Juranek Jenifer, Fletcher Jack M, Hasan Khader M, Breier Joshua I, Cirino Paul T, Pazo-Alvarez Paula, Diaz Javier D, Ewing-Cobbs Linda, Dennis Maureen, Papanicolaou Andrew C
Department of Pediatrics, University of Texas Health Science Center at Houston, Texas, USA.
Neuroimage. 2008 May 1;40(4):1516-22. doi: 10.1016/j.neuroimage.2008.01.043. Epub 2008 Feb 9.
Normal brain development throughout childhood and adolescence is usually characterized by decreased cortical thickness in the frontal regions as well as region-specific patterns of increased white matter myelination and volume. We investigated total cerebral volumes, neocortical surface area, and neocortical thickness in 16 children with a neural tube defect, spina bifida myelomeningocele (SB), and 16 age-matched typically developing controls using a semi-automated, quantitative approach to MRI-based brain morphometry. The results revealed no significant group differences in total cerebral volume. However, group differences were observed in the global distribution of distinct tissue classes within the cerebrum: the SB group demonstrated a significant 15% reduction in total white matter and a 69% increase in cerebrospinal fluid, with no differences in total gray matter. Group comparisons of neocortical surface area assessments were significantly smaller in the occipital regions for SB, with no significant group differences in the frontal regions. Group comparisons of cortical thickness measurements demonstrated reduced cortical thickness in all regions except the frontal regions, where the SB group exhibited an increase relative to the PC group. Although regional patterns of thinning may be associated with the mechanical effects of hydrocephalus, the overall reduction in white matter and increased neocortical thickness in the frontal regions suggest that SB reflects a long-term disruption of brain development that extends far beyond the neural tube defect in the first weeks of gestation.
儿童期和青少年期正常的大脑发育通常表现为额叶皮质厚度减小，以及白质髓鞘形成和体积增加的区域特异性模式。我们采用基于MRI的脑形态计量学的半自动定量方法，对16名患有神经管缺陷、脊柱裂脊髓脊膜膨出（SB）的儿童和16名年龄匹配的正常发育对照儿童的全脑体积、新皮质表面积和新皮质厚度进行了研究。结果显示，两组在全脑体积上无显著差异。然而，在大脑内不同组织类别的整体分布上观察到了组间差异：SB组的总白质显著减少了15%，脑脊液增加了69%，而总灰质无差异。SB组枕叶区域的新皮质表面积评估组间比较显著较小，额叶区域无显著组间差异。皮质厚度测量的组间比较显示，除额叶区域外，所有区域的皮质厚度均减小，SB组额叶区域相对于对照组有所增加。尽管区域变薄模式可能与脑积水的机械效应有关，但白质的整体减少和额叶区域新皮质厚度的增加表明，SB反映了大脑发育的长期破坏，这种破坏远远超出了妊娠最初几周的神经管缺陷。
