Li Hong-Xin, Yu Min, Zheng Ai-Bin, Zhang Qin-Fen, Hua Guo-Wei, Tu Wen-Juan, Zhang Li-Chi
Department of Neonatology, Changzhou Children's Hospital, Changzhou, Jiangsu Province, China.
Graduate Student, Nantong University, Nantong, Jiangsu Province, China.
Neural Regen Res. 2019 Apr;14(4):642-648. doi: 10.4103/1673-5374.247468.
Resting-state functional magnetic resonance imaging has revealed disrupted brain network connectivity in adults and teenagers with cerebral palsy. However, the specific brain networks implicated in neonatal cases remain poorly understood. In this study, we recruited 14 term-born infants with mild hypoxic ischemic encephalopathy and 14 term-born infants with severe hypoxic ischemic encephalopathy from Changzhou Children's Hospital, China. Resting-state functional magnetic resonance imaging data showed efficient small-world organization in whole-brain networks in both the mild and severe hypoxic ischemic encephalopathy groups. However, compared with the mild hypoxic ischemic encephalopathy group, the severe hypoxic ischemic encephalopathy group exhibited decreased local efficiency and a low clustering coefficient. The distribution of hub regions in the functional networks had fewer nodes in the severe hypoxic ischemic encephalopathy group compared with the mild hypoxic ischemic encephalopathy group. Moreover, nodal efficiency was reduced in the left rolandic operculum, left supramarginal gyrus, bilateral superior temporal gyrus, and right middle temporal gyrus. These results suggest that the topological structure of the resting state functional network in children with severe hypoxic ischemic encephalopathy is clearly distinct from that in children with mild hypoxic ischemic encephalopathy, and may be associated with impaired language, motion, and cognition. These data indicate that it may be possible to make early predictions regarding brain development in children with severe hypoxic ischemic encephalopathy, enabling early interventions targeting brain function. This study was approved by the Regional Ethics Review Boards of the Changzhou Children's Hospital (approval No. 2013-001) on January 31, 2013. Informed consent was obtained from the family members of the children. The trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800016409) and the protocol version is 1.0.
静息态功能磁共振成像显示，患有脑瘫的成年人和青少年大脑网络连接中断。然而，新生儿病例中涉及的具体脑网络仍知之甚少。在本研究中，我们从中国常州市儿童医院招募了14名足月出生的轻度缺氧缺血性脑病婴儿和14名足月出生的重度缺氧缺血性脑病婴儿。静息态功能磁共振成像数据显示，轻度和重度缺氧缺血性脑病组的全脑网络均具有有效的小世界组织。然而，与轻度缺氧缺血性脑病组相比，重度缺氧缺血性脑病组的局部效率降低，聚类系数较低。与轻度缺氧缺血性脑病组相比，重度缺氧缺血性脑病组功能网络中枢纽区域的分布节点较少。此外，左侧中央前回、左侧缘上回、双侧颞上回和右侧颞中回的节点效率降低。这些结果表明，重度缺氧缺血性脑病患儿静息态功能网络的拓扑结构与轻度缺氧缺血性脑病患儿明显不同，可能与语言、运动和认知受损有关。这些数据表明，有可能对重度缺氧缺血性脑病患儿的脑发育进行早期预测，从而实现针对脑功能的早期干预。本研究于2013年1月31日获得常州市儿童医院区域伦理审查委员会批准（批准号：2013-001）。已获得患儿家属的知情同意。该试验已在中国临床试验注册中心注册（注册号：ChiCTR1800016409），方案版本为1.0。
