Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.
Brain Imaging Behav. 2020 Aug;14(4):998-1011. doi: 10.1007/s11682-019-00057-z.
The impact of very preterm (VP) birth on the development of individual basal ganglia nuclei and the thalamus during childhood remains unclear. We first aimed to compare (1a) the volumes of individual basal ganglia nuclei (nucleus accumbens, caudate nucleus, pallidum, putamen) and the thalamus at age 7 years, and (1b) their volumetric change from infancy to 7 years, in VP children with term-born children. Secondly, we aimed to (2a) determine whether basal ganglia and thalamic volumes at 7 years, or (2b) basal ganglia and thalamic growth rates from infancy to 7 years were associated with neurodevelopmental outcomes at 7 years, and whether these associations differed between the VP and term-born children. One hundred and fifty-four VP (<30 weeks' gestational age or birth weight < 1250 g) and 35 term-born children had useable magnetic resonance imaging (MRI) scans that could be analyzed at 7 years. Of these, 149 VP and 30 term-born infants also had useable MRI scans at term-equivalent age. Volumes of the individual basal ganglia nuclei and the thalamus were automatically generated from the MRI scans. Compared with the term-born group, the VP group had smaller basal ganglia and thalamic volumes at 7 years and slower growth rates from birth to 7 years. After controlling for overall brain size, VP children still had smaller thalamic volumes but the deep grey matter volume growth rates from birth to 7 years were similar between groups. Reduced basal ganglia and thalamic volumes and slower growth rates in the VP group were associated with poorer cognition, academic achievement and motor function at 7 years. After controlling for overall brain size, the nucleus accumbens and pallidum were the deep grey matter structures most strongly associated with 7-year neurodevelopmental outcomes. In conclusion, basal ganglia and thalamic growth is delayed during early childhood in VP children, with delayed development contributing to poorer functional outcomes.
早产儿（VP）出生对儿童期基底节核和丘脑发育的影响尚不清楚。我们首先旨在比较（1a）7 岁时个体基底节核（伏隔核、尾状核、苍白球、壳核）和丘脑的体积，以及（1b）从婴儿期到 7 岁时的体积变化，在 VP 儿童与足月出生的儿童中。其次，我们旨在（2a）确定 7 岁时的基底节和丘脑体积，或（2b）从婴儿期到 7 岁时的基底节和丘脑生长速度，是否与 7 岁时的神经发育结果相关，以及这些关联在 VP 和足月出生的儿童之间是否存在差异。154 名 VP（<30 周的胎龄或出生体重<1250 克）和 35 名足月出生的儿童有可用于 7 岁时分析的磁共振成像（MRI）扫描。其中，149 名 VP 和 30 名足月出生的婴儿也有可用于胎龄相等年龄的 MRI 扫描。从 MRI 扫描中自动生成个体基底节核和丘脑的体积。与足月出生组相比，VP 组在 7 岁时基底节和丘脑体积较小，从出生到 7 岁的生长速度较慢。在控制总脑容量后，VP 儿童的丘脑体积仍然较小，但从出生到 7 岁的深部灰质体积生长速度在两组之间相似。VP 组的基底节和丘脑体积较小，生长速度较慢，与 7 岁时的认知、学业成绩和运动功能较差有关。在控制总脑容量后，伏隔核和苍白球是与 7 岁神经发育结果最密切相关的深部灰质结构。总之，VP 儿童在幼儿期基底节和丘脑的生长发育延迟，发育迟缓导致功能结果较差。
