Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom; Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, Dublin, Ireland.
J Pediatr. 2013 Dec;163(6):1596-604. doi: 10.1016/j.jpeds.2013.08.011. Epub 2013 Sep 24.
To investigate the relationship between preterm birth, adolescent, and adult psychosocial outcomes, and alterations in gray matter volume.
Individuals (n = 73) born at <33 weeks of gestation (very preterm) and 49 controls completed the Child Behavior Checklist (CBCL) at age 15 years to identify 'social immaturity' (SI) cases. Voxel-based morphometry was used to investigate gray matter volumes according to CBCL-SI 'caseness.' The Clinical Interview Schedule-Revised (CIS-R) was administered at age 19 years.
Very preterm adolescents were almost 4 times more likely to reach CBCL-SI 'caseness' compared with controls. Ex-preterm SI 'cases' had increased gray matter volume in the fusiform gyrus bilaterally (Talairach coordinates: x = 60, y = -27, z = -30; Z = 3.78; x = -61, y = -35, z = -27; Z = 3.56, after correction for multiple comparisons) compared with ex-preterm SI 'noncases.' Left fusiform volume displayed a stronger correlation with ipsilateral orbitofrontal cortex in SI 'cases' (x = -15, y = 22, z = -26; Z = 3.64). CIS-R total scores were slightly higher in ex-preterm individuals compared with controls. In the whole sample, SI 'cases' in midadolescence also had higher CIS-R scores in adulthood compared with 'noncases' (SI 'cases': mean = 5.7, 95% CI = 4.0-7.4; SI 'noncases': mean = 2.7, 95% CI = 1.1-4.3; F = 6.4, df = 74; P = .013).
Ex-preterm adolescents had increased socialization problems in adolescence, which were associated with volumetric alterations in an emotion-processing brain network. Atypical social development is linked to an increased vulnerability to psychiatric disorder.
探讨早产、青少年和成人心理社会结局与灰质体积变化之间的关系。
本研究纳入了 73 名妊娠＜33 周（极早产）的个体和 49 名对照，他们在 15 岁时完成了儿童行为检查表（CBCL），以确定“社会不成熟”（SI）病例。根据 CBCL-SI“病例”情况，采用基于体素的形态计量学方法来研究灰质体积。在 19 岁时进行临床访谈量表修订版（CIS-R）。
与对照组相比，极早产儿发生 CBCL-SI“病例”的可能性几乎高出 4 倍。与 SI 非病例相比，前早产儿 SI 病例双侧梭状回的灰质体积增加（Talairach 坐标：x = 60，y = -27，z = -30；Z = 3.78；x = -61，y = -35，z = -27；Z = 3.56，经多重比较校正后）。左梭状回体积与同侧眶额皮质的相关性在 SI 病例中更强（x = -15，y = 22，z = -26；Z = 3.64）。与对照组相比，前早产儿个体的 CIS-R 总分略高。在整个样本中，青春期的 SI 病例在成年期的 CIS-R 评分也高于非病例（SI 病例：均值 = 5.7，95%CI = 4.0-7.4；SI 非病例：均值 = 2.7，95%CI = 1.1-4.3；F = 6.4，df = 74；P =.013）。
前早产儿青少年在青春期出现更多的社会化问题，这与情绪处理脑网络的体积变化有关。非典型的社会发展与精神障碍的易感性增加有关。
