Kesler Shelli R, Ment Laura R, Vohr Betty, Pajot Sarah K, Schneider Karen C, Katz Karol H, Ebbitt Timothy B, Duncan Charles C, Makuch Robert W, Reiss Allan L
Stanford Psychiatry Neuroimaging Laboratory, Stanford University School of Medicine, Stanford, CA 94305-5719, USA.
Pediatr Neurol. 2004 Nov;31(5):318-25. doi: 10.1016/j.pediatrneurol.2004.06.008.
Preterm birth is frequently associated with both neuropathologic and cognitive sequelae. This study examined cortical lobe, subcortical, and lateral ventricle development in association with perinatal variables and cognitive outcome. High-resolution volumetric magnetic resonance imaging scans were acquired and quantified using advanced image processing techniques. Seventy-three preterm and 33 term control children ages 7.3-11.4 years were included in the study. Results indicated disproportionately enlarged parietal and frontal gray matter, occipital horn, and ventricular body, as well as reduced temporal and subcortical gray volumes in preterm children compared with control subjects. Birth weight was negatively correlated with parietal and frontal gray, as well as occipital horn volumes. Intraventricular hemorrhage was associated with reduced subcortical gray matter. Ventricular cerebrospinal fluid was negatively correlated with subcortical gray matter volumes but not with white matter volumes. Maternal education was the strongest predictor of cognitive function in the preterm group. Preterm birth appears to be associated with disorganized cortical development, possibly involving disrupted synaptic pruning and neural migration. Lower birth weight and the presence of intraventricular hemorrhage may increase the risk for neuroanatomic abnormality.
早产常与神经病理学和认知后遗症相关。本研究调查了与围产期变量及认知结果相关的皮质叶、皮质下及侧脑室发育情况。使用先进的图像处理技术获取并量化了高分辨率容积磁共振成像扫描结果。该研究纳入了73名年龄在7.3至11.4岁的早产儿童和33名足月对照儿童。结果显示，与对照受试者相比，早产儿童的顶叶和额叶灰质、枕角及脑室体不成比例地增大，而颞叶和皮质下灰质体积减小。出生体重与顶叶和额叶灰质以及枕角体积呈负相关。脑室内出血与皮质下灰质减少有关。脑室脑脊液与皮质下灰质体积呈负相关，但与白质体积无关。母亲教育程度是早产组认知功能的最强预测因素。早产似乎与皮质发育紊乱有关，可能涉及突触修剪和神经迁移受阻。较低的出生体重和脑室内出血的存在可能会增加神经解剖学异常的风险。
