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早期经历会改变大脑的功能和结构。

Early experience alters brain function and structure.

作者信息

Als Heidelise, Duffy Frank H, McAnulty Gloria B, Rivkin Michael J, Vajapeyam Sridhar, Mulkern Robert V, Warfield Simon K, Huppi Petra S, Butler Samantha C, Conneman Nikk, Fischer Christine, Eichenwald Eric C

机构信息

Department of Psychiatry, Harvard Medical School and Children's Hospital Boston, Pediatric Research Laboratories, Boston, Massachusetts 02115, USA.

出版信息

Pediatrics. 2004 Apr;113(4):846-57. doi: 10.1542/peds.113.4.846.

Abstract

OBJECTIVE

To investigate the effects of early experience on brain function and structure.

METHODS

A randomized clinical trial tested the neurodevelopmental effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Thirty preterm infants, 28 to 33 weeks' gestational age (GA) at birth and free of known developmental risk factors, participated in the trial. NIDCAP was initiated within 72 hours of intensive care unit admission and continued to the age of 2 weeks, corrected for prematurity. Control (14) and experimental (16) infants were assessed at 2 weeks' and 9 months' corrected age on health status, growth, and neurobehavior, and at 2 weeks' corrected age additionally on electroencephalogram spectral coherence, magnetic resonance diffusion tensor imaging, and measurements of transverse relaxation time.

RESULTS

The groups were medically and demographically comparable before as well as after the treatment. However, the experimental group showed significantly better neurobehavioral functioning, increased coherence between frontal and a broad spectrum of mainly occipital brain regions, and higher relative anisotropy in left internal capsule, with a trend for right internal capsule and frontal white matter. Transverse relaxation time showed no difference. Behavioral function was improved also at 9 months' corrected age. The relationship among the 3 neurodevelopmental domains was significant. The results indicated consistently better function and more mature fiber structure for experimental infants compared with their controls.

CONCLUSIONS

This is the first in vivo evidence of enhanced brain function and structure due to the NIDCAP. The study demonstrates that quality of experience before term may influence brain development significantly.

摘要

目的

研究早期经历对脑功能和结构的影响。

方法

一项随机临床试验测试了新生儿个体化发育照护与评估项目(NIDCAP)的神经发育效果。30名早产儿参与了该试验,他们出生时的胎龄为28至33周,且无已知的发育风险因素。NIDCAP在重症监护病房入院后72小时内启动,并持续至矫正年龄2周。对对照组(14名)和试验组(16名)婴儿在矫正年龄2周和9个月时进行健康状况、生长发育及神经行为评估,在矫正年龄2周时还进行脑电图频谱相干性、磁共振扩散张量成像及横向弛豫时间测量。

结果

治疗前后两组在医学和人口统计学方面具有可比性。然而,试验组显示出明显更好的神经行为功能,额叶与广泛的主要枕叶脑区之间的相干性增加,左侧内囊的相对各向异性更高,右侧内囊和额叶白质有增加趋势。横向弛豫时间无差异。在矫正年龄9个月时行为功能也有所改善。三个神经发育领域之间的关系显著。结果表明,与对照组相比,试验组婴儿的功能持续更好,纤维结构更成熟。

结论

这是NIDCAP导致脑功能和结构增强的首个体内证据。该研究表明,早产前的经历质量可能会显著影响大脑发育。

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