极低出生体重儿青春期的心理健康与小脑体积：一项纵向研究。
Mental health and cerebellar volume during adolescence in very-low-birth-weight infants: a longitudinal study.
作者信息
Botellero Violeta L, Skranes Jon, Bjuland Knut Jørgen, Løhaugen Gro C, Håberg Asta Kristine, Lydersen Stian, Brubakk Ann-Mari, Indredavik Marit S, Martinussen Marit
机构信息
Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway.
Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway ; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.
出版信息
Child Adolesc Psychiatry Ment Health. 2016 Mar 16;10:6. doi: 10.1186/s13034-016-0093-8. eCollection 2016.
BACKGROUND
Preterm birth at very low birth weight (VLBW) poses a risk for cerebellar abnormalities and increased psychiatric morbidity compared with reference populations. We aimed to study cerebellar volumes (grey and white matter; GM, WM) and mental health in VLBW individuals and controls at 15 and 19 years of age, as well as changes between the two time points.
METHODS
Forty VLBW (≤1500 g) and 56 control adolescents were included in the study at 15 years of age, and 44 VLBW and 60 control adolescents at 19 years of age. We had longitudinal data for 30 VLBW participants and for 37 controls. Clinical diagnoses were assessed following the schedule for affective disorders and schizophrenia for school-age children (KSADS). Psychiatric symptoms and function were further investigated with the Achenbach System of Empirically Based Assessment (ASEBA), ADHD Rating Scale-IV and the children's global assessment scale (CGAS). An automatic segmentation of cerebellar GM and WM volumes was performed in FreeSurfer. The MRI scans were obtained on the same 1.5T scanner at both ages.
RESULTS
The VLBW group had higher rates of psychiatric disorders at both ages. Cerebellar growth trajectories did not differ between VLBW adolescents and controls, regardless of psychiatric status. However, VLBW adolescents who had a psychiatric diagnosis at both ages or developed a psychiatric disorder from 15 to 19 years had maintained smaller cerebellar WM and GM volumes than controls and also smaller volumes than VLWB adolescents who were or became healthy in this period. Moreover, there were no differences in cerebellar WM and GM volumes between controls and those VLBW who were healthy or became healthy. In the VLBW group, cerebellar WM and GM volumes correlated positively with psycho-social function at both 15 and 19 years of age, and smaller GM volumes were associated with inattention at 15 years.
CONCLUSIONS
Smaller cerebellar volume in adolescents born very preterm and with VLBW may be a biomarker of increased risk of psychiatric problems in young adulthood.
背景
与参照人群相比，极低出生体重（VLBW）的早产儿出现小脑异常及精神疾病发病率增加的风险。我们旨在研究15岁和19岁时VLBW个体及对照人群的小脑体积（灰质和白质；GM，WM）和心理健康状况，以及两个时间点之间的变化。
方法
40名VLBW（≤1500克）和56名对照青少年在15岁时纳入研究，44名VLBW和60名对照青少年在19岁时纳入研究。我们有30名VLBW参与者和37名对照的纵向数据。根据学龄儿童情感障碍和精神分裂症评定量表（KSADS）评估临床诊断。使用基于经验的评估阿肯巴克系统（ASEBA）、注意缺陷多动障碍评定量表-IV和儿童总体评定量表（CGAS）进一步调查精神症状和功能。在FreeSurfer中对小脑GM和WM体积进行自动分割。两个年龄段的MRI扫描均在同一台1.5T扫描仪上进行。
结果
VLBW组在两个年龄段的精神疾病发病率均较高。无论精神状态如何，VLBW青少年和对照人群的小脑生长轨迹没有差异。然而，在两个年龄段都有精神疾病诊断或在15至19岁期间患上精神疾病的VLBW青少年，其小脑WM和GM体积一直小于对照人群，也小于在此期间保持健康或变得健康的VLBW青少年。此外，对照人群与健康或变得健康的VLBW人群之间的小脑WM和GM体积没有差异。在VLBW组中，15岁和19岁时小脑WM和GM体积与心理社会功能呈正相关，15岁时较小的GM体积与注意力不集中有关。
结论
极早产且出生体重极低的青少年小脑体积较小，可能是其成年后精神问题风险增加的生物标志物。
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