Department of Pediatrics, Turku University Hospital, Turku, Finland.
Eur Child Adolesc Psychiatry. 2010 May;19(5):407-17. doi: 10.1007/s00787-009-0070-3. Epub 2009 Oct 11.
The objective of this study is to assess the relationship between brain volumes at term equivalent age and neuropsychological functions at 5 years of age in very low birth weight (VLBW) children, and to compare the results from a neuropsychological assessment and a parental questionnaire at 5 years of age. The study group included a regional cohort of 97 VLBW children and a control group of 161 children born at term. At term equivalent age, brain magnetic resonance imaging (MRI) was performed on the VLBW children, and analysed for total and regional brain volumes. At 5 years of age, a psychologist assessed the neuropsychological performance with NEPSY II, and parents completed the Five to fifteen (FTF) questionnaire on development and behaviour. The results of the control group were used to give the age-specific reference values. No significant associations were found between the brain volumes and the NEPSY II domains. As for the FTF, significant associations were found between a smaller total brain tissue volume and poorer executive functions, between a smaller cerebellar volume and both poorer executive functions and motor skills, and, surprisingly, between a larger volume of brainstem and poorer language functions. Even after adjustment for total brain tissue volume, the two associations between the cerebellar volume and the FTF domains remained borderline significant (P = 0.05). The NEPSY II domains Executive Functioning, Language and Motor Skills were significantly associated with the corresponding FTF domains. In conclusion, altered brain volumes at term equivalent age appear to affect development still at 5 years of age. The FTF seems to be a good instrument when used in combination with other neuropsychological assessment.
本研究旨在评估极低出生体重儿（VLBW）在足月时的脑容量与 5 岁时神经心理学功能之间的关系，并比较 5 岁时神经心理学评估和父母问卷调查的结果。研究组包括 97 名 VLBW 儿童的区域性队列和 161 名足月出生的儿童对照组。在足月等效年龄时，对 VLBW 儿童进行脑磁共振成像（MRI）检查，并对总脑容量和区域脑容量进行分析。在 5 岁时，心理学家使用 NEPSY II 评估神经心理学表现，父母则使用 Five to fifteen (FTF) 问卷评估发育和行为。对照组的结果用于给出特定年龄的参考值。脑容量与 NEPSY II 各领域之间未发现显著相关性。对于 FTF，总脑组织体积较小与执行功能较差之间、小脑体积较小与执行功能和运动技能较差之间均存在显著相关性，令人惊讶的是，脑干体积较大与语言功能较差之间也存在显著相关性。即使在校正总脑组织体积后，小脑体积与 FTF 各领域之间的两个相关性仍具有边缘显著性（P = 0.05）。NEPSY II 各领域的执行功能、语言和运动技能与相应的 FTF 领域显著相关。总之，足月时的脑容量改变似乎仍会影响 5 岁时的发育。FTF 似乎是一种很好的工具，可与其他神经心理学评估结合使用。
