Neurobehavioral Impairments in Preterm Children - A Longitudinal MR Study

早产儿的神经行为损伤——一项纵向 MR 研究

• 批准号: 8052886
• 负责人: TERRIE E INDER
• 金额: $ 31.97万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8052886
• 关键词: 2 year old; 6 year old; Address; Admission activity; Age; Anxiety; Atlases; Attention; Attention deficit hyperactivity disorder; Australia; Autistic Disorder; Behavioral; Biological Markers; Birth; Blindness; Brain; Brain Injuries; Caring; Cerebral Palsy; Cerebrum; Characteristics; Child; Childhood; Clinical; Cognition; Communities; Control Groups; Data; Data Analyses; Databases; Delayed Memory; Development; Diffusion Magnetic Resonance Imaging; Emotional; Environmental Risk Factor; Evaluation; Evolution; Face; Family; Financial compensation; Functional disorder; Gestational Age; Growth; Health; Hospitals; Image; Impaired cognition; Impairment; Incidence; Infant; Language Delays; Language Development; Learning Disabilities; Lesion; Longitudinal Studies; Magnetic Resonance; Magnetic Resonance Imaging; Measurement; Measures; Mental Depression; Mental Health; Microscopic; Motor; Nature; Neonatal; Neurobiology; Neurologic; Outcome; Parenting behavior; Perinatal; Population; Pregnancy; Premature Birth; Premature Infant; Prevalence; Problem behavior; Psychological Tests; Public Health; Readiness; Recovery; Recruitment Activity; Risk Factors; Schizophrenia; School-Age Population; Schools; Sensitivity and Specificity; Social support; Structure; Surface; Survival Rate; Techniques; Underachievement; Universities; Variant; Visual; Visual Perception; Washington; Withdrawal; Woman; base; brain volume; cohort; comparison group; deafness; design; developmental disease; disability; early childhood; executive function; experience; follow-up; imaging modality; improved; insight; longitudinal course; longitudinal design; morphometry; neurobehavioral; neuromechanism; neuropsychological; novel; prenatal; relating to nervous system; response; skills; social; social skills; visual motor

DESCRIPTION (provided by applicant): Preterm birth is a major public-health issue because of its increasing incidence combined with the frequent occurrence of subsequent behavioral, neurological, and psychiatric challenges faced by surviving infants. Approximately 10-15% of very preterm children (born < 30 weeks gestational age) develop cerebral palsy, and 30 - 60% of very preterm children experience cognitive impairments. These impairments include visual-motor problems, attentional difficulties, impaired memory, delayed acquisition of language, executive dysfunction, learning disabilities, poor social skills, and higher rates of social withdrawal, anxiety and depression. In addition, an increased prevalence of developmental disorders such as attention deficit/hyperactivity disorder, autism and schizophrenia, has been described in the preterm population. A greater understanding of the mechanisms leading to neurobehavioral impairments in preterm children is an important step in developing strategies for improving clinical outcomes. We have a unique, large cohort of 229 preterm infants (<30 weeks gestation or <1250g) for whom we have developed an extensive perinatal database and obtained advanced magnetic resonance (MR) images at term equivalent. Evaluation of these data has led to novel insights into the nature of the cerebral lesion associated with preterm birth. Importantly, we have maintained ongoing contact with 97% of this cohort during the course of longitudinal neuropsychological follow up. This population now offers a rare opportunity for longitudinal evaluation of the mechanisms of neurobehavioral impairment in association with modern, advanced MR imaging methods. We propose to apply state-of-the-art MR imaging methods to this cohort at 6 years of age in conjunction with neuropsychological evaluation. The MR data will allow us to study the evolution of structural changes in the brain from term equivalent into childhood in both the preterm and term born infants. The techniques will include surface based morphometry (SBM), brain volume measurements (volumetry), and diffusion tensor imaging (DTI). The MR approaches will provide both macroscopic (volumes and SBM) and microscopic (DTI) measures of cerebral development that address different aspects of brain structure and maturation. These will be related to the longitudinal social and neuropsychological evaluations to investigate the relationship of MR measures to neurobehavioral impairments. The longitudinal design will allow us to study both structural abnormalities and compensatory changes over childhood in response to early brain injury. These data will likely provide new understanding of neural recovery and strategies for improving outcomes in preterm infants. PUBLIC HEALTH RELEVANCE: This study is designed to use magnetic resonance (MR) imaging to improve our understanding of the brain injury sustained by prematurely-born infants and how the brain subsequently develops over childhood. The longitudinal design, using both advanced MR imaging and psychological testing, will allow us to study both structural abnormalities and positive adaptive changes over childhood in response to early brain injury. This will assist us in understanding how to reduce the global and specific disabilities that these vulnerable children later face.

描述(由申请人提供)：早产是一个重大的公共卫生问题，因为它的发病率不断增加，而且存活的婴儿随后面临的行为、神经和精神方面的挑战也经常发生。大约10%-15%的极早产儿(出生和30周胎龄)发展为脑性瘫痪，30%-60%的极早产儿经历认知障碍。这些障碍包括视觉运动问题、注意力障碍、记忆力受损、语言习得延迟、执行功能障碍、学习障碍、社交技能差，以及较高的社交退缩、焦虑和抑郁发生率。此外，在早产儿中，注意缺陷/多动障碍、自闭症和精神分裂症等发育障碍的患病率也有所增加。更好地了解导致早产儿神经行为障碍的机制是制定改善临床结果的策略的重要一步。我们有229名早产儿(妊娠30周或1250g)的独特、庞大的队列，我们为他们开发了一个广泛的围产期数据库，并获得了相当于足月的高级磁共振(MR)图像。对这些数据的评估导致了对与早产相关的脑损伤性质的新见解。重要的是，在纵向神经心理学随访的过程中，我们与97%的受试者保持着持续的联系。这一人群现在提供了一个难得的机会，可以结合现代先进的磁共振成像方法对神经行为损害的机制进行纵向评估。我们建议在6岁时将最先进的磁共振成像方法应用于这一队列，并结合神经心理学评估。磁共振数据将使我们能够研究早产儿和足月儿从足月到童年的大脑结构变化的演变。这些技术将包括基于表面的形态测量(SBM)、脑体积测量(体积测量)和扩散张量成像(DTI)。MR方法将提供脑发育的宏观(体积和SBM)和微观(DTI)测量，以解决大脑结构和成熟的不同方面。这些将与纵向的社会和神经心理评估有关，以调查MR措施与神经行为损害的关系。纵向设计将使我们能够研究儿童时期对早期脑损伤的结构异常和代偿性变化。这些数据可能会为改善早产儿神经康复和改善结局的策略提供新的理解。与公众健康相关：这项研究旨在使用磁共振(MR)成像来提高我们对早产婴儿大脑损伤的理解，以及大脑随后如何在童年时期发育。纵向设计，使用先进的磁共振成像和心理测试，将使我们能够研究儿童时期对早期脑损伤的结构异常和积极的适应性变化。这将有助于我们了解如何减少这些弱势儿童今后面临的全球性和具体残疾。

项目成果

Hippocampal volume and memory and learning outcomes at 7 years in children born very preterm.

• DOI: 10.1017/s1355617713000891
• 发表时间: 2013-11
• 期刊: Journal of the International Neuropsychological Society : JINS
• 作者: Omizzolo C;Thompson DK;Scratch SE;Stargatt R;Lee KJ;Cheong J;Roberts G;Doyle LW;Anderson PJ
• 通讯作者: Anderson PJ

White matter abnormalities and impaired attention abilities in children born very preterm.

• DOI: 10.1016/j.neuroimage.2015.08.044
• 发表时间: 2016-01-01
• 期刊: NeuroImage
• 影响因子: 5.7
• 作者: Murray AL;Thompson DK;Pascoe L;Leemans A;Inder TE;Doyle LW;Anderson JFI;Anderson PJ
• 通讯作者: Anderson PJ

Thirteen-Year Outcomes in Very Preterm Children Associated with Diffuse Excessive High Signal Intensity on Neonatal Magnetic Resonance Imaging.

• DOI: 10.1016/j.jpeds.2018.10.016
• 发表时间: 2019-03
• 期刊: The Journal of pediatrics
• 作者: Mürner-Lavanchy IM;Kidokoro H;Thompson DK;Doyle LW;Cheong JLY;Hunt RW;Inder TE;Anderson PJ
• 通讯作者: Anderson PJ

Neurodevelopmental Outcomes and Neural Mechanisms Associated with Non-right Handedness in Children Born Very Preterm.

与早产儿非右利手相关的神经发育结果和神经机制。

• DOI: 10.1017/s1355617715000715
• 发表时间: 2015
• 期刊: Journal of the International Neuropsychological Society : JINS
• 作者: Pascoe,Leona;Scratch,ShannonE;Burnett,AliceC;Thompson,DeanneK;Lee,KatherineJ;Doyle,LexW;Cheong,JeanieLY;Inder,TerrieE;Anderson,PeterJ
• 通讯作者: Anderson,PeterJ

The Structural Connectome and Internalizing and Externalizing Symptoms at 7 and 13 Years in Individuals Born Very Preterm and Full Term.

• DOI: 10.1016/j.bpsc.2021.10.003
• 发表时间: 2022-04
• 期刊: Biological psychiatry. Cognitive neuroscience and neuroimaging
• 作者: Gilchrist CP;Thompson DK;Kelly CE;Beare R;Adamson C;Dhollander T;Lee K;Treyvaud K;Matthews LG;Tolcos M;Cheong JLY;Inder TE;Doyle LW;Cumberland A;Anderson PJ
• 通讯作者: Anderson PJ