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产前轻度脑室扩大预示新生儿脑发育异常。

Prenatal mild ventriculomegaly predicts abnormal development of the neonatal brain.

作者信息

Gilmore John H, Smith Lauren C, Wolfe Honor M, Hertzberg Barbara S, Smith J Keith, Chescheir Nancy C, Evans Dianne D, Kang Chaeryon, Hamer Robert M, Lin Weili, Gerig Guido

机构信息

Schizophrenia Research Center and the Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, NC 27599-7160, USA.

出版信息

Biol Psychiatry. 2008 Dec 15;64(12):1069-76. doi: 10.1016/j.biopsych.2008.07.031. Epub 2008 Oct 2.

Abstract

BACKGROUND

Many psychiatric and neurodevelopmental disorders are associated with mild enlargement of the lateral ventricles thought to have origins in prenatal brain development. Little is known about development of the lateral ventricles and the relationship of prenatal lateral ventricle enlargement with postnatal brain development.

METHODS

We performed neonatal magnetic resonance imaging on 34 children with isolated mild ventriculomegaly (MVM; width of the atrium of the lateral ventricle >/= 1.0 cm) on prenatal ultrasound and 34 age- and sex-matched control subjects with normal prenatal ventricle size. Lateral ventricle and cortical gray and white matter volumes were assessed. Fractional anisotropy (FA) and mean diffusivity (MD) in corpus callosum and corticospinal white matter tracts were determined obtained using quantitative tractography.

RESULTS

Neonates with prenatal MVM had significantly larger lateral ventricle volumes than matched control subjects (286.4%; p < .0001). Neonates with MVM also had significantly larger intracranial volumes (ICV; 7.1%, p = .0063) and cortical gray matter volumes (10.9%, p = .0004) compared with control subjects. Diffusion tensor imaging tractography revealed a significantly greater MD in the corpus callosum and corticospinal tracts, whereas FA was significantly smaller in several white matter tract regions.

CONCLUSIONS

Prenatal enlargement of the lateral ventricle is associated with enlargement of the lateral ventricles after birth, as well as greater gray matter volumes and delayed or abnormal maturation of white matter. It is suggested that prenatal ventricle volume is an early structural marker of altered development of the cerebral cortex and may be a marker of risk for neuropsychiatric disorders associated with ventricle enlargement.

摘要

背景

许多精神疾病和神经发育障碍都与侧脑室轻度扩大有关,这种扩大被认为起源于产前大脑发育。关于侧脑室的发育以及产前侧脑室扩大与产后大脑发育的关系,我们知之甚少。

方法

我们对34名产前超声检查发现孤立性轻度脑室扩大(MVM;侧脑室房部宽度≥1.0 cm)的儿童以及34名年龄和性别匹配、产前脑室大小正常的对照儿童进行了新生儿磁共振成像检查。评估了侧脑室以及皮质灰质和白质的体积。使用定量纤维束成像技术测定胼胝体和皮质脊髓白质束中的分数各向异性(FA)和平均扩散率(MD)。

结果

产前MVM的新生儿侧脑室体积明显大于匹配的对照儿童(286.4%;p<.0001)。与对照儿童相比,MVM新生儿的颅内体积(ICV)也明显更大(7.1%,p=.0063),皮质灰质体积更大(10.9%,p=.0004)。扩散张量成像纤维束成像显示胼胝体和皮质脊髓束中的MD明显更大,而在几个白质束区域FA明显更小。

结论

产前侧脑室扩大与出生后侧脑室扩大、更大的灰质体积以及白质延迟或异常成熟有关。提示产前脑室体积是大脑皮质发育改变的早期结构标志物,可能是与脑室扩大相关的神经精神疾病风险的标志物。

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