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极低出生体重早产儿的大脑皮层厚度与认知能力。

Cortical thickness and cognition in very-low-birth-weight late teenagers.

机构信息

Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Early Hum Dev. 2013 Jun;89(6):371-80. doi: 10.1016/j.earlhumdev.2012.12.003. Epub 2012 Dec 27.

Abstract

BACKGROUND

Preterm born children with very low birth weight (VLBW: bw ≤ 1500 g) have an increased risk of perinatal brain injury which may influence the subsequent maturation of grey and white matter. Aberrant cortical development may have implications for future cognitive functioning.

AIMS

The aim of this study was to measure deviations in cortical thickness and to investigate the relationship between cortical thickness, perinatal variables and IQ measurements in VLBW late teenagers compared with term-born controls.

STUDY DESIGN

Prospective follow-up study of three year cohorts of children from birth to early adulthood.

SUBJECT

Forty-seven VLBW and 61 term born controls were examined at ages 18-21.

OUTCOME MEASURES

Cognitive function was assessed with the WAIS-III, measuring full IQ and IQ indices. We applied an automated method to reconstruct the cortical surface based on T1-weighted MRI images using the FreeSurfer software.

RESULTS

We found widespread areas of thinner cerebral cortex in the left parietal and temporal lobes and thicker cortex in frontal areas bilaterally in the VLBW group compared to controls. There were positive correlations between IQ and cortical thickness in areas in ventro-lateral frontal, parietal and temporal lobes in the VLBW group. The most pronounced cortical changes were seen in the VLBW subjects with the lowest birth weight and gestational age, and in those with IQ below 89.

CONCLUSION

Persistent cortical deviations seen in VLBW late teenagers are associated with immaturity at birth and level of cognitive functioning.

摘要

背景

极低出生体重(VLBW:bw ≤ 1500 克)的早产儿围产期脑损伤风险增加,这可能影响灰质和白质的后续成熟。皮质发育异常可能对未来的认知功能产生影响。

目的

本研究旨在测量皮质厚度的偏差,并研究与足月出生对照组相比,VLBW 青少年晚期皮质厚度与围产变量和智商测量值之间的关系。

研究设计

对出生至成年早期的三年队列儿童进行前瞻性随访研究。

受试者

47 名 VLBW 和 61 名足月出生对照组在 18-21 岁时进行了检查。

结果测量

认知功能采用韦氏智力量表第三版(WAIS-III)进行评估,测量全智商和智商指数。我们应用一种自动方法,使用 FreeSurfer 软件基于 T1 加权 MRI 图像重建皮质表面。

结果

与对照组相比,我们发现 VLBW 组左侧顶叶和颞叶以及双侧额区的脑皮质普遍变薄,而额区的皮质较厚。在 VLBW 组中,智商与额下外侧、顶叶和颞叶区域的皮质厚度之间存在正相关。在出生体重和胎龄最低且智商低于 89 的 VLBW 受试者中,皮质变化最为明显。

结论

VLBW 青少年晚期持续存在的皮质偏差与出生时的不成熟和认知功能水平有关。

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