Mañeru Cristina, Serra-Grabulosa Josep M, Junqué Carme, Salgado-Pineda Pilar, Bargalló Núria, Olondo Miren, Botet-Mussons Francesc, Tallada Mercé, Mercader Josep Maria
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, C/Casanova, 143, 08036 Barcelona, Spain.
J Neuroimaging. 2003 Jan;13(1):68-74.
Previous studies have shown the hippocampus and basal ganglia to be highly sensitive to hypoxic-ischemic insult. The authors' aim was to evaluate the long-term effects of perinatal asphyxia (PA) on the hippocampus and caudate nucleus in a group of participants born at term and who met the criteria for hypoxic-ischemic encephalopathy (HIE). Additionally, the authors looked for damage in other brain regions using voxel-based morphometry (VBM).
The sample consisted of 13 participants (8 boys and 5 girls) with a mean age at study of 16.23 years (+/- 2.89) with antecedents of perinatal asphyxia, diagnosed as moderate hypoxic-ischemic encephalopathy. A group of 13 healthy adolescents matched for age, sex, educational level, and social background were recruited as a comparison group. MR scans were acquired on a 1.5T Signa (General Electric, Milwaukee, WI) to evaluate hippocampal and caudate volumes and to perform VBM analysis. Finally, Rey's Auditory Verbal Learning Test was administered to evaluate verbal long-term memory.
HIE participants were found to have bilateral hippocampal atrophy (P = .015) and gray matter damage in temporal and frontal lobes. The caudate nucleus showed no atrophic changes in PA participants, and VBM analysis did not reveal other consistent brain abnormalities. Verbal long-term memory was slightly worse in HIE participants.
These findings indicate that PA produces hippocampal and other nonspecific long-term damage, which cannot be compensated for by plasticity mechanisms. However, this damage does not preclude normal development and scholarship.
既往研究表明，海马体和基底神经节对缺氧缺血性损伤高度敏感。作者的目的是评估围产期窒息（PA）对一组足月出生且符合缺氧缺血性脑病（HIE）标准的参与者海马体和尾状核的长期影响。此外，作者使用基于体素的形态学测量（VBM）方法寻找其他脑区的损伤情况。
样本包括13名参与者（8名男孩和5名女孩），研究时的平均年龄为16.23岁（±2.89），有围产期窒息史，被诊断为中度缺氧缺血性脑病。招募了13名年龄、性别、教育水平和社会背景相匹配的健康青少年作为对照组。在1.5T Signa（通用电气公司，威斯康星州密尔沃基）上进行磁共振成像扫描，以评估海马体和尾状核的体积，并进行VBM分析。最后，进行雷伊听觉语言学习测试以评估语言长期记忆。
发现HIE参与者双侧海马体萎缩（P = 0.015），颞叶和额叶存在灰质损伤。PA参与者的尾状核未显示萎缩性变化，VBM分析也未发现其他一致的脑部异常。HIE参与者的语言长期记忆略差。
这些发现表明，PA会造成海马体及其他非特异性的长期损伤，这种损伤无法通过可塑性机制得到代偿。然而，这种损伤并不妨碍正常发育和学业。
