A longitudinal study of associations between psychiatric symptoms and disorders and cerebral gray matter volumes in adolescents born very preterm.
A longitudinal study of associations between psychiatric symptoms and disorders and cerebral gray matter volumes in adolescents born very preterm.
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DOI：
10.1186/s12887-017-0793-0
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发表时间：
2017-02-01
期刊：
影响因子：
2.4
通讯作者：
Martinussen M
中科院分区：
文献类型：
--
作者：
Botellero VL;Skranes J;Bjuland KJ;Håberg AK;Lydersen S;Brubakk AM;Indredavik MS;Martinussen M
与足月出生的人相比，出生体重极低（VLBW ≤ 1500克）的早产儿存在皮质和皮质下灰质（GM）异常的风险，并且在儿童期和青春期出现更多精神问题。本研究的目的是调查 VLBW 个体皮质和皮质下 GM 体积与青春期精神疾病病程之间的关系。我们对 15 岁（VLBW；对照 n = 40；56）至 19 岁（n = 44；60）岁的 VLBW 个体和足月出生对照（出生体重≥10 个百分位数）进行了跟踪。其中，30；37 人接受了纵向检查。从两个时间点使用相同的 1.5 T MRI 扫描仪获得的 MRPRAGE 图像中提取皮质和皮质下 GM 体积，并使用 FreeSurfer 软件包 5.3.0 的纵向流在每个时间点进行分析。所有参与者都接受了临床访谈，并接受了精神症状和诊断评估（学龄儿童情感障碍和精神分裂症表、儿童整体评估量表、注意力缺陷/多动障碍评定量表-IV）。根据 15 至 19 岁的诊断状态，极低出生体重青少年被分为两组：持续/正在发展精神病学诊断或健康/变得健康。 15 岁和 19 岁时皮质下 GM 体积的减少（不包括丘脑）仅限于在青春期持续/发展诊断的 VLBW 青少年，而健康/变得健康组的 VLBW 青少年的皮质下 GM 体积与对照组相似。此外，在整个 VLBW 组中，两个时间点的皮层下 GM 体积较小，以及 15 年时丘脑、顶叶和枕叶皮质的 GM 体积减少，预示着心理社会功能较差。顶叶和枕叶皮层的 GM 体积较小可以预测注意力不集中的问题。顶叶和枕叶皮质的 GM 体积减少以及丘脑和皮质下 GM 体积的减小与整个 VLBW 组精神症状的发生率较高有关。与足月出生的同龄人相比，VLBW 个体的皮质下 GM 体积显着较小，这可能会给青春期期间发展和维持精神病诊断带来风险。未来的研究应探讨皮质和皮质下 GM 体积减少在极低体重青少年精神疾病发病机制中的可能作用。本文的在线版本 (doi:10.1186/s12887-017-0793-0) 包含补充材料，可供授权用户使用。
Being born preterm with very low birthweight (VLBW ≤ 1500 g) poses a risk for cortical and subcortical gray matter (GM) abnormalities, as well as for having more psychiatric problems during childhood and adolescence than term-born individuals. The aim of this study was to investigate the relationship between cortical and subcortical GM volumes and the course of psychiatric disorders during adolescence in VLBW individuals. We followed VLBW individuals and term-born controls (birth weight ≥10th percentile) from 15 (VLBW;controls n = 40;56) to 19 (n = 44;60) years of age. Of these, 30;37 individuals were examined longitudinally. Cortical and subcortical GM volumes were extracted from MRPRAGE images obtained with the same 1.5 T MRI scanner at both time points and analyzed at each time point with the longitudinal stream of the FreeSurfer software package 5.3.0. All participants underwent clinical interviews and were assessed for psychiatric symptoms and diagnosis (Schedule for Affective Disorders and Schizophrenia for School-age Children, Children’s Global Assessment Scale, Attention-Deficit/Hyperactivity Disorder Rating Scale-IV). VLBW adolescents were divided into two groups according to diagnostic status from 15 to 19 years of age: persisting/developing psychiatric diagnosis or healthy/becoming healthy. Reduction in subcortical GM volume at 15 and 19 years, not including the thalamus, was limited to VLBW adolescents with persisting/developing diagnosis during adolescence, whereas VLBW adolescents in the healthy/becoming healthy group had similar subcortical GM volumes to controls. Moreover, across the entire VLBW group, poorer psychosocial functioning was predicted by smaller subcortical GM volumes at both time points and with reduced GM volume in the thalamus and the parietal and occipital cortex at 15 years. Inattention problems were predicted by smaller GM volumes in the parietal and occipital cortex. GM volume reductions in the parietal and occipital cortex as well as smaller thalamic and subcortical GM volumes were associated with the higher rates of psychiatric symptoms found across the entire VLBW group. Significantly smaller subcortical GM volumes in VLBW individuals compared with term-born peers might pose a risk for developing and maintaining psychiatric diagnoses during adolescence. Future research should explore the possible role of reduced cortical and subcortical GM volumes in the pathogenesis of psychiatric illness in VLBW adolescents. The online version of this article (doi:10.1186/s12887-017-0793-0) contains supplementary material, which is available to authorized users.