From the Departments of Radiology & Biomedical Imaging (O.T., R.J.T., T.F., A.J.B., D.X.)
Neurology (D.G., H.C.G., D.M.F.).
AJNR Am J Neuroradiol. 2018 Nov;39(11):2140-2147. doi: 10.3174/ajnr.A5834. Epub 2018 Oct 18.
Differences in structural brain connectivity that underlie inattention have been previously investigated in adolescents with attention deficit/hyperactivity disorder, but not in the context of premature birth, which is often associated with attentional problems. The purpose of this study was to identify the neural correlates of attentional problems in adolescents born prematurely and determine neonatal predictors of those neural correlates and attention problems.
The study included 24 adolescents (12.5 ± 1.8 years of age; 12 girls, 12 boys) who were born prematurely and underwent MR imaging of the brain and cognitive assessment, both shortly after birth and as adolescents. Structural connectivity was assessed at adolescence using diffusion tensor imaging and tractography.
Of the 24 subjects, 12 had attention deficits. A set of axonal pathways connecting the frontal, parietal, temporal, and occipital lobes had significantly lower fractional anisotropy in subjects with attentional problems. The temporoparietal connection between the left precuneus and left middle temporal gyrus was the most significantly underconnected interlobar axonal pathway. Low birth weight and ventriculomegaly, but not white matter injury or intraventricular hemorrhage on neonatal MR imaging, predicted temporoparietal hypoconnectivity in adolescence. However, neither birth weight nor other neonatal characteristics were associated with attention deficits directly.
We identified an aberrant structural brain connectivity pattern, involving temporoparietal hypoconnectivity, in prematurely born adolescents with attentional problems. We also identified birth weight as a potential neonatal predictor of the temporoparietal hypoconnectivity. These findings add to our understanding of the neural basis and etiology of inattention in adolescents after premature birth.
先前的研究已经调查了注意缺陷/多动障碍青少年大脑结构连接的差异，但没有在早产儿的背景下进行，早产儿通常与注意力问题有关。本研究的目的是确定早产儿注意力问题的神经相关性，并确定新生儿预测这些神经相关性和注意力问题的指标。
该研究纳入了 24 名青少年（12.5±1.8 岁；12 名女孩，12 名男孩），他们均为早产儿，在出生后不久和青少年时期进行了大脑磁共振成像和认知评估。在青少年时期，使用弥散张量成像和束追踪技术评估结构连接。
在 24 名受试者中，有 12 名存在注意力缺陷。一组连接额叶、顶叶、颞叶和枕叶的轴突通路在存在注意力问题的受试者中具有显著较低的各向异性分数。左侧楔前叶和左侧颞中回之间的颞顶连接是连接性最差的跨叶轴突通路。新生儿磁共振成像上的低出生体重和脑室扩大，但不是白质损伤或室管膜下出血，可预测青少年时期的颞顶叶连接不足。然而，出生体重或其他新生儿特征与注意力缺陷均无直接相关性。
我们发现早产儿注意力问题存在异常的大脑结构连接模式，涉及颞顶叶连接不足。我们还发现出生体重是颞顶叶连接不足的潜在新生儿预测指标。这些发现增加了我们对早产儿注意力不集中的神经基础和病因的理解。
