Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8; Department of Psychology, University of Toronto, Toronto, Ontario, Canada, M5S 3G3.
Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8.
Neuroimage. 2015 May 1;111:360-8. doi: 10.1016/j.neuroimage.2015.02.030. Epub 2015 Feb 21.
We evaluated whether the volume and growth rate of critical brain structures measured by MRI in the first weeks of life following very preterm (<32/40 weeks) birth could predict subsequent neurodevelopmental outcomes at 4 years of age. A significant proportion of children born very prematurely have cognitive deficits, but these problems are often only detected at early school age. Structural T2-weighted magnetic resonance images were acquired in 96 very preterm neonates scanned within 2 weeks of birth and 70 of these at term-equivalent age. An automated 3D image analysis procedure was used to measure the volume of selected brain structures across all scans and time points. At 4 years of age, 53 children returned for neuropsychological assessments evaluating IQ, language and visual motor integration. Associations with maternal education and perinatal measures were also explored. Multiple regression analyses revealed that growth of the caudate and globus pallidus between preterm birth and term-equivalent age predicted visual motor integration scores after controlling for sex and gestational age. Further associations were found between caudate and putamen growth with IQ and language scores. Analyses at either preterm or term-equivalent age only found associations between normalized deep grey matter growth and visual motor integration scores at term-equivalent age. Maternal education levels were associated with measures of IQ and language, but not visual motor integration. Thalamic growth was additionally linked with perinatal measures and presence of white matter lesions. These results highlight deep grey matter growth rates as promising biomarkers of long-term outcomes following very preterm birth, and contribute to our understanding of the brain-behaviour relations in these children.
我们评估了极早产儿（<32/40 周）出生后最初几周内通过 MRI 测量的关键脑结构的体积和增长率是否可以预测 4 岁时的后续神经发育结局。相当一部分极早产儿存在认知缺陷，但这些问题通常仅在早期学龄时才被发现。对 96 名出生后 2 周内扫描的极早产儿和其中 70 名胎龄相当的婴儿进行了 T2 加权磁共振成像。使用自动 3D 图像分析程序来测量所有扫描和时间点的选定脑结构的体积。在 4 岁时，53 名儿童返回接受神经心理学评估，评估智商、语言和视觉运动整合。还探讨了与母亲教育和围产期措施的关联。多元回归分析显示，在控制性别和胎龄后，大脑脚和苍白球在早产和胎龄相当期间的生长与视觉运动整合评分相关。还发现大脑脚和壳核生长与智商和语言评分之间存在关联。仅在早产或胎龄相当期间进行的分析仅发现了正常化深部灰质生长与胎龄相当时的视觉运动整合评分之间的关联。母亲的教育水平与智商和语言相关，但与视觉运动整合无关。丘体生长还与围产期指标和白质病变的存在有关。这些结果突出了深部灰质生长率作为极早产儿出生后长期结局的有前途的生物标志物，并有助于我们了解这些儿童的大脑-行为关系。
