Nagy Zoltan, Westerberg Helena, Skare Stefan, Andersson Jesper L, Lilja Anders, Flodmark Olof, Fernell Elisabeth, Holmberg Kirsten, Bohm Birgitta, Forssberg Hans, Lagercrantz Hugo, Klingberg Torkel
Neonatal Unit, Karolinska Institutet, Stockholm, Sweden.
Pediatr Res. 2003 Nov;54(5):672-9. doi: 10.1203/01.PDR.0000084083.71422.16. Epub 2003 Aug 6.
Preterm birth frequently involves white matter injury and affects long-term neurologic and cognitive outcomes. Diffusion tensor imaging has been used to show that the white matter microstructure of newborn, preterm children is compromised in a regionally specific manner. However, until now it was not clear whether these lesions would persist and be detectible on long-term follow-up. Hence, we collected diffusion tensor imaging data on a 1.5-T scanner, and computed fractional anisotropy and coherence measures to compare the white matter integrity of children born preterm to that of control subjects. The subjects for the preterm group (10.9 +/- 0.29 y; n = 9; birth weight <or= 1500 g; mean gestational age, 28.6 +/- 1.05 wk) possessed attention deficits, a common problem in preterms. They were compared with age- and sex-matched control children (10.8 +/- 0.33 y; n = 10; birth weight >or= 2500; gestational age, >or= 37 wk). We found that the preterm group had lower fractional anisotropy values in the posterior corpus callosum and bilaterally in the internal capsules. In the posterior corpus callosum this difference in fractional anisotropy values may partially be related to a difference in white matter volume between the groups. An analysis of the coherence measure failed to indicate a group difference in the axonal organization. These results are in agreement with previous diffusion tensor imaging findings in newborn preterm children, and indicate that ex-preterm children with attention deficits have white matter disturbances that are not compensated for or repaired before 11 y of age.
早产常伴有白质损伤，并影响长期神经和认知预后。弥散张量成像已被用于显示，早产新生儿的白质微观结构在区域上存在特定方式的受损。然而，直到现在尚不清楚这些病变是否会持续存在以及在长期随访中是否可检测到。因此，我们在1.5-T扫描仪上收集了弥散张量成像数据，并计算了分数各向异性和相干性指标，以比较早产儿童与对照受试者的白质完整性。早产组受试者（年龄10.9±0.29岁；n = 9；出生体重≤1500 g；平均胎龄28.6±1.05周）存在注意力缺陷，这是早产儿童常见的问题。将他们与年龄和性别匹配的对照儿童（10.8±0.33岁；n = 10；出生体重≥250 g；胎龄≥37周）进行比较。我们发现，早产组在胼胝体后部以及双侧内囊的分数各向异性值较低。在胼胝体后部，分数各向异性值的这种差异可能部分与两组之间白质体积的差异有关。相干性指标分析未能显示出两组在轴突组织方面的差异。这些结果与先前对早产新生儿的弥散张量成像研究结果一致，并表明有注意力缺陷的早产儿童存在白质紊乱，且在11岁之前未得到代偿或修复。
