NEURODEVELOPMENT AND EXPERIENCE: BEHAVIOR, QEEG AND MRI

妊娠28到30周是一个意义重大的时期 神经重组，启动胎儿行为的开始 单独和维持宫外存活期。在这里出生的婴儿 过渡期，PT婴儿成长最快、规模最大的一段 (PT)人群，后来表现出出乎意料的显著脑功能障碍 并一直处于危险之中，一直到上学年龄。高达52%的这类婴儿 精神运动、认知和注意力功能有缺陷， 情绪脆弱和学校表现不达标，所有这些都被认为是 由于在处理复杂信息方面存在中央赤字，并可归因于 联合大脑皮层额叶系统。据推测，这样一个中心 缺陷可能是由于脑白质易损性增加所致 妊娠的最后三个月，是其发育最快的阶段。 由于不适当的感觉刺激造成的持续压力被认为是 导致这种早期大脑结构和功能的改变。的目的是 这项拟议的研究是为了确定PT脑在 最后12周孕期到NICU环境的短暂体验 为了估计这种经历在重塑中的潜力 神经解剖结构和神经发育功能。一位潜在的 将进行随机临床试验。60名出生时身体健康的患者 在28到30周之间将随机分配到两种治疗中的一种 条件，代表着明显不同的NICU经历，标准护理 (SC)和发展护理(DC)。他们将与30名健康的足月女性进行比较 婴儿(FT)。所有90名婴儿将在怀孕后42周接受评估 三个神经发育领域，神经行为功能(APIB；Prechtl)， 神经电生理功能(qEEG；Fver)和神经解剖结构 (3D-MRI；DTI)。具体的感兴趣区域将在早期进行调查 成熟的枕叶和较晚成熟的额叶和胼胝体 结构。假设接受DC的PTS将展示 与接受治疗的患者相比，区域内的区域性脑增强 南加州大学。此外，与接受SC的PTS相比，这种PTS将更类似于FTS。 为了检验这一假设，我们将按领域使用Manova。典范 将使用相关性来检查 域名。预计拟议的研究将为 第一次体验对更高层次重塑的影响 神经功能和神经结构过程，并将建议和方法 对于以后的赤字改善，与PT的最大部分相关 人口。

The period from 28 to 30 weeks gestation is one of significant neurological reorganization, initiating the beginning of fetal behavioral individually and maintenance of extrauterine survival. Infants born at this transitional stage, the fastest growing and largest segment of the PT infant (PT) population, later on exhibit unexpectedly significant brain dysfunction and remain at risk well into school age. Up to 52 percent of such infants present with deficits in psychomotor, cognitive, and attentional function, emotional vulnerability and substandard school performance, all thought to be due to a central deficit in processing complex information and attributable to association cortical frontal systems. It is postulated that such a central deficit may result from increased vulnerability of cerebral white matter during the last trimester of gestation, its phase of most rapid development. Persistent stress due to inappropriate sensory stimulation is thought to contribute to such alteration of early brain structure and function. The aim of the proposed study is to identify specific adaptations of the PT brain in the last 12 weeks of gestation to the transient experience of the NICU environment in order to estimate the potential of such experience in remodeling neuroanatomical structure and neurodevelopmental function. A prospective randomized clinical trial will be conducted. Sixty medically healthy PTs born between 28 and 30 weeks will be randomly assigned to one of two treatment conditions, representing measurably different NICU experiences, standard care (SC) and developmental care (DC). They will be compared to 30 healthy full-term infants (FT). All 90 infants will be assessed at 42 w postconceptional age in three neurodevelopmental domains, neurobehavioral function (APIB; Prechtl), neuroelectrophysiological function (qEEG; FVER), and neuroanatomic structure (3D-MRI; DTI). Specific regions of interest investigated will be the early maturing occipital lobe and the later maturing frontal lobe and corpus callosum structures. It is hypothesized that PTs who receive DC will demonstrate regionally specific brain enhancement within domain compared to PTs who receive SC. Furthermore, such PTs will be more similar to FTs that PTs who receive SC. MANOVA will be employed by domain in order to test this hypothesis. Canonical correlations will be used to examine the relationships among and within the domains. It is anticipated that the proposed study will demonstrate for the first time the effect of experience on the remodeling of higher order neurofunctional and neuro structural processes, and will suggest and approach for later deficit amelioration, relevant to the largest segment of the PT population.