孕龄小于31周出生婴儿的早期脑结构与神经运动、神经及神经行为功能之间的关系
Relationship between very early brain structure and neuromotor, neurological and neurobehavioral function in infants born <31 weeks gestational age.
作者信息
George Joanne M, Fiori Simona, Fripp Jurgen, Pannek Kerstin, Guzzetta Andrea, David Michael, Ware Robert S, Rose Stephen E, Colditz Paul B, Boyd Roslyn N
机构信息
Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Stella Maris Scientific Institute, Department of Developmental Neuroscience, The University of Pisa, Pisa, Italy.
出版信息
Early Hum Dev. 2018 Feb;117:74-82. doi: 10.1016/j.earlhumdev.2017.12.014. Epub 2018 Jan 23.
AIM
This study aimed to examine associations between structural MRI and concurrent motor, neurological and neurobehavioral measures at 30-32 weeks postmenstrual age (PMA; 'Early'), and at term equivalent age ('Term').
METHOD
In this prospective cohort study, infants underwent Early MRI (n = 119; 73 male; median 32 weeks 1 day PMA) and Term MRI (n = 102; 61 male; median 40 weeks 4 days PMA) at 3 T. Structural images were scored generating white matter (WM), cortical gray matter, deep gray matter, cerebellar and global brain abnormality scores. Clinical measures were General Movements Assessment (GMs), Hammersmith Neonatal Neurological Examination (HNNE) and NICU Neonatal Neurobehavioral Scale (NNNS). The Premie-Neuro was administered Early and the Test of Infant Motor Performance (TIMP) and a visual assessment at Term.
RESULTS
Early MRI cerebellar scores were strongly associated with neurological components of HNNE (reflexes), NNNS (Hypertonicity), the Premie-Neuro neurological subscale (regression coefficient β = -0.06; 95% confidence interval CI = -0.09, -0.04; p < .001) and cramped-synchronized GMs (β = 1.10; 95%CI = 0.57, 1.63; p < .001). Term MRI WM and global scores were strongly associated with the TIMP (WM β = -1.02; 95%CI = -1.67, -0.36; p = .002; global β = -1.59; 95%CI = -2.62, -0.56; p = .001).
INTERPRETATION
Brain structure on Early and Term MRI was associated with concurrent motor, neurological and neurobehavioral function in very preterm infants.
目的
本研究旨在探讨在月经龄30 - 32周（“早期”）和足月等效年龄（“足月”）时，结构磁共振成像（MRI）与同时期运动、神经及神经行为测量指标之间的关联。
方法
在这项前瞻性队列研究中，婴儿在3T条件下接受早期MRI检查（n = 119；73名男性；月经龄中位数为32周1天）和足月MRI检查（n = 102；61名男性；月经龄中位数为40周4天）。对结构图像进行评分，得出白质（WM）、皮质灰质、深部灰质、小脑及全脑异常评分。临床测量指标包括全身运动评估（GMs）、哈默史密斯新生儿神经检查（HNNE）和新生儿重症监护病房新生儿神经行为量表（NNNS）。早产神经评估在早期进行，婴儿运动表现测试（TIMP）和一项视觉评估在足月时进行。
结果
早期MRI小脑评分与HNNE的神经成分（反射）、NNNS（张力亢进）、早产神经评估神经子量表（回归系数β = -0.06；95%置信区间CI = -0.09，-0.04；p <.001）以及痉挛同步GMs（β = 1.10；95%CI = 0.57，1.63；p <.001）密切相关。足月MRI的WM和全脑评分与TIMP密切相关（WM β = -1.02；95%CI = -1.67，-0.36；p =.002；全脑β = -1.59；95%CI = -2.62，-0.56；p =.001）。
解读
极早早产儿早期和足月MRI的脑结构与同时期运动、神经及神经行为功能相关。
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