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极低出生体重儿幸存者脑部的定量磁共振成像

Quantitative magnetic resonance imaging of the brain in survivors of very low birth weight.

作者信息

Abernethy L J, Palaniappan M, Cooke R W I

机构信息

Department of Child Health, Royal Liverpool Childrens Hospital, Alder Hey, Liverpool, UK.

出版信息

Arch Dis Child. 2002 Oct;87(4):279-83. doi: 10.1136/adc.87.4.279.

Abstract

BACKGROUND

Children who survive very low birth weight (VLBW) without major disability have a high prevalence of learning difficulty, attention deficit, and dyspraxia.

AIMS

To determine whether learning difficulty in children with VLBW is associated with structural brain abnormalities.

METHODS

A total of 87 children (aged 15-16 years) with a history of VLBW (<1500 g) and eight age matched full term controls have been studied with detailed magnetic resonance brain scans. Volume measurements of the caudate nuclei and hippocampal formations were made.

RESULTS

Scans in 42.5% of the children showed evidence of perinatal brain injury. There was no significant difference in IQ, dyspraxia, or attention deficit between children with qualitatively normal and abnormal scans. However, quantitative volumetric analysis showed that children with a low IQ had smaller volume measurements for the right caudate nucleus and left hippocampus, and a smaller hippocampal ratio (left volume:right volume) than those with normal IQ.

CONCLUSION

Data suggest that learning disorder, attention deficit, and dyspraxia in children who survive VLBW do not correlate with conventional markers of perinatal brain injury, and may be related to global brain growth and the development of key structures, such as the caudate nuclei and hippocampal formations.

摘要

背景

极低出生体重(VLBW)且无重大残疾存活下来的儿童,学习困难、注意力缺陷和发育性运动障碍的患病率很高。

目的

确定极低出生体重儿童的学习困难是否与脑结构异常有关。

方法

对87名有极低出生体重(<1500克)病史的儿童(15 - 16岁)和8名年龄匹配的足月对照儿童进行了详细的脑部磁共振扫描研究。对尾状核和海马结构进行了体积测量。

结果

42.5%的儿童扫描显示有围产期脑损伤的证据。扫描结果正常和异常的儿童在智商、发育性运动障碍或注意力缺陷方面没有显著差异。然而,定量体积分析表明,智商低的儿童右侧尾状核和左侧海马的体积测量值较小,海马比率(左体积:右体积)比智商正常的儿童小。

结论

数据表明,极低出生体重存活儿童的学习障碍、注意力缺陷和发育性运动障碍与围产期脑损伤的传统标志物无关,可能与全脑生长以及关键结构如尾状核和海马结构的发育有关。

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