Sølsnes Anne Elisabeth, Grunewaldt Kristine H, Bjuland Knut J, Stavnes Elisabeth M, Bastholm Irén A, Aanes Synne, Østgård Heidi F, Håberg Asta, Løhaugen Gro C C, Skranes Jon, Rimol Lars M
Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway.
Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway ; Department of Pediatrics, St. Olav University Hospital, Trondheim, Norway.
Neuroimage Clin. 2015 Apr 14;8:193-201. doi: 10.1016/j.nicl.2015.04.004. eCollection 2015.
Children born prematurely with very low birth weight (VLBW: bw ≤ 1500 g) have an increased risk of preterm perinatal brain injury, which may subsequently alter the maturation of the brain, including the cerebral cortex. The aim of study was to assess cortical thickness and surface area in VLBW children compared with term-born controls, and to investigate possible relationships between cortical morphology and Full IQ. In this cross-sectional study, 37 VLBW and 104 term children born between the years 2003-2007 were assessed cognitively at 5-10 years of age, using age appropriate Wechsler tests. The FreeSurfer software was used to obtain estimates of cortical thickness and surface area based on T1-weighted MRI images at 1.5 Tesla. The VLBW children had smaller cortical surface area bilaterally in the frontal, temporal, and parietal lobes. A thicker cortex in the frontal and occipital regions and a thinner cortex in posterior parietal areas were observed in the VLBW group. There were significant differences in Full IQ between groups (VLBW M = 98, SD = 9.71; controls M = 108, SD = 13.57; p < 0.001). There was a positive relationship between IQ and surface area in both groups, albeit significant only in the larger control group. In the VLBW group, reduced IQ was associated with frontal cortical thickening and temporo-parietal thinning. We conclude that cortical deviations are evident in childhood even in VLBW children born in 2003-2007 who have received state of the art medical treatment in the perinatal period and who did not present with focal brain injuries on neonatal ultrasonography. The cortical deviations were associated with reduced cognitive functioning.
出生时体重极低(VLBW:体重≤1500克)的早产儿童发生早产围产期脑损伤的风险增加,这可能随后改变大脑的成熟,包括大脑皮层。本研究的目的是评估VLBW儿童与足月儿对照组相比的皮质厚度和表面积,并研究皮质形态与全量表智商之间的可能关系。在这项横断面研究中,对2003年至2007年间出生的37名VLBW儿童和104名足月儿在5至10岁时进行了认知评估,使用了适合其年龄的韦氏测试。使用FreeSurfer软件基于1.5特斯拉的T1加权MRI图像获得皮质厚度和表面积的估计值。VLBW儿童双侧额叶、颞叶和顶叶的皮质表面积较小。在VLBW组中观察到额叶和枕叶区域的皮质较厚,而后顶叶区域的皮质较薄。两组之间的全量表智商存在显著差异(VLBW组M = 98,SD = 9.71;对照组M = 108,SD = 13.57;p < 0.001)。两组的智商与表面积之间均呈正相关,尽管仅在较大的对照组中显著。在VLBW组中,智商降低与额叶皮质增厚和颞顶叶变薄有关。我们得出结论,即使是2003年至2007年间出生的VLBW儿童,在围产期接受了先进的医疗治疗且新生儿超声检查未发现局灶性脑损伤,其童年时期的皮质偏差也很明显。皮质偏差与认知功能降低有关。