The effects of hemorrhagic parenchymal infarction on the establishment of sensori-motor structural and functional connectivity in early infancy
The effects of hemorrhagic parenchymal infarction on the establishment of sensori-motor structural and functional connectivity in early infancy
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DOI：
10.1007/s00234-014-1412-5
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发表时间：
2014-11-01
期刊：
影响因子：
2.8
通讯作者：
Edwards, A. D.
中科院分区：
文献类型：
--
作者：
Arichi, T.;Counsell, S. J.;Edwards, A. D.
该研究的目的是描述局灶性围产期脑损伤和脑瘫高风险婴儿发育中的感觉运动系统的结构和功能连接的变化。采用功能磁共振成像（fMRI）和弥散张量成像（DTI）数据研究了6例足月年龄早产儿的功能和结构连接框架的发育。首先在三名没有局灶性病理的婴儿中发现了这一特征，然后将其与三名单侧出血性脑实质梗死和继发局灶性脑室周围白质病变的婴儿进行了比较，这些婴儿后来发展为血瘫。无论局灶性病理如何，被动手部运动的功能反应均发生在对侧地盂周围皮层。在单侧脑室周围损伤的婴儿中，传入丘脑-皮质束似乎已经形成了代偿轨迹，绕过了损伤区域。相反，在局灶性脑损伤后的足月年龄，传出皮质脊髓束表现出明显的不对称性。感觉-运动网络分析表明，尽管病理异常，半球间功能连通性在很大程度上得到了保留，而且这种损害可能与不良的神经发育结果有关。局灶性围产期脑损伤后，结构和功能连接的改变已经存在，可以在足月等效年龄用MRI进行表征。这个小病例系列的结果表明，这些技术可能为脑瘫的预后和病理生理学提供有价值的新信息。
The objective of the study was to characterize alterations of structural and functional connectivity within the developing sensori-motor system in infants with focal perinatal brain injury and at high risk of cerebral palsy.Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) data were used to study the developing functional and structural connectivity framework in six infants born prematurely at term equivalent age. This was first characterised in three infants without focal pathology, which was then compared to that derived from three infants with unilateral haemorrhagic parenchymal infarction and a subsequent focal periventricular white matter lesion who developed later haemiparesis.Functional responses to passive hand movement were in the contralateral perirolandic cortex, regardless of focal pathology. In infants with unilateral periventricular injury, afferent thalamo-cortical tracts appeared to have developed compensatory trajectories which circumvented areas of damage. In contrast, efferent corticospinal tracts showed marked asymmetry at term equivalent age following focal brain injury. Sensori-motor network analysis suggested that inter-hemispheric functional connectivity is largely preserved despite pathology and that impairment may be associated with adverse neurodevelopmental outcome.Following focal perinatal brain injury, altered structural and functional connectivity is already present and can be characterized with MRI at term equivalent age. The results of this small case series suggest that these techniques may provide valuable new information about prognosis and the pathophysiology underlying cerebral palsy.