
产前暴露于高水平的酒精往往导致出生缺陷，结合形态学污点和神经或神经心理缺陷。但是，在青少年和成人中诊断这些综合征已经证明是有问题的，在这些患者中，形态学症状缺失或减弱，行为缺陷非特异性，并且暴露史通常难以重建。定位相关的大脑异常可能会规避这些困难。为此，我们记录了60名正常青少年和成人、60名诊断为胎儿酒精综合征和60名诊断为胎儿酒精影响的青少年和成人的脑磁共振图像中胼胝体上或附近67个同源点的三维（3D）位置。我们将这类几何数据的标准统计方法，Procrustes分析与多变量策略结合起来，重点关注变异的差异。在这组数据中，系统地证明，受酒精影响的大脑中，胼胝体及其附近区域的形状比正常受试者的变化要大得多。从这个多余的可变性遵循一个有希望的分类规则，在这个样本中具有高灵敏度（117分之100）和高特异性（60分之49）。该判别方法采用胼胝体轮廓形状的4个地标点和2个总结性分数。成年受试者的MR脑图像显示，胼胝体及其附近的信息可以作为酒精产前影响的永久记录，即使是在生命相对较晚时首次怀疑这些综合征或没有产前酒精损伤面部迹象的患者。胼胝体诊断的统计模式也导致了对产前损伤机制的推测。
Prenatal exposure to high levels of alcohol often induces birth defects that combine morphological stigmata with neurological or neuropsychological deficits. But it has proved problematic to diagnose these syndromes in adolescents and adults, in whom the morphological signs are absent or attenuated, the behavioral deficits nonspecific, and the exposure history often difficult to reconstruct. Localizing the associated brain abnormalities might circumvent most of these difficulties. To this end, three-dimensional (3D) locations were recorded for 67 homologous points on or near the corpus callosum in magnetic resonance (MR) brain images from 60 adolescents and adults who were normal, 60 diagnosed with fetal alcohol syndrome, and 60 diagnosed with fetal alcohol effects. We combined the standard statistical approach to this type of geometric data, Procrustes analysis, with a multivariate strategy focusing on differences in variability. In this data set, the shape of the corpus callosum and its vicinity proves systematically much more variable in the alcohol-affected brains than in those of the normal subjects. From this excess variability follows a promising classification rule, having both high sensitivity (100 out of 117) and high specificity (49 out of 60) in this sample. The discrimination uses four landmark points and two summary scores of callosal outline shape. The information from the corpus callosum and vicinity, as viewed in MR brain images of full-grown subjects, may serve as a permanent record of the prenatal effects of alcohol, even in patients who are first suspected of these syndromes relatively late in life or who lack the facial signs of prenatal alcohol damage. The statistical pattern underlying the callosal diagnosis also leads to speculations on mechanisms of the prenatal damage.