Injury to the Premature Cerebellum: Outcome is Related to Remote Cortical Development
Injury to the Premature Cerebellum: Outcome is Related to Remote Cortical Development
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DOI：
10.1093/cercor/bhs354
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发表时间：
2014-03-01
期刊：
影响因子：
3.7
通讯作者：
du Plessis, Adre J.
中科院分区：
文献类型：
--
作者：
Limperopoulos, Catherine;Chilingaryan, Gevorg;du Plessis, Adre J.
小脑损伤是早产的一种重要并发症，具有深远的神经精神后遗症。我们先前已经表明，早产儿小脑的孤立性损伤与对侧大脑区域体积增长的后续受损之间存在显著关联。在当前的研究中，我们检验了这些儿童大脑体积增长的远程区域受损与特定领域功能缺陷之间的关系。在40名有孤立性小脑损伤的早产儿中，我们在平均年龄为34个月时进行了神经发育评估和定量磁共振成像（MRI）研究。我们测量了每个大脑半球8个分区的皮质灰质体积以及左右小脑体积。我们发现自闭症的早期迹象与背外侧前额叶皮质体积之间存在极显著的关联（P＜0.001）；粗大运动评分与感觉运动皮质体积之间存在极显著的关联（P＜0.001）；认知和表达性语言评分与运动前区和颞叶中部皮质体积之间存在极显著的关联（P＜0.001）。通过多变量分析，在调整了MRI检查时的年龄和对侧小脑体积后，相应区域大脑体积每增加一个单位，异常结果评分的几率就会降低。这是首次将早产相关小脑损伤幸存者的远程大脑皮质生长继发性受损与功能障碍联系起来的报告。
Cerebellar injury is an important complication of preterm birth with far-reaching neuropsychiatric sequelae. We have previously shown a significant association between isolated injury to the premature cerebellum and subsequent impairment of regional volumetric growth in the contralateral cerebrum. In the current study, we examine the relationship between these remote regional impairments of cerebral volumetric growth and domain-specific functional deficits in these children. In 40 ex-preterm infants with isolated cerebellar injury, we performed neurodevelopmental evaluations and quantitative magnetic resonance imaging (MRI) studies at a mean age of 34 months. We measured cortical gray matter volumes in 8 parcellated regions of each cerebral hemisphere, as well as right and left cerebellar volumes. We show highly significant associations between early signs of autism and dorsolateral prefrontal cortex volume (P 0.001); gross motor scores and sensorimotor cortical volumes (P 0.001); and cognitive and expressive language scores and premotor and mid-temporal cortical volumes (P 0.001). By multivariate analyses, each unit increase in the corresponding regional cerebral volume was associated with lower odds of abnormal outcome score, adjusted for age at MRI and contralateral cerebellar volume. This is the first report linking secondary impairment of remote cerebral cortical growth and functional disabilities in survivors of prematurity-related cerebellar brain injury.