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低出生体重青少年:精神症状与脑部磁共振成像异常

Low-birth-weight adolescents: psychiatric symptoms and cerebral MRI abnormalities.

作者信息

Indredavik Marit S, Skranes Jon S, Vik Torstein, Heyerdahl Sonja, Romundstad Pål, Myhr Gunnar E, Brubakk Ann-Mari

机构信息

Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Pediatr Neurol. 2005 Oct;33(4):259-66. doi: 10.1016/j.pediatrneurol.2005.05.002.

Abstract

To explore associations between psychiatric symptoms and cerebral magnetic resonance imaging abnormalities in low-birth-weight adolescents, 55 very low-birth-weight (<or=1500 gm), 54 term small for gestational age (birth weight <10th centile) and 66 term control adolescents (birth weight >or=10th centile) were assessed at 14-15 years of age. Outcome measures were Schedule for Affective Disorders and Schizophrenia for School-Age Children, Attention-Deficit/Hyperactivity Disorder Rating Scale IV, Autism Spectrum Screening Questionnaire, and qualitatively assessed cerebral magnetic resonance images. The very low-birth-weight group manifested increased prevalence of psychiatric symptoms and disorders compared with controls (P < 0.001), especially symptoms of attention-deficit/hyperactivity disorder, and high frequency of ventricular dilatation, white matter reduction, thinning of corpus callosum, and gliosis (P < 0.01 vs controls). The Attention-Deficit/Hyperactivity Disorder Rating Scale score was significantly associated with white matter reduction and thinning of corpus callosum in this group. The term small for gestational age group had increased prevalence of psychiatric symptoms compared with control subjects, but not more frequent abnormalities on cerebral magnetic resonance imaging. In conclusion, attention-deficit/hyperactivity disorder symptoms were significantly associated with white matter reduction and thinning of corpus callosum in very low-birth-weight adolescents. No associations were found for other psychiatric symptoms and brain abnormalities in any of the groups.

摘要

为探究低出生体重青少年精神症状与脑磁共振成像异常之间的关联,研究人员对55名极低出生体重(≤1500克)、54名小于胎龄足月儿(出生体重<第10百分位数)以及66名足月对照青少年(出生体重≥第10百分位数)在14至15岁时进行了评估。观察指标包括儿童情感障碍和精神分裂症评定量表、注意缺陷/多动障碍评定量表第四版、孤独症谱系筛查问卷以及经定性评估的脑磁共振图像。与对照组相比,极低出生体重组精神症状和障碍的患病率更高(P<0.001),尤其是注意缺陷/多动障碍症状,且脑室扩张、白质减少、胼胝体变薄和胶质增生的发生率较高(与对照组相比P<0.01)。该组中,注意缺陷/多动障碍评定量表得分与白质减少和胼胝体变薄显著相关。小于胎龄足月儿组精神症状的患病率高于对照受试者,但脑磁共振成像异常的频率并未更高。总之,在极低出生体重青少年中,注意缺陷/多动障碍症状与白质减少和胼胝体变薄显著相关。在任何一组中,均未发现其他精神症状与脑异常之间存在关联。

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