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足月儿的神经行为及极早产儿的白质和灰质异常

Neurobehavior at term and white and gray matter abnormalities in very preterm infants.

作者信息

Brown Nisha C, Inder Terrie E, Bear Merilyn J, Hunt Rod W, Anderson Peter J, Doyle Lex W

机构信息

Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.

出版信息

J Pediatr. 2009 Jul;155(1):32-8, 38.e1. doi: 10.1016/j.jpeds.2009.01.038. Epub 2009 Apr 24.

DOI:10.1016/j.jpeds.2009.01.038
PMID:19394041
Abstract

OBJECTIVE

To examine the relationship between very preterm infant neurobehavior at term and concurrent magnetic resonance-defined cerebral abnormalities.

STUDY DESIGN

168 very preterm infants (birth weight <1250 g or gestation <30 weeks) were examined at term with 2 standardized neurobehavioral assessments, the Revised Hammersmith Neonatal Neurological Examination and the Neonatal Intensive Care Unit Network Neurobehavioral Scale. The relationship between composite neurobehavioral scores and qualitative white and gray matter abnormalities on magnetic resonance imaging was determined.

RESULTS

Poorer neurobehavioral performance related to magnetic resonance-defined cerebral abnormalities. Composite neurobehavioral scores related to the total grade of white matter abnormality, and worse neurobehavior related most strongly to 2 components of this grade: white matter signal abnormalities and reduction in white matter volumes. Neurobehavior was not related to the total grade of gray matter abnormality. However, delayed gyral maturation, a component of the total gray matter grade, was related to poorer performance on both neurobehavioral scales.

CONCLUSION

Very preterm infant neurobehavior at term is related to concurrent cerebral abnormalities in both white and gray matter defined by qualitative magnetic resonance imaging.

摘要

目的

研究足月儿极早早产儿神经行为与同时期磁共振成像定义的脑异常之间的关系。

研究设计

对168名极早早产儿(出生体重<1250克或孕周<30周)在足月儿期进行两项标准化神经行为评估,即修订版哈默史密斯新生儿神经学检查和新生儿重症监护病房网络神经行为量表。确定了综合神经行为评分与磁共振成像上定性白质和灰质异常之间的关系。

结果

较差的神经行为表现与磁共振成像定义的脑异常有关。综合神经行为评分与白质异常的总等级相关,较差的神经行为与该等级的两个组成部分最密切相关:白质信号异常和白质体积减少。神经行为与灰质异常的总等级无关。然而,脑回成熟延迟是总灰质等级的一个组成部分,与两项神经行为量表的较差表现有关。

结论

足月儿极早早产儿神经行为与定性磁共振成像定义的白质和灰质同时期脑异常有关。

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