Shany Eilon, Inder Terrie E, Goshen Sharon, Lee Iris, Neil Jeffrey J, Smyser Christopher D, Doyle Lex W, Anderson Peter J, Shimony Joshua S
Department of Neonatology, Soroka Medical Center, P.O. Box 151, 84101, Beer Sheva, Israel.
Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Cerebellum. 2017 Apr;16(2):314-325. doi: 10.1007/s12311-016-0796-7.
The objective of this study was to correlate neurodevelopmental outcome of preterm-born children and their perinatal clinical and imaging characteristics with diffusion magnetic resonance imaging (MRI) measures of the three cerebellar peduncles at age 7. Included in this prospective longitudinal study were 140 preterm-born children (<30 weeks gestation) who underwent neurodevelopmental assessment (IQ, motor, language, working memory) and diffusion-weighted imaging (DWI) at age 7 years. White matter tracts in the superior, middle, and inferior cerebellar peduncles were delineated using regions of interest drawn on T2-weighted images and fractional anisotropy (FA) maps. Diffusion measures (mean diffusivity (MD) and FA) and tract volumes were calculated. Linear regression was used to assess relationships with outcome. The severity of white matter injury in the neonatal period was associated with lower FA in the right superior cerebellar peduncle (SCP) and lower tract volumes of both SCPs and middle cerebellar peduncles (MCPs). In the MCP, higher IQ was associated with lower MD in the whole group and higher FA in right-handed children. In the SCP, lower motor scores were associated with higher MD and higher language scores were associated with higher FA. These associations remained significant in multivariable models. This study adds to the body of literature detailing the importance of cerebellar involvement in cognitive function related to reciprocal connections with supratentorial structures.
本研究的目的是将早产儿童的神经发育结局及其围产期临床和影像学特征与7岁时三个小脑脚的扩散磁共振成像(MRI)测量结果相关联。这项前瞻性纵向研究纳入了140名早产儿童(孕周<30周),他们在7岁时接受了神经发育评估(智商、运动、语言、工作记忆)和扩散加权成像(DWI)。使用在T2加权图像和分数各向异性(FA)图上绘制的感兴趣区域勾勒出上、中、下小脑脚的白质束。计算扩散测量值(平均扩散率(MD)和FA)和束体积。采用线性回归评估与结局的关系。新生儿期白质损伤的严重程度与右侧上小脑脚(SCP)的FA较低以及双侧SCP和中小脑脚(MCP)的束体积较低有关。在MCP中,较高的智商与全组较低的MD以及右利手儿童较高的FA相关。在SCP中,较低的运动评分与较高的MD相关,较高的语言评分与较高的FA相关。这些关联在多变量模型中仍然显著。本研究增加了文献资料,详细说明了小脑通过与幕上结构的相互连接参与认知功能的重要性。