CEREBRAL AUTOREG & PERIVENTRICULAR LEUKOMALACIA IN PREMIES

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。主要分析将检查新生儿期PVL的诊断（通过头颅US、早产MR和足月MR）与结构（1年MR）和功能（1年神经发育）结局之间的关系。独立变量为：二元（PVL/无PVL）和分类（无PVL、局灶性PVL、弥漫性PVL、局灶性和弥漫性PVL）。相关结构变量将是WM中有髓鞘WM和RA的体积。因功能变量为：神经学结局分类，即正常、无残疾的异常、有残疾的异常;发育结局连续，即，整体Bayley量表评分。次要分析将通过检查结构（1年MR）和功能（神经/认知）结局之间的关系来探索临床-解剖学相关性。自变量为（1）WM体积（2）标准WM部位的RA水平;（3）1H-MRS检测WM中NAA的浓度，因变量为（1）运动结果（正常、双瘫、偏瘫、四肢瘫），和（2）个体贝利量表分项评分，即精神发育指数（MDI）和精神发育指数（PDI）。由于绝大多数髓鞘是在足月后形成的，因此与1年MR研究相比，足月MR研究可能需要更大的样本量来证明统计学显著的结构差异。为了确定所需的样本量，我们使用术语MR研究中的WM体积作为关注的结局。我们使用我们的初步数据，并假设在新生儿期WM损伤的婴儿是压力被动，而没有WM损伤的婴儿是自动调节。基于这些数据，并假设在0.05水平下进行双样本检验，自动调节与压力被动调节之间的比例为3：1，我们将需要总共约20名婴儿来证明婴儿的血容量与压力被动调节之间的显著差异。

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