Nosarti Chiara, Al-Asady Mazin H S, Frangou Sophia, Stewart Ann L, Rifkin Larry, Murray Robin M
Division of Psychological Medicine, Department of Psychiatry, Institute of Psychiatry, London, UK.
Brain. 2002 Jul;125(Pt 7):1616-23. doi: 10.1093/brain/awf157.
Infants born very preterm have an increased risk of brain injury. Given the great increase in the number of such infants that are surviving, it is important to establish whether any resultant brain abnormalities persist into adolescence and adult life. We therefore examined in vivo whole brain, grey matter, white matter and hippocampal volumes, ventricular size and grey/white matter ratios in a series of adolescents who had been born very preterm, and an age-matched full-term control group. Structural MRI was carried out on a cohort of 72 adolescents (mean age 15 years) who were born before 33 weeks, and 48 age-matched full-term controls. Brain measurements were made blind to group affiliation using stereological principles. After controlling for gender and height, the very preterm subjects showed a 6.0% decrease in whole brain volume, and an 11.8% decrease in cortical grey matter volume, as well as a 15.6% decrease in right and a 12.1% decrease in left hippocampal volumes; they also had a 42.0% increase in the size of the lateral ventricles. Therefore, individuals who were born very preterm continue to show noticeable decrements in brain volumes and striking increases in lateral ventricular volume into adolescence. The functional significance of these abnormalities merits further investigation.
极早产儿发生脑损伤的风险增加。鉴于此类存活婴儿数量大幅增加，确定由此产生的任何脑异常是否会持续至青少年期和成年期很重要。因此，我们对一系列极早产儿青少年以及年龄匹配的足月儿对照组进行了活体全脑、灰质、白质和海马体积、脑室大小及灰白质比例的检查。对72名出生于33周前的青少年（平均年龄15岁）和48名年龄匹配的足月儿对照组进行了结构磁共振成像（MRI）检查。使用体视学原理在不了解分组情况的前提下进行脑测量。在控制了性别和身高因素后，极早产儿受试者的全脑体积减少了6.0%，皮质灰质体积减少了11.8%，右侧海马体积减少了15.6%，左侧海马体积减少了12.1%；他们的侧脑室大小还增加了42.0%。因此，极早产儿在进入青少年期后，脑体积仍持续出现明显减少，侧脑室体积显著增加。这些异常的功能意义值得进一步研究。
