From the Departments of Radiology and Medical Informatics (K.P., W.J.N.), Biomedical Imaging Group Rotterdam.
Departments of Child and Adolescent Psychiatry (T.J.W.).
AJNR Am J Neuroradiol. 2018 May;39(5):956-962. doi: 10.3174/ajnr.A5589. Epub 2018 Mar 22.
Infants born preterm are commonly diagnosed with structural brain lesions known to affect long-term neurodevelopment negatively. Yet, the effects of preterm birth on brain development in the absence of intracranial lesions remain to be studied in detail. In this study, we aim to quantify long term consequences of preterm birth on brain development in this specific group.
Neonatal cranial sonography and follow-up T1-weighted MR imaging and DTI were performed to evaluate whether the anatomic characteristics of the cerebrum and cerebellum in a cohort of school-aged children (6-12 years of age) were related to gestational age at birth in children free of brain lesions in the perinatal period.
In the cohort consisting of 36 preterm (28-37 weeks' gestational age) and 66 term-born infants, T1-weighted MR imaging and DTI at 6-12 years revealed a reduction of cerebellar white matter volume (β = 0.387, < .001), altered fractional anisotropy of cerebellar white matter (β = -0.236, = .02), and a reduction of cerebellar gray and white matter surface area (β = 0.337, < .001; β = 0.375, < .001, respectively) in relation to birth age. Such relations were not observed for the cerebral cortex or white matter volume, surface area, or diffusion quantities.
The results of our study show that perinatal influences that are not primarily neurologic are still able to disturb long-term neurodevelopment, particularly of the developing cerebellum. Including the cerebellum in future neuroprotective strategies seems therefore essential.
早产儿常被诊断出存在结构脑损伤,这些损伤已知会对长期神经发育产生负面影响。然而,在没有颅内病变的情况下,早产儿对大脑发育的影响仍有待详细研究。在本研究中,我们旨在定量研究早产儿出生对这一特定群体大脑发育的长期影响。
对新生儿进行颅超声检查,并进行后续的 T1 加权磁共振成像和 DTI 检查,以评估在无围产期脑损伤的儿童中,大脑和小脑的解剖特征是否与出生时的胎龄有关。
在由 36 名早产儿(28-37 周胎龄)和 66 名足月出生婴儿组成的队列中,6-12 岁时的 T1 加权磁共振成像和 DTI 显示小脑白质体积减少(β=0.387,<0.001),小脑白质各向异性分数改变(β=-0.236,=0.02),小脑灰质和白质表面积减少(β=0.337,<0.001;β=0.375,<0.001),与出生年龄有关。但这些关系在大脑皮层或白质体积、表面积或扩散量中并未观察到。
本研究结果表明,非主要神经系统的围产期影响仍能干扰长期神经发育,特别是发育中的小脑。因此,在未来的神经保护策略中包括小脑似乎至关重要。