fMRI and DTI in Children with PVH/PVL

描述（由申请人提供）：早产儿有脑室周围出血（PVH）和脑室周围白质软化（PVL）的风险，这些病变分别导致单侧和多灶性白色损害。PVH和PVL儿童有神经发育障碍的风险。本研究的目的是将PVH和PVL引起的白色损害的程度和模式与语言和认知结果联系起来。两个复杂的MRI程序将补充行为测试。扩散张量成像（DTI）提供了详细的基于体素的定量信息的完整性的白色物质的微观结构;功能性磁共振成像（fMRI）的特点的模式的神经活动的认知技能。功能磁共振成像任务将评估已知由广泛分布的脑回路支持的成熟功能的领域，这些脑回路可能在白色物质损伤后受损--依赖于半球间整合的句法复杂句子的理解，以及依赖于枕-额和皮质-皮质下整合的眼反应抑制和空间工作记忆。这些方法的结合将使我们能够将大脑结构、大脑功能和行为结果联系起来。受试者为40名9至14岁的早产PVH或PVL青少年。年龄、性别和社会经济地位（SES）匹配的两个对照组（早产儿和足月儿）将阐明白色损害与其他影响（如年龄和早产）对结局的贡献。回归分析将评估全局和特定轨道白色物质损伤与行为结果的关联。模型还将考虑年龄、性别、SES和灰质损伤程度对白色物质完整性和结果的贡献。将根据白色物质损伤的程度和模式以及行为测量评分来评价fMRI上的激活模式。我们将识别揭示神经结构和功能之间重要关系的案例。这项研究将有助于了解PVH和PVL的结果，这是一个重要的问题，因为有大量的受影响婴儿。这将有助于理解白色物质连接在认知过程正常发展中的重要性。这也将有助于理解白色物质损伤的影响和早期脑损伤后皮质可塑性的发展。

DESCRIPTION (provided by applicant): Children born prematurely are at risk for Periventricular Hemorrhage (PVH) and Periventricular Leukomalacia (PVL), lesions which lead to unilateral and multi-focal white matter damage, respectively. Children with PVH and PVL are at risk for neurodevelopmental disabilities. The goal of this study is to relate the degree and patterns of white matter damage from PVH and PVL to linguistic and cognitive outcomes. Two sophisticated MRI procedures will complement behavioral testing. Diffusion Tensor Imaging (DTI) provides detailed voxel-based quantitative information on the integrity of white matter microstructure; functional Magnetic Resonance Imaging (fMRI) characterizes the patterns of neural activity underlying cognitive skills. fMRI tasks will assess domains known to be supported in mature functioning by widely distributed brain circuitry that may be impaired after white matter injury-comprehension of syntactically complex sentences, which relies on interhemispheric integration, and oculomotor response inhibition and spatial working memory, which rely on occipital-frontal and cortical-subcortical integration. The combination of methods will allow us to link brain structure, brain functioning, and behavioral outcomes. Participants will be 40 adolescents, 9 to 14 years old, with PVH or PVL from preterm delivery. Two control groups (children born prematurely and children born at term) matched for age, gender and socioeconomic status (SES) will clarify the contribution of white matter damage versus other influences, such as age and premature delivery, on outcomes. Regression analyses will evaluate the associations of global and track-specific white matter damage and behavioral outcomes. Models will also consider the contributions of age, gender, SES, and extent of gray matter injury to white matter integrity and outcomes. Patterns of activation on fMRI will be evaluated in relation to the extent and pattern of white matter damage and to scores on the behavioral measures. We will identify cases that reveal important relations between neural structure and function. This study will contribute to understanding the outcomes of PVH and PVL, an important issue because of the large number of affected infants. It will contribute to understanding the importance of white matter connections in the normal development of cognitive processes. It will also contribute to understanding the impact of white matter injury and the development of cortical plasticity after early brain injuries.