Early experience alters brain function and structure
Early experience alters brain function and structure
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DOI：
10.1542/peds.113.4.846
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发表时间：
2004-04-01
期刊：
影响因子：
8
通讯作者：
Eichenwald, EC
中科院分区：
文献类型：
--
作者：
Als, H;Duffy, FH;Eichenwald, EC
Objective.探讨早期经验对脑功能和结构的影响。一项随机临床试验测试了新生儿个体化发育护理和评估计划（NIDCAP）的神经发育有效性。30名出生时胎龄为28至33周且无已知发育风险因素的早产儿参与了该试验。NIDCAP在重症监护室入院后72小时内开始，并持续到2周龄，纠正早产。对照组（14例）和实验组（16例）婴儿在2周龄和9月龄时进行健康状况、生长和神经行为评估，在2周龄时进行脑电图频谱相干性、磁共振弥散张量成像和横向弛豫时间测量。治疗前后，两组在医学和人口统计学上具有可比性。然而，实验组表现出明显更好的神经行为功能，额叶和主要枕叶脑区的广泛范围之间的一致性增加，左侧内囊的相对各向异性更高，右侧内囊和额叶白色物质的趋势。横向弛豫时间无差异。行为功能在9个月矫正龄时也得到改善。3个神经发育领域之间存在显著的相关性。结果表明，实验组婴儿的功能和纤维结构均优于对照组。这是NIDCAP增强脑功能和结构的第一个体内证据。这项研究表明，足月前的经验质量可能会显着影响大脑发育。
Objective. To investigate the effects of early experience on brain function and structure.Methods. A randomized clinical trial tested the neurodevelopmental effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Thirty preterm infants, 28 to 33 weeks' gestational age (GA) at birth and free of known developmental risk factors, participated in the trial. NIDCAP was initiated within 72 hours of intensive care unit admission and continued to the age of 2 weeks, corrected for prematurity. Control ( 14) and experimental ( 16) infants were assessed at 2 weeks' and 9 months' corrected age on health status, growth, and neurobehavior, and at 2 weeks' corrected age additionally on electroencephalogram spectral coherence, magnetic resonance diffusion tensor imaging, and measurements of transverse relaxation time.Results. The groups were medically and demographically comparable before as well as after the treatment. However, the experimental group showed significantly better neurobehavioral functioning, increased coherence between frontal and a broad spectrum of mainly occipital brain regions, and higher relative anisotropy in left internal capsule, with a trend for right internal capsule and frontal white matter. Transverse relaxation time showed no difference. Behavioral function was improved also at 9 months' corrected age. The relationship among the 3 neurodevelopmental domains was significant. The results indicated consistently better function and more mature fiber structure for experimental infants compared with their controls.Conclusions. This is the first in vivo evidence of enhanced brain function and structure due to the NIDCAP. The study demonstrates that quality of experience before term may influence brain development significantly.