CEREBRAL AUTOREG & PERIVENTRICULAR LEUKOMALACIA IN PREMIES

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。初步分析将检查新生儿PVL的诊断(通过头颅超声、早产MR和足月MR)与结构(一年MR)和功能(一年神经发育)结果之间的关系。自变量为：二元(PVL/无PVL)和分类(无PVL、局限性PVL、弥漫性PVL、局限性和弥漫性PVL)。因变量为有髓白质体积和白质类风湿因子。因应功能变量将是：神经功能结果分类，即正常、异常无残疾、异常伴残疾；发育结果连续，即整体贝利量表评分。二次分析将通过检查结构(一年MR)和功能(神经/认知)结果之间的关系来探索临床解剖相关性。自变量将是(1)白质体积(无髓和总体积)、皮质灰质、皮质下灰质、全脑；(2)标准白质部位的RA水平；(3)1H-MRS测定白质中NAA的浓度。因变量将是(1)运动结果(正常、双瘫、偏瘫、四肢瘫痪)，以及(2)个体贝利量表分值，即智力发展指数(MDI)和精神运动发育指数(PDI)。由于绝大多数髓鞘是在足月后形成的，术语磁共振研究可能需要更大的样本量，以证明与一年的磁共振研究相比，在统计学上存在显著的结构性差异。为了确定所需的样本量，我们使用了术语MR研究中的WM体积作为感兴趣的结果。我们利用我们的初步数据，假设新生儿期有WM损伤的婴儿是压力被动的，而没有WM损伤的婴儿是自我调节的。基于这些数据，并假设在0.05水平，自动调节和被动压力之间的比例为3：1的两个样本测试，我们将要求总共大约20个婴儿表现出显著的体积差异。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The primary analysis will examine the relationship between the diagnosis of PVL in the newborn period (by Cranial US, Preterm MR and Term MR) and the structual (One-Year MR) and functional (one-year neurodevelopmental) outcomes. Independent variables will be: binary (PVL/no PVL) and categorical (no PVL, focal PVL, diffuse PVL, focal and diffuse PVL). Dependent structural variables will be volume of myelinated WM and RA in WM. Dependent functional variables will be: neurologic outcome categorical, i.e. normal, abnormal without disability, abnormal with disability; development outcome continuous, i.e., global Bayley Scale score. The secondary analyses will explore clinical-anatomic correlations by examining the relationship between structural (One-Year MR) and functional (neurologic/cognitive) outcomes. Independent variables will be (1) volumes of WM (unmyelinated and total), cortical gray matter, subcortical gray matter, total brain; (2) RA levels in the standard WM locations; and (3) the concentration of NAA in the WM by 1H-MRS. The dependent variables will be (1) motor outcome (normal, diplegia, hemiplegia, quadriplegia), and (2) the individual Bayley Scale sub-scores, i.e. Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI). Since the vast majority of myelin is formed after term, the Term MR studies are likely to demand a larger sample size to demonstrate statistically significant structural differences than the One-Year MR studies. To determine the required sample size we used the WM volume on the Term MR studies as the outcome of interest. We used our preliminary data and assumed that infants with WM injury in the newborn period are pressure passive while infants without WM injury are autoregulating. Based on these data and assuming a two-sample test at 0.05 level with a ratio of 3:1 between autoregulation vs pressure passive, we will require approximately 20 infants total to demonstrate a significant difference in volume o