Superior longitudinal fasciculus and cognitive dysfunction in adolescents born preterm and at term
Superior longitudinal fasciculus and cognitive dysfunction in adolescents born preterm and at term
复制标题
DOI：
10.1111/j.1469-8749.2010.03633.x
复制
发表时间：
2010-08-01
影响因子：
3.8
通讯作者：
Landry, Susan
中科院分区：
文献类型：
--
作者：
Frye, Richard E.;Hasan, Khader;Landry, Susan
目的了解无明显脑损伤的早产儿认知与脑白质结构的关系。方法根据出生时发育障碍风险（足月出生：男8名，女5名，年龄中位数16 ~ 1个月，四分位数差10个月）、低危早产儿：男4名，女5名，年龄中位数16 ~ 1个月，范围4 ~ 2个月；高危早产儿：男3名，女7名，年龄中位数16 ~ 2个月，范围1 ~ 2个月)和阅读能力(良好：男3名，女8名，年龄中位数16 ~ 7个月，范围7个月；平均：男性6人，女性3人，年龄中位数16 ~ 10月龄，范围1y；差：男6名，女6名，年龄中位数16岁，范围60岁)。早产的定义是胎龄小于或等于36周，出生体重小于或等于1600克。所有参与者均有正常的临床神经影像学表现。我们检查了分数各向异性、径向扩散率和三个主要白质束的体积。使用混合模型回归分析结构测量与出生风险、半球和认知能力（注意力、词汇和亚词汇解码、听觉语音意识和处理速度）之间的关系。结果左半球上纵束分数各向异性和径向扩散率与阅读相关技能相关(分数各向异性vs字母-单词识别，r((30))=-0.37, p < 0.05；分数各向异性vs音素反转，r((30))=-0.34, p=0.05；径向扩散率与字母-单词识别，r((30))=0.31, p < 0.10；径向扩散与音素反转，r((30))=0.40, p < 0.05)，而右半球SLF分数各向异性与注意技能相关（分数各向异性与注意力不集中，r((30))=-0.38, p < 0.05）。早产儿的SLF体积随着这些技能的下降而下降(体积vs音素反转，r((17))=0.58, p < 0.01；体积vs注意力不集中，r((17))=-0.69, p < 0.01)，但对足月出生的婴儿没有影响。认知能力与SLF体积之间的关系表明，尽管临床神经影像学正常，但早产儿可能存在隐性白质损伤，可能与少突胶质细胞或轴突丢失有关。
AimTo understand the relationship between cognition and white-matter structure in adolescents born preterm without obvious brain injury.MethodsThirty-two adolescents from a longitudinal study of child development were selected according to risk of developmental disorders at birth (born at term: eight males, five females; median age 16y 1mo, interquartile range 10mo; low risk preterm: four males, five females, median age 16y, range 4mo; high risk preterm: three males, seven females, median age 16y 2mo, range 1y 2mo) and reading ability (good: three males, eight females, median age 16y, range 7mo; average: six males, three females, median age 16y 10mo, range 1y; poor: six males, six females, median age 16y, range 6mo). Preterm birth was defined as a gestational age of 36 weeks or less and a birthweight of 1600g or less. All participants had normal clinical neuroimaging findings. We examined fractional anisotropy, radial diffusivity, and volume of three major white-matter fasciculi. The relationship between structural measures and birth risk, hemisphere, and cognitive ability (attention, lexical and sublexical decoding, auditory phonological awareness, and processing speed) were analysed using mixed-model regression.ResultsLeft-hemisphere superior longitudinal fasciculus (SLF) fractional anisotropy and radial diffusivity were linked to reading-related skills (fractional anisotropy vs letter-word identification, r((30))=-0.37, p < 0.05; fractional anisotropy vs phoneme reversal, r((30))=-0.34, p=0.05; radial diffusivity vs letter-word identification, r((30))=0.31, p < 0.10; radial diffusivity vs phoneme reversal, r((30))=0.40, p < 0.05), whereas right-hemisphere SLF fractional anisotropy was related to attention skills (fractional anisotropy vs inattentiveness, r((30))=-0.38, p < 0.05). SLF volume decreased as these skills declined for adolescents born preterm (volume vs phoneme reversal, r((17))=0.58, p < 0.01; volume vs inattentiveness, r((17))=-0.69, p < 0.01), but not for those born at term.InterpretationThe relationship between cognitive skills and SLF volume suggests that in adolescents born preterm, cryptic white-matter injury may exist, possibly related to oligodendrocyte or axonal loss, despite normal clinical neuroimaging.