The Developing Brain Research Laboratory, Department of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC 20010, USA; Institute for Biomedical Sciences, George Washington University, Washington, DC 20037, USA.
Department of Pediatrics Neurology, McGill University Health Center, Montreal, QC H4A3J1, Canada.
Neuroimage Clin. 2018 Mar 16;18:871-880. doi: 10.1016/j.nicl.2018.03.020. eCollection 2018.
To compare regional cerebral cortical microstructural organization between preterm infants at term-equivalent age (TEA) and healthy full-term newborns, and to examine the impact of clinical risk factors on cerebral cortical micro-organization in the preterm cohort.
We prospectively enrolled very preterm infants (gestational age (GA) at birth<32 weeks; birthweight<1500 g) and healthy full-term controls. Using non-invasive 3T diffusion tensor imaging (DTI) metrics, we quantified regional micro-organization in ten cerebral cortical areas: medial/dorsolateral prefrontal cortex, anterior/posterior cingulate cortex, insula, posterior parietal cortex, motor/somatosensory/auditory/visual cortex. ANCOVA analyses were performed controlling for sex and postmenstrual age at MRI.
We studied 91 preterm infants at TEA and 69 full-term controls. Preterm infants demonstrated significantly higher diffusivity in the prefrontal, parietal, motor, somatosensory, and visual cortices suggesting delayed maturation of these cortical areas. Additionally, postnatal hydrocortisone treatment was related to accelerated microstructural organization in the prefrontal and somatosensory cortices.
Preterm birth alters regional microstructural organization of the cerebral cortex in both neurocognitive brain regions and areas with primary sensory/motor functions. We also report for the first time a potential protective effect of postnatal hydrocortisone administration on cerebral cortical development in preterm infants.
比较足月龄（TEA）的早产儿与健康足月儿之间的大脑皮质区域微观结构组织，并研究临床危险因素对早产儿皮质微观结构组织的影响。
我们前瞻性纳入极早产儿（出生胎龄<32 周；出生体重<1500 克）和健康足月儿对照组。使用非侵入性的 3T 扩散张量成像（DTI）指标，我们定量评估了十个大脑皮质区域的局部微观组织：内侧/背外侧前额叶皮质、前后扣带皮质、岛叶、后顶叶皮质、运动/体感/听觉/视觉皮质。通过协方差分析（ANCOVA），控制 MRI 时的性别和胎龄校正。
我们研究了 91 名 TEA 早产儿和 69 名健康足月儿对照组。早产儿在前额叶、顶叶、运动、体感和视觉皮质的弥散度明显较高，提示这些皮质区域的成熟延迟。此外，产后氢化可的松治疗与前额叶和体感皮质的加速微观结构组织有关。
早产儿出生会改变大脑皮质的区域性微观结构组织，包括神经认知脑区和具有初级感觉/运动功能的区域。我们还首次报道了产后氢化可的松给药对早产儿大脑皮质发育的潜在保护作用。
