Brain Volumes at Term-Equivalent Age Are Associated with 2-Year Neurodevelopment in Moderate and Late Preterm Children
Brain Volumes at Term-Equivalent Age Are Associated with 2-Year Neurodevelopment in Moderate and Late Preterm Children
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DOI：
10.1016/j.jpeds.2016.04.002
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发表时间：
2016-07-01
影响因子：
5.1
通讯作者：
Doyle, Lex W.
中科院分区：
文献类型：
--
作者：
Cheong, Jeanie L. Y.;Thompson, Deanne K.;Doyle, Lex W.
目的探讨中晚期早产儿2岁发育与足月龄脑成熟、脑损伤及脑容量的关系。研究设计在出生时招募中度和晚期早产儿，并在2岁时使用Bayley婴幼儿发育量表（第三版）进行评估。在同等年龄进行脑磁共振成像（MRI），并定性评估脑成熟（内囊后肢髓鞘形成和脑回折叠）和损伤。脑容量测量采用先进的分割技术。使用线性回归分析探讨脑MRI测量与发育结果之间的关系。结果共197名儿童接受了MRI检查，并使用Bayley婴幼儿发育量表（第三版）进行了评估。脑组织总体积越大，认知和语言得分越高（脑体积每增加10%调整系数；95% CI分别为3.2[0.4,5.6]和5.6[2.4,8.8]）。在认知和语言分数与白质体积、语言分数与多脑结构、运动分数与小脑体积之间也有类似的关系。在对其他围产儿因素进行校正后，小脑体积较大与语言和运动评分较高独立相关。很少有证据表明后肢内囊髓鞘形成、脑回折叠或损伤与2年的发展有关。结论：中等和晚期早产儿足月龄脑组织、白质和小脑体积较大，神经发育较好。脑容量可能是中度和晚期早产儿神经发育缺陷的重要标志。
Objective To explore the association between brain maturation, injury, and volumes at term-equivalent age with 2-year development in moderate and late preterm children.Study design Moderate and late preterm infants were recruited at birth and assessed at age 2 years using the Bayley Scales of Infant and Toddler Development, Third Edition. Brain magnetic resonance imaging (MRI) was performed at term-equivalent age and qualitatively assessed for brain maturation (myelination of the posterior limb of the internal capsule and gyral folding) and injury. Brain volumes were measured using advanced segmentation techniques. The associations between brain MRI measures with developmental outcomes were explored using linear regression analyses.Results A total of 197 children underwent MRI and assessed using the Bayley Scales of Infant and Toddler Development, Third Edition. Larger total brain tissue volumes were associated with higher cognitive and language scores (adjusted coefficients per 10% increase in brain size; 95% CI of 3.2 [0.4, 5.6] and 5.6 [2.4, 8.8], respectively). Similar relationships were documented for white matter volumes with cognitive and language scores, multiple cerebral structures with language scores, and cerebellar volumes with motor scores. Larger cerebellar volumes were independently associated with better language and motor scores, after adjustment for other perinatal factors. There was little evidence of relationships between myelination of the posterior limb of the internal capsule, gyral folding, or injury with 2-year development.Conclusions Larger total brain tissue, white matter, and cerebellar volumes at term-equivalent age are associated with better neurodevelopment in moderate and late preterm children. Brain volumes may be an important marker for neurodevelopmental deficits described in moderate and late preterm children.