Differential vulnerability of gray matter and white matter to intrauterine growth restriction in preterm infants at 12 months corrected age
Differential vulnerability of gray matter and white matter to intrauterine growth restriction in preterm infants at 12 months corrected age
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DOI：
10.1016/j.brainres.2013.12.007
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发表时间：
2014-01-30
期刊：
影响因子：
2.9
通讯作者：
Gratacos, Eduard
中科院分区：
文献类型：
--
作者：
Padilla, Nelly;Junque, Carme;Gratacos, Eduard
宫内生长受限（IUGR）与神经发育异常的高风险相关。部分记录了潜在的神经解剖学基础。我们假设 12 个月大的早产儿会出现由严重 IUGR 引起的特定白质微观结构改变和灰质差异。将 20 名 IUGR 早产儿（妊娠 26-34 周）与 20 名足月出生婴儿和 20 名相似胎龄的适合胎龄早产儿进行比较。早产组没有表现出大脑异常的证据。 12 个月大时，对自然睡眠的婴儿进行了扫描。使用基于体素的形态测量法研究灰质体积。使用基于束的空间统计检查白质微观结构。还研究了白质扩散指数、灰质体积和围产期数据之间的关系。 IUGR 导致的灰质减少包括杏仁核、基底神经节、双侧丘脑和岛叶、左枕叶和顶叶以及右兰周区。灰质体积与出生体重呈正相关。早产儿胼胝体 FA 减少，前放射冠 FA 增加。此外，IUGR婴儿的小镊子、内囊和外囊、钩突和额枕白质束的FA增加。在几个白质束中观察到轴向扩散率增加。各向异性分数与出生体重和出生胎龄呈正相关。这些数据表明，IUGR 对灰质和白质发育的影响不同，优先影响灰质。 12 个月时，IUGR 与一组特定的结构灰质减少相关。白质遵循不寻常的发育模式，并且显然受到 IUGR 和早产的共同影响。 (C) 2013 Elsevier B.V. 保留所有权利。
Intrauterine growth restriction (IUGR) is associated with a high risk of abnormal neuro-development. Underlying neuroanatomical substrates are partially documented. We hypothesized that at 12 months preterm infants would evidence specific white-matter microstructure alterations and gray-matter differences induced by severe IUGR. Twenty preterm infants with IUGR (26-34 weeks of gestation) were compared with 20 term-born infants and 20 appropriate for gestational age preterm infants of similar gestational age. Preterm groups showed no evidence of brain abnormalities. At 12 months, infants were scanned sleeping naturally. Gray-matter volumes were studied with voxel-based morphometry. White-matter microstructure was examined using tract-based spatial statistics. The relationship between diffusivity indices in white matter, gray matter volumes, and perinatal data was also investigated. Gray-matter decrements attributable to IUGR comprised amygdala, basal ganglia, thalamus and insula bilaterally, left occipital and parietal lobes, and right perirolandic area. Gray-matter volumes positively correlated with birth weight exclusively. Preterm infants had reduced FA in the corpus callosum, and increased FA in the anterior corona radiata. Additionally, IUGR infants had increased FA in the forceps minor, internal and external capsules, uncinate and fronto-occipital white matter tracts. Increased axial diffusivity was observed in several white matter tracts. Fractional anisotropy positively correlated with birth weight and gestational age at birth. These data suggest that IUGR differentially affects gray and white matter development preferentially affecting gray matter. At 12 months IUGR is associated with a specific set of structural gray-matter decrements. White matter follows an unusual developmental pattern, and is apparently affected by IUGR and prematurity combined. (C) 2013 Elsevier B.V. All rights reserved.